Declining Health of 81-Yr-Old Patient With Multiple Conditions - Essay Sample

Introduction

The Patient, P.G, from room 208W, is an 81year-old lady who is on the functional decline. The patient is blind and is also losing her hearing abilities. The patient suffers from esophagitis, Chronic Gastritis, hypertension, types 1 and 2 diabetes mellitus, dementia, Recurrent UGI bleed, as well as anemia. Despite this, the patient does not have any known allergies. The patient has also recorded the history of a healed pressure ulcer on the buttocks area, prior stroke, chronic anemia. The patient is demented, has diabetes, DVT, GERD, recurrent hematemesis, chronic renal insufficiency, esophagitis, gastritis, and hiatal hernia.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Save 25%

Patient Care

The patient receives a multidrug combination that comprises of thiazide diuretic to manage hypertension since the patient also suffers from types 1 and 2 diabetes mellitus combines with insulin to combat the two types of diabetes mellitus. The patient also receives a combination of memantine to manage her dementia. Some of the medications administered to the patient include proton pump inhibitors for the treatment of esophagitis and chronic gastritis. The nurse also helps with basic services such as assisting with showering as well as turning the patient in order to reduce the reoccurrence of wounds and ulcers.

The nursing staff are responsible for monitoring as well as administering the patient with her medication. Furthermore, the nurses are also responsible for checking and dressing her wound to aid with healing as well as preventing reoccurrence of healed wounds. Additionally, the nurse is responsible for prepping the patient for possible blood transfusion as the patient is anemic with UGI bleeding. This nursing staff has to continually communicate with the patient to identify any concerns that the patient may have towards the treatment or her condition. The nurse further conducted skin integrity and wound assessment daily for the patient using the SSKIN tool.

These interventions are essential as communication enables the nurse to identify and report possible issues that the patient may have to the physician. Furthermore, the nurse can identify and record the patient's progress, such as her skin condition or the presence and or condition of any wounds that may have developed or been pre-existing. Through these interventions, the physicians are able to note the patient's recovery process as well as note whether the patient is receiving proper care and or if there are any adjustments that are necessary. Furthermore, the nurse is able to help the patient improve her skin condition by performing tasks such as moisturizing and turning.

Analysis

Based on the current patient records, the patient has increased risk for a reoccurrence of a pressure ulcer. As a result, the patient should be turned at least once every 2 hours. Assessing skin integrity as well as performing services such as turning is essential as it decreases the possibility of skin breakdown, which may result in a reoccurrence of a pressure ulcer. According to Wound UK (2018), all patients who are at risk of pressure ulcers are required to reposition themselves frequently. Therefore, assisting the patient in turning dramatically reduces her chances of getting another pressure ulcer.

The application of the SSKIN tool by the nurse was not a necessity as it does not aid in healing the patient. However, the nurse is required to administer services that will further promote the health of the patient. Taking the skin integrity of the patient into consideration is essential as it will help in preventing the occurrence of another pressure ulcer. Furthermore, Silva et al. (2017) noted that skin and wound problems are highly reported among elderly hospitalized patients.

Cowdell et al. (2014) explain that it is essential to make additional effort to protect the skin of aging patients as their skin is more vulnerable due to the presence of chronic and cardiovascular diseases. To further enhance the chances of preventing the reoccurrence of pressure ulcers, a new bandage called "smart bandage" has been created (Yang, 2015). With this implementation, the nurse can be able to detect and prevent pressure ulcers quickly.

Summary

Although nurses have numerous roles when dealing with patients, it is essential to take into consideration the patient's skin integrity, particularly when faced with history and high-risk reoccurrence of pressure ulcers. Nurses should ensure that aside from their daily routine, such as administering medication and monitoring the progress of the patient, they also check and try to maintain the skin integrity of their patients to promote the overall health of the patient.

Reflection

I have learned how to treat patients with impaired skin integrity using the SSKIN method. Prior to using the SSKIN method, I had basic knowledge on helping patients maintain normal skin integrity. Therefore, I realized that trial and error is usually made in order to get the best possible intervention. As a result, there is a need for nurses to be patient-centered so that they can come up with the best possible interventions and provide the best available care to the patients. Also, one of the essential skills that I can apply is the SSKIN method, and I hope that it would enable me to take good care of patients with impaired skin integrity in the future.

References

Cowdell, F., Jadotte, Y. T., Ersser, S. J., Danby, S., Walton, S., Lawton, S., Roberts, A., Gardiner, E., Ware, F., & Cork, M. (2014). Hygiene and emollient interventions for maintaining skin integrity in older people in hospital and residential care settings. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd011377

Silva, C. F., Santana, R. F., De Oliveira, B. G., & Do Carmo, T. G. (2017). High prevalence of skin and wound care of hospitalized elderly in Brazil: A prospective observational study. BMC Research Notes, 10(1). https://doi.org/10.1186/s13104-017-2410-6

Wounds UK. (2018). Best Practice Statement-Maintaining Skin Integrity. www.wounds-uk.comYang, S. (2015, March 17). 'Smart bandage' detects bed sores before they are visible to doctors. Berkeley News. https://news.berkeley.edu/2015/03/17/smart-bandages-detect-bedsores/