med surg wounds

Introduction to Delayed Wound Healing

• Notable example of delayed healing due to diabetes and weight issues.

• Characteristics of the wound included serious drainage; no purulent drainage observed but significant pain and discomfort noted.

• Patient received IV antibiotics before being discharged to continue with oral antibiotics and follow-up at the wound clinic.

Excessive Wound Healing and Scarring

• Discussed types of scars:

  • Hypertrophic scars: raised scars that do not extend beyond the original wound area.

  • Keloid scars: extend beyond the boundaries of the original wound, more prominent and can be painful.

• Chronic Wound Healing

  • Defined as wounds remaining open for over one month without progressing through normal healing stages.

Psychological Impact of Wounds

• Wounds can correlate with psychological conditions such as depression and anxiety.

• Stress or anxiety surrounding health insurance and medical costs often exacerbates the psychological burden.

Assessment and Risk Factors in Skin Health

• Regular skin assessments should be conducted upon admission and at each shift.

• Use of the Braden Scale for assessing risk of skin breakdown, considering moisture, mobility, and nutritional factors.

Clinical Interventions

• Importance of assessing and monitoring blood sugar levels as well as wound care directives.

• Different types of wounds:

  • Acute wounds: incision, skin tear, abrasions.

  • Chronic wounds: arterial ulcers, venous ulcers, diabetic ulcers.

• Stages of Decubitus ulcers and critical thinking regarding patient care involving wound stages.

Laboratory Tests and Diagnostics

• Familiarity with relevant lab results, including CBC, BNP, albumin levels.

• Use of diagnostic methods like ankle-brachial index and imaging techniques (CT, MRI).

Factors Indicating Issues with Healing

• Clinical indications such as elevated blood sugar levels and pressure fluctuations could hinder healing.

Nursing Role in Wound Care

• Focus on environmental and individual factors influencing wound healing; ensure safety and effective patient education.

• Teaching methods include the teach-back method to confirm patient understanding.

Safety Protocols and PPE

• Importance of utilizing appropriate PPE during patient care, especially in outbreak scenarios (e.g., COVID-19).

Health Preferences and Patient Education

• The significance of considering cultural and social determinants of health during patient teaching.

• Development of teaching plans based on patient capabilities and documentation of learning outcomes.

Quizzes and Evaluations as Learning Tools

• Examples of client assessments and scenarios reinforcing knowledge on dressing changes and wound care.

Wound Assessment Techniques

• Steps include measuring the wound, evaluating drainage, and identifying granulation tissue versus slough or necrotic tissue.

• Ideal wound care involves appropriate dressing, debridement, and humidity control in the healing environment.

Treatment Options

• Various therapies available: hydrogel, hydrocolloid, negative pressure wound therapy (Wound VAC), and electrical stimulation.

Monitoring Patient Confidence in Self-Care

• Ensuring patients understand when to seek medical help regarding wound care.

Case Study

• A patient example illustrating wound management, effects of diabetes, and coordination of care with healthcare providers.

• Highlighted the importance of ongoing monitoring and professional consultations to optimize recovery.