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Pressure Ulcers

Pressure Ulcers. Care and Prevention. Lori Baker, RN, BSN. Pressure Ulcers What is it? Preventable? Primary focus… Regular assessment…. Pressure Ulcers Risk factors Age-related skin changes Immobility Incontinence Skin friction/shearing Vascular disorders Obesity . Pressure Ulcers

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Pressure Ulcers

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  1. Pressure Ulcers Care and Prevention Lori Baker, RN, BSN

  2. Pressure Ulcers • What is it? • Preventable? • Primary focus… • Regular assessment…

  3. Pressure Ulcers • Risk factors • Age-related skin changes • Immobility • Incontinence • Skin friction/shearing • Vascular disorders • Obesity

  4. Pressure Ulcers • Added factors • Inadequate hydration/nutrition • Anemia • Fever • Impaired circulation • Edema • Sensory deficits • Low diastolic blood pressure (DBP)

  5. Pressure Ulcers • More added factors • Impaired cognitive function • Neurological disorders • Chronic diseases • Sedation

  6. Pressure Ulcers • Diagnostic Procedures/Nursing Interventions • C&S • CBC • Blood cultures • Serum Albumin

  7. Pressure Ulcers • Therapeutic Procedures/Nursing Interventions • Wound Vacuum-assisted Closure (wound VAC) • Hyperbaric oxygen therapy • Surgical debridement

  8. Pressure Ulcers • Data collection • S/S • Staging • Assess/Monitor • Skin integrity • Moisture • Incontinence • Nutrition/hydration • Mobility

  9. Pressure Ulcers • NANDA • Acute pain/Chronic pain • Impaired skin integrity • Impaired tissue integrity • Ineffective peripheral tissue perfusion

  10. Pressure Ulcers • Staging • Stage I • Epidermal • Color • Blanching • Reversible? • Interventions

  11. Pressure Ulcers • Staging • Stage II • Layers • The lesion • Edema/Pain • Healing time • Interventions • Moisture • Natural healing • Nutrition/hydration • Analgesics

  12. Pressure Ulcers • Staging • Stage III • Layers • Lesions • Slough/Necrosis • Healing time • Interventions • Clean/Debride • Nutrition/Hydration • Analgesics • Antimicrobials

  13. Pressure Ulcers • Staging • Stage IV • Layers • Lesion • Infection • Healing time • Interventions • Dressing changes • Skin grafts • Nutrition/Hydration • Analgesics?? • antimicrobials

  14. Prevention • Clean, dry, wrinkle-free • Pressure-reducing surfaces • Inspection • Incontinence care • Barrier creams • Care when bathing • Reposition • HOB • Prevent sliding

  15. Prevention (continued) • Lift, don’t pull • Protect heels • Ambulate • ROM • Hydration (as well as nutrition)

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