Stages I through III of pressure ulcers can be treated aggressively locally and with adequate dietary care, whereas stage IV pressure ulcers typically need surgery. Assessing the contributing factors leading to a loss of tissue perfusion, evaluating the seriousness of the injury, encouraging drug compliance, and avoiding further damage are all part of nursing treatment for clients with pressure ulcers.
Skin integrity problems linked to malnutrition and pressure ulcers, as evidenced by epidermal and dermal tissue disruption. As evidenced by nursing documentation, Arjun will be turned in every two hours. Arjun’s wounds will be changed regularly, and good hand hygiene will be followed before and after dressing changes. Arjun will be started on TPN per the doctor’s orders, and he will be weighed daily. The nurse will explain and show four ways to prevent pressure ulcers to Arjun’s family.
The Implementation Team will assess the big picture, including current practice strengths and weaknesses, and the current state of prevention and incidence tracking, before determining what changes need to be made and what specific practices, tools, and resources will be required to implement these changes. The Wound Care Team can serve as an expert resource in this process.
If necessary, obtain wound cultures. Since skin usually has flora that can be contained in an open skin lesion, all pressure ulcers are colonized; however, not all pressure ulcers are infected. Infection is present when there is copious, foul-smelling, purulent drainage, and the client has other symptoms of disease (fever, elevated pain), as well as a bacteria count greater than 105. Swab cultures aren’t advised. Instead, tissue biopsy can be used to assess how many aerobic and anaerobic species are present.
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