It is very important for nursing assistants to learn the risk factors of the disease that a patient is suffering from.
Knowing the risk factors you will be able to assist and provide support to the patient so that he/she will feel comfortable and to prevent his condition from developing worse.
And make sure you need to report to the nurse whatever changes you see in the patient. Let the nurse know also what you need to do to assist the patient.
Nursing Assistant Skill Scenario and Follow-up Questions
Our nursing assistant online class instructor gives us this “Risk Factors” skill scenario for us to discuss. . .
Mr. George Shaw is a 95-year-old resident of Merryville Nursing Home. He has poor circulation, and suffered a stroke that left him with right-sided paralysis. He is incontinent of urine and stool. He wears a wrist splint on the right to prevent contracture.
He has been eating less and less over the past two weeks and is losing weight. It is difficult to get him to drink adequate fluids during the day, and lately he has become less and less willing to be up and involved in activities. He wishes to remain in his room most of the day.
• What are Mr. Shaw’s risk factors for the development of pressure ulcers?
• How can skin damage affect his health?
• What will you do to prevent him from developing a pressure ulcer?
Answer each of the three questions list above.
Response and Discussion
Here are my responses to the scenario. . .
What are Mr. Shaw’s risk factors for the development of pressure ulcers?
Here are Mr. Shaw’s risk factors for the development of pressure ulcers:
- Poor circulation – His blood flow is sluggish. When the blood doesn’t circulate correctly, it can’t deliver the oxygen and nutrients to the body cells and tissues―cells and tissues will die. Therefore, Mr. Shaw’s skin doesn’t have protection against pressure ulcers.
- Incontinency – Urine and stools produce moisture. Moisture irritates the skin and will cause the skin to breakdown and it will result in pressure ulcers.
- Blisters from Medical device – After wearing a wrist splint for a while, it can cause pressure ulcers. The splint causes friction or irritation on the skin.
- Poor nutrition (Malnutrition) – Mr. Shaw has been eating less and less resulting in poor nutrition. A balanced diet is needed to nourish the skin.
- Weight loss – When one is losing weight, the muscles and fat will be reduced. These muscles and fat serve as paddings between bones and hard surfaces such as mattresses, chairs, wheelchairs, etc.
- Inadequate fluid (Dehydration) – Adequate water intake promotes healthy skin.
- Immobility / Paralysis – Mr. Shaw is becoming less and less willing to be up and involved in activities. A person in paralysis needs more help in moving. Paralysis affects the person’s ability to move. Pressure ulcers occur from lying or sitting too long in the same position.
How can skin damage affect his health?
Skin damage produces pain. Pain causes anxiety. When there is too much pain, it causes severe anxiety. Anxiety affects the person’s mood and health adversely.
What will I do to prevent him from developing a pressure ulcer?
- Report to the nurse on any changes in Mr. Shaw’s skin.
- Provide him daily care for his skin to keep it clean and dry.
- Change clothing and linens often.
- Follow Mr. Shaw’s reposition care plan.
- Reposition him at least every 2 hours.
- Check his skin each time he is repositioned. Use pillows or foam wedges for support.
- Do not leave him on a bedpan longer than needed.
- Remove rough and scratchy fabrics away from him.
- Massage the skin often with light, circular strokes to increase circulation.
- Encourage him to eat in order to have proper nutrition.
- Encourage him to drink more water.
- I will encourage Mr. Shaw to move and walk with an assistive device and my assistance. Moving around will increase his circulation. Good blood circulation will deliver oxygen and nutrients to cells and tissue, and promotes good health.
- Follow the care plan. It may include instructions about special skin care.
