Patient was instructed on factors that may contribute to chronic wounds is old age. The skin of older people is more easily damaged, and older cells do not proliferate as fast and may not have an adequate response to stress in terms of gene up regulation of stress related proteins. In older cells, stress response genes are over expressed when the cell is not stressed, but when it is, the expression of these proteins is not regulated by as much as in younger cells.
Instructed patient about some signs and symptoms of pressure ulcers, such as, skin tissue that feels firm or boggy, local redness, warmth, tenderness or swelling.
Instructed patient in position and reposition every hour to prevent skin breakdown.
Instructed in wound care as ordered by MD such as proper storage of dressing supplies, proper handwashing technique and removal of dressing, proper storage of dressing supplies, cleansing of wound as specifically ordered by MD, proper application of ointments, powders, solutions, etc, if ordered by MD, proper application of specific dressing change if ordered by MD, return demonstration of complete dressing change technique; more than one teaching may be needed.
Instructed in proper handwashing before and after wound care or touching wound site to prevent spread of infection.
Instructed in materials used in wound care. However, even with proper treatment, a wound infection may occur. Check the wound daily for signs of infection like increased drainage or bleeding from the wound that won’t stop with direct pressure, redness in or around the wound, foul odor or pus coming from the wound, increased swelling around the wound and ever above 101.0°F or shaking chills.
Instructed in overall dressing change technique, and observed SN during wound care.
Instructed in wound care per MD order using aseptics technique.
Patient was instructed on wound healing. Healing time depends on a variety of factors, such as wound size and location, pressure on the wound from walking or standing, swelling, circulation, blood glucose levels, wound care, and what is being applied to the wound. Healing may occur within weeks or require several months.
Instructed patient consider nutritional supplementation/support for nutritionally
consistent with overall goals of care.