Analysis of Patient Care and Injury Prevention Studies

CARE PLANNING

TABLE OF CONTENTS
CARE PLAN FOR HEATHER COOK ..........................................................................................1
Nursing Diagnostic statement 1: Acute pain ..................................................................................1
Nursing Diagnostic statement 2: Impaired skin integrity................................................................2
Nursing Diagnostic statement 3: Impaired urinary elimination ......................................................3
Nursing Diagnostic statement 4: Impaired physical mobility .........................................................4
Handover of care.........................................................................................................................5
Discharge plan ............................................................................................................................7
REFERENCES ...............................................................................................................................8

CARE PLAN FOR HEATHER COOK
Nursing Diagnostic statement 1: Acute pain
Mrs. Heather Cook described the pain level as 7/10 on pain assessment scale. Mrs
Heather Cook informed that she has community nurses who helped her in bathing, shifting and
doing other routine activities. When she has to wait too long on wheelchair for her home nurse to
come then it causes her great pain because she even cannot shift to bed for her afternoon sleep
without their support.
Expected outcome: From the nursing interventions her pain level will be reduced. She will be
comforted. The nursing interventions will help her to minimise the pain which occurred
frequently due to continuous sitting on wheelchair.
Nursing intervention 1:The nurses and therapists must provide occasional rest durations in
between movement.
Rationale 1: This intervention will reduce the pain extent of patient. It is essential to regain
energy so that fatigue instances or the sufferings as a result of intense pain can be avoided
(Pilutti & Edwards, 2017). The occupational therapists can assist Heather to make her learn
about use of aids and management strategies to deal with pain occurrence and its elimination.
Nursing intervention 2: The position of patient must be changed after every two hours.
Rationale 2: The periodic movement will prevent ulcer to develop further and it will not move
to next severe stages. It will also encourage mobility. The continuous sitting on wheelchair
leads to regular pressure on superior ischium resulting in extreme pain (Gabison & et.al., 2018).
If she will increase mobility with the help and support of her home nurse and husband, then it
will give her relief from the pain and discomfort.
Nursing intervention 3: Nursing care providers must give assistive devices to the patient.
Rationale 3: Heather is suffering from mobility concerns thus aids such as elevated toilet seats
along with support for arms, shower chair will give her comfort for self-care activities such as
hygiene, dressing and toileting. Along with pain relief by limiting regular sitting these aids will
give her balance so she will not fall due to weakness or fatigue. She will be able to perform
these tasks with minimum support of nurse and she will instantly perform these functions
without waiting for the nurse to come. It will also reduce the possibilities of fatigue and patient
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will be able to participate more actively in simple routine activities by elimination of pain
sources (Hocaloski & et.al., 2016).
Nursing intervention 4: Nurse must report frequency of urination, incontinence, burning and
force of urinary stream.
Rationale 4: Heather is using catheter care. The patient may suffer from bladder or urinary
tract infection. This intervention will indicate the presence of infection so that it can be treated
in initial phase only (Moss-Morris & et.al., 2016). The infection can also lead to pain in urinary
bladder and discomfort. The intervention will help to avoid this probability. The timed voiding
and bladder training programs will help to restore adequate bladder functioning and elimination
of pain due to urinary tract infection.
Nursing Diagnostic statement 2: Impaired skin integrity
It was evident by the patient’s observation. Her skin had non-blanchable redness. Ischial
tuberosity pressure injury of stage 1 can cause affected skin to appear discoloured. This can lead
to severe damage to underlying body tissues and skin as the stage of pressure ulcer increases.
Skin breakdown, infection and skin integrity alteration are possible risks of the diagnosis.
Expected outcome: With the below nursing interventions, Mrs Heather Cook will be provided
adequate care for healing of wound developed due to pressure ulcer. It will also regulate that
pressure ulcer does not turn more severe by shifting into next stage. Skin itching will be reduced
within few hours and skin breakdown or infection will normalise within few days.
Nursing intervention 1: Nurses and carers must place soft cushioning between bony regions
Rationale 1: The regular sitting on wheel chair can cause pressure ulcer in the regions of ankles
and wrists as well. The attachment of sheepskin to hard surfaces such as wheelchair sides will
help the patient to reduce the pressure development (Gabison & et.al., 2017). It will avoid the
shear amount and friction due to these hard elements on skin.
Nursing intervention 2: The skin of patient must be kept wetness free. For this, moisture must
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