diverticulosis-and-diverticulitis
Wound Care
Instructed in management and control of wound through activity such as frequent rest periods, no overexertion, no lifting, bending or stooping. Passive and active exercises to increase vascular tone. Elevate affected extremity to promote venous return. Give pain medication, if prescribed, 30 minutes prior to any activity.
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.
Patient was instructed on another leading type of chronic wounds is pressure ulcers. That occurs when pressure on the tissue is grater than the pressure in capillaries, and thus restricts blood flow into the area. Muscle tissues, which needs more oxygen and nutrients than skin does, show the worst effects from prolonged pressure. As in other chronic ulcers, reperfusion injury damage tissue.
Patient was instructed on the risk and factors that contribute to the development of pressure ulcers, such as malnutrition, dehydration, impaired mobility, chronic conditions, impaired sensation, infection, advance age and pressure ulcer present.
Patient was instructed on what to avoid in presence of ulcers. Friction and shear need to be reduced. Friction is the mechanical force exerted when skin is dragged against a coarse surface while shear is the mechanical force caused by the interplay of gravity and friction.
Patient was instructed how to reduce friction and shear. Use draw sheet for repositioning, encourage use of trapeze if possible, keep head of bed elevated (if tolerated), elevate foot of bed slightly (if condition permits), use pillow or wedge to support hip (side lying, lateral position), utilize lifts and transfer devices.
Patient was instructed on pain caused by pressure ulcers. Pain can be classified as acute or chronic. Cyclic acute pain, which is periodic and corresponds to the pain experienced during repeated management, such as dressing changes or patient repositioning and non-cyclic acute pain, which is accidental, including pain experienced during occasional procedures such as debridement or drain removal.
Patient was instructed on wounds contributing facts. In addition to poor circulation, neuropathy, and difficulty moving, factors that contribute to chronic wounds include systemic illness, age and repeated trauma.
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.
Patient was instructed on chronic wound healing. That may be compromised by coexisting underlying conditions, such as, venous valve backflow, peripheral vascular disease, uncontrolled edema and diabetes mellitus. It is important to remember that increased wound pain may be an indicator of wound complications that need treatment, and therefore practitioners may be constantly reassess the wound as well as the associated pain.