BED SORES.pptx medicine and nursing management

health

1. BED SORES

2. OBJECTIVES 1. Define the terms pressure areas and pressure sores. 2. Identify patients who are prone to bedsores. 3. Outline the causes of pressure sores.

3. 4. Identify the pressure sites . 5. Identify the requirements for treating pressure areas

4. CONTI........ Definition Pressure areas ~. Is a part of the body where weight is born heavily and the tissues are compressed between .... the bed and underlying bone. The blood supply is interfered with and the skin gives way. - • wound that forms is called a decubitus ulcer.

5. PRESSURE SORES. These are tender and painful parts on the exposed parts of the body as a result of we ight being born heavily on them

6. Pressure ulcer This is an opened pressure sore on the body where the blood supply has been interfe re with and the skin gives way

7. COMMON SITE • Occiput • Scapulae . Trochanters • Knees • Ankle

8. • Shoulders • Elbows • Heels an sacrum • Skin fold

9. Patients who are liable to Pressure Sores The paralyzed: The skin is deprived of its nerve supply and the patient can neither move avoid pressure nor feel its effects. The sores in paralyzed patients are called Tropical Ulc ers

10. 1. The heavy: They carry much weight on their pressure areas 2 . The emaciated: Skin breaks easily on thin patients 3. The incontinence patients: Their skin is frequently soaked by urine; urine contains urea which irritates the skin.

11. CONT....... Debilitating diseases: These include diabetes, neoplasm, anaemia and oedema due 1 various causes, patients with fractures and very ill patients who are confined to bed.

12. Causes of Bed Sores 1. Pressure: once there is pressure exerted on bony areas from the bed or other . U nderlving surface particularly lying for too long in one position. Pressure from splints, plasters and other apparatus will prevent the flow of blood to soft tissues and if allowed to continue lead to necrosis. This can result into a large sore before the skin breaks

13. 2. Moisture: I nsufficient care in drying the patient, from sweat, urine or stool and through moi sture collecting in the folds. 3 . Friction (rubbing) crumbs in the bed and creases in the sheets. Similarly w hen the pa tient is Medicineged over the surface of the bedclothes and not lifted, as well as improper method of giving and removing and removing of bedpan

14. Predisposing factors: poor general health or nutritional status, old age, immobility s u ch as those on traction, mental apathy, muscle weakness particularly in paralyzed patients and debilitating diseases.

15. Prevention of pressure sores a . Relief of pressures . This is done by taking weight off the pressure areas i.e. regular turning of the patient at least 2 hours even if it need four nurses or the whole nursing staff on the ward. Soft cillows can be used to distribute weight evenly. Use of bed aids e.g. air rings, heel rings, cillows and bed cradles to relieve pressure .

16. b . C leanliness . S weat, Urine and stool must not be allowed to remain in contact with the skin. In certain cases where the patient is incontinent of urine, an indwelling catheter should be inserted under sterile precautions to keep the skin dry

17. C. Improve the general health of the patient. • A nutritional diet is required • Low hemoglobin should be raised and other conditions treated as they arise

18. Routine attention to pressure areas This is done by massaging of pressure sites 2-4 hourly .

19. SURGICAL MANAGEMENT OF PRESSURE SORES NOTE Surgical management for bed sores ,or pressure ulcers ,is considered when consrvative treatment are indequate when sores are severe .the surgical approach depends on the stage and extent of the ulcer

20. Debridement It involves removing dead or infected tissue from the wound to promote healing .it can be done surgically ,with enzymes or through other methods like autolytic debridement

21. Skin grafting involves taking skin from another of the body and transplanting it to cover the ulcer . This can be a split –thickness graft

22. Flap surgery this technique uses flap of tissue ,which includes skin ,muscle and sometimes bone,from the near the area to cover the ulcer

23. RECONSTRUCTIVE SURGERY For severe cases reconstructive surgery may be needed to restore the affected area ,Which can involve multiple technicques and may include prosthetic devices

24. Points to reme mber Advantages of Vaseline or oil: • It is easily absorbed; it nourishes the skin, keep it soft and it acts as water repellent. • Olive oil may also used instead of Vaseline a s it nourishes and protects the ski n

25. Management of a pressure sore 1. Once the skin is broken efforts must be made to heal it before the lesion gets bigger or infected. The type of ulcer, the patient and the cause of skin loss must all be considered

26. . I f the sore involves more than the superficial layers of the skin, it must be treated with full aseptic precautions using non touch dressing technique.

27. The nurse must ensure that the patient receives an adequate nourishing diet and if necessary arrangements should be made to supplement the diet.

28. Also ensures that there is adequate fluid intake. Exercise should be encouraged to improve the circulation to the area

29. Points to remember • Alternative therapeutic applications of substances such as pawpaw fruit, sugar and honey may be used.

30. REFERENCES Wound,Ostomy and Continence Nurses Society

31. Nursing care plan Nursing diagnosis planning Implementation Rationale evaluation 1.Impaired skin intergrity related to pressure and immobility as evidenced by presence of pressure ulcer To restore the skin intergrity To dress the wound using the non touch method By dressing the wound with non touch method Relieve pressure Risk for related to open wounds and skin breakdown Imbalanced nutrition less than body requirements related to decreased intake or malnutrition Acute pain related related to skin breakdown

32. Thank you for listening