skin breakdown
General
SN completed patient cardiovascular and pulmonary assessment. Educated staff on monitoring patient for dizziness, syncope, cardiovascular status, anxiety, and agitation related to medication SEs. Staff to encourage patient to rise slowly to prevent syncope and dizziness. Staff instructed to monitor environmental hazards to prevent falls and injuries in addition to monitoring skin for breakdown due to episodes of bowel and bladder incontinence.
SN instructed the patient on good diabetic foot care and assessment as follows: using a handheld mirror if needed assess feet daily to include in between toes. Never cut toenails or file down calluses. Only a podiatrist should do this. Report any blisters, cracks, wounds or any other concerns to your podiatrist immediately. Wash and lotion feet very well daily. Do not lotion between toes as this may cause maceration and cause skin breakdown. Recommended wearing diabetic socks. Always wear good fitting shoes. Preferably tailor-made for the patient. Never walk around barefoot.
Instructed caregiver clean patient's skin daily: Clean the patient's skin around your tube 1 to 2 times each day.
SN teaching patient / caregiver on measures to prevent pressure ulcers, such as: Clean skin at times of soiling, avoid irritating cleaning agents, use moisturizers on dry skin, do not message bony prominences, keep skin clean and dry, and comply with proper lifting and positioning techniques.
SN instructed patient and caregiver on importance good hydration, drinking plenty of water; apply skin lotion after bath and after wash hands , to keep skin hydrated/moisturized.
Instructed in the importance of bathing to preserve personal hygiene and skin integrity. Instructed to keep skin clean and dry.
Instructed caregiver how to prevent Pressure Ulcers for Bed bound patients: Protect the Skin
patient from injury - Avoid massaging the skin on bony parts of the patient body. Limit pressure
on bony areas by changing positions frequently. If the patient in a bed, preferably every 2 hours.
Instructed patient watch for these problems: a hole in the skin where the IV is -- medicine or fluid can go into the tissue around the vein. This could harm the skin or tissue.Swelling of the vein -- this can lead to a blood clot (called thrombophlebitis).
SN instructed that Swelling occurs whenever the organs, skin, or other parts of your body enlarge. It is typically the result of inflammation or a buildup of fluid. Swelling can occur internally (within the body) or it can affect your outer skin and muscles. A range of conditions can cause swelling.
SN instructed patient that steri strips may fall off the skin after 10 days. Leave the steri strips in place until they fall off on their own accord or until your doctor determines it is appropriate to remove them. If the wound has healed and your doctor says you can remove the strips, use lotion or a small amount of water to loosen them from your skin.