Josephine Morrow PDF

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Josephine Morrow...

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Josephine Morrow Documentation Assignments 1. Document the findings of a focused skin assessment of Ms. Morrow, including any findings that identify the presence of chronic venous insufficiency.  Skin intact exceot for the venous stasis ulcer on the right medial malleoulus She has brown hyperpigmentation on both lower legs with +2 edema The venous stasis ulcer is covered with a hydrocolloid dressing, she was medicated for pain half an hour ago. The patient showed no sings of sweating and skin’s elasticity and color were normal. A dressing covered skin lesion on lower leg that was changed, the wound assessment was made for any changes noted. Pt’s pedal pulses and radial pulse were palpable with a strong rate of 95/min 2. Document any abnormal laboratory results that are associated with the presence or status of Ms. Morrow's stasis ulcer. 

Document any abnormal laboratory results that are associated with the presence orstatus of Ms. Morrow's stasis ulcer.albumin labs test result: normal range levels of 3.4 to 5.4 g/dL (SI, 34 to 54 g/L) arenormal for adults. Ms. Morrow were 14.7 mg/dL (Low)Albumin lab test result: Values of 19 to 38 mg/dL (SI, 190 to 380 mg/L) are seen. Ms.Morrow were 14.7 mg/dL (Low) which indicate mild protein depletion.3.Record the results of Ms. Morrow's Braden Scale assessment.Braden Scale score provides a baseline for comparison of increased or decreased risk of development of pressure ulcers.

3. Record the results of Ms. Morrow's Braden Scale assessment. Braden scale of 16, which is very high and alerting. This puts her at a mild risk for a pressure ulcer, the rest of skin is intact except for the venous stasis ulcer on her right medial malleoulus 4. Document the characteristics of Ms. Morrow's venous stasis ulcer. The venous stais ulcer is shallow, 1 inch in width, looks mostly pink to red, no signs of necrosis or infection. 5. Document the dressing change and irrigation of Ms. Morrow’s wound. First assessed the current dressing and saw that it was clean, dry and intact.I Livermore the dressing and assess the current status of the ulcer and saw that it was an ancient with, color was mostly pink to red and had no signs of necrosis or From vSim for Nursing | Fundamentals. © Wolters Kluwer

infection. I then cleaned it and irrigated the wound using normal Saline and reapplied a new and clean dressing before handling off the patient.

6. In the chart, record patient education on ways to promote venous return. The patient was provided with the necessary education to promote venous return and understood all information given to her period to promote venous return the person should ambulant regularly and if that is not possible in the patient ship elevate the legs and wiggle their feet up and down in bed or in a chair. The patient should also be encourage to use compression stockings which will help alleviate any symptoms and prevent blood clots ; help with blood circulation .

Guided Reflection Questions Opening Questions How did the simulated experience of Josephine Morrow’s case make you feel? These stimulated experience gave me better understanding regarding the proper care that is needed for ulcers and what to look for in case of an infection. I was also able to learn about what to educate be patient about in order to promote venous return and methods to use to improve circulation. Talk about what went well in the scenario. The patient was able to understand all that was asked of her when educating the patient. Reflecting on Josephine Morrow’s case, were there any actions you would do differently if you were to repeat this scenario? If so, how would your patient care change? What I would do different would be maintaining asepsis regarding the procedures that were taken and maintain adequate hygiene in order to prevent any further infection.

Scenario Analysis Questions 

 The Scenario Analysis Questions are correlated to the Quality and Safety Education for Nurses (QSEN) competencies: Patient-Centered Care (PCC), Teamwork and Collaboration (T&C), Evidence-Based Practice (EBP), Quality Improvement (QI), Safety (S), and Informatics (I). Find more information at:

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S

What priority problem(s) did you identify for Josephine Morrow? Priority problems that were identified for Josephine Morrow were as follow obesity , impaired mobility, past hx of COPD and DVT. Therefor, she has a continued risk for skin breakdowns and ulcers

Identify in Josephine Morrow’s health history any factors that predisposed her to having chronic venous insufficiency. COPD, DVT, obesity comma and lack of ability are all factors that will increase her predisposing to venous insufficiency. PCC/S Discuss the assessment findings and diagnostic studies that correlate with chronic venous insufficiency and venous stasis ulceration. Provide the reasons behind these findings. The patient developed a venous stasis ulcers or her right medial malleolus and has Brown pigmentation on both lower legs with an +2 edema. Her lab results show that she has abnormal pre albumin albumin in HC03 levels. S

What is the rationale for the daily dose of ASA? The rationale for the daily dose of ASA is to promote circulation .

EBP/I What is the rationale for compression therapy? Compression therapy is used to improve the signs and symptoms of various venous disease is by providing graduated compression therapy to help control leg swelling and discomfort. The compression socks are designed to provide support to the legs and veins, assist with circulation comma and minimize swelling.

EBP/I What is the rationale for performing a Braden scale assessment on Josephine Morrow? The Braden scale is used to assess how severe and also raise and whether or not it will become a pressure ulcer. An initial bring skill system will also provide any information on any changes in given initial assessment of the ulcer. If the Braden scale begins to change then different measures will be taken.

T&C What other interprofessional team members should be involved in Josephine Morrow’s care? Other interprofessional team members that should be involved in the patient's care include physical therapy, cardiac specialist, respiratory specialist, dietitian and a home care nurse. http://qsen.org/

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Concluding Questions Describe how you would apply the knowledge and skills that you acquired in Josephine Morrow’s case to an actual patient care situation. Patient prioritization is an important key factor to successful patient outcome. Patience needs work Matt an overall outcome will be an improvement in quality of life. Making sure that the patient is safe and conserval at all times to minimize fall risks. Educating the patient to promote better healing and better life solid changes. By including the interprofessional team assigned to the patient in Clare plan it works together as a health care team will provide the best care for the patient.

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