Question

Case Study

Mr. Omar Ahmed, a 76-year-old accountant, has come to the hospital again, this time for pneumonia. Before admission, he was unable to eat and lost more than 20 lbs over the last 2 months. Three years ago, he had coronary artery bypass surgery. As a precaution, he is placed on telemetry monitoring. He also has hypertension and type 2 diabetes mellitus. His mobility is limited because of weakness.

What mobility concerns do you anticipate for Mr. Ahmed?

Mr. Ahmed is retired. He lives in a one-family home with his wife, Natalie. Their children and grandchildren live nearby and visit often. He complains that his “bottom hurts” from lying in bed.

What risk factors does Mr. Ahmed have for pressure ulcer development?

The nursing assessment and finds that Mr. Ahmed was admitted with a pressure ulcer. The ulcer is a stage II, 3cm x 6cm and 1/8-inch deep partial-thickness wound over his sacral area. No necrotic tissue is present, and the wound bed has red moist tissue.

As you recall the descriptions of the ulcer stages, do you know why Mr. Ahmed’s ulcer is a stage II? Explain.

Based on previous information, and additional information below - what nursing diagnosis is appropriate for Mr. Ahmed?

Mr. Ahmed is eating fewer than 1600 calories daily.

Mr. Ahmed cannot tolerate positions that might relieve or reduce pressure to his skin

The wound is a 3x6cm, full thinckness ulcer over the sacral area with a red moist base with reddened periwound skin.

What is an appropriate goal that might be achieved in 1 week?

What outcome would you expect in 7 days?

What outcome would you expect in 3 days?

Remember: It is important to set achievable goals and expected outcomes for the patient

In preparation for her husband’s discharge, Mrs. Ahmed is interested in learning how to change Mr. Ahmed’s pressure ulcer dressing. The nurse develops a teaching plan to include Mrs. Ahmed, with the outcome goal that “At the end of the teaching session, Mrs. Ahmed will perform an acceptable return demonstration of dressing application.”

What teaching strategies would be appropriate for Mrs. Ahmed?

How would you know if teaching was effective?

      

Why is teaching family members at discharge an important factor in promoting continued health for the health of the patient?

Answer 1

What teaching strategies would be appropriate for Mrs. Ahmed?

Why is teaching family members at discharge an important factor in promoting continued health for the health of the patient?