Skin Integrity and Pressure Injury Care

Running Head: SKIN INTEGRITY AND PRESSURE INJURY CARE
SKIN INJURY AND PRESSURE INJURY CARE
Name of the Student
Name of the University
Author Note

SKIN INTEGRITY AND PRESSSURE INJURY CARE1
Mary lives all alone in her residential home and it has become difficult for her to do
the daily household chores such as regular dusting, cleaning and gardening. She also noticed
that she is occasionally becoming very tired, sweats profusely and is experiencing shortness
in breathing. She is also forgetting about certain things now-a-days and she walks with the
help of the walking stick as she was suffering from leg hemiparesis caused after she had a
stroke. During the last five days, she was suffering from dizziness, fatigue and shortness of
breath following which she was admitted to the hospital. She was diagnosed with brief period
of rapid atrial fibrillation (AF) that is caused by the abnormal heart beat. She was released to
home after a short treatment of the AF with trans-oesophageal echocardiogram and cardio-
version. She was advised to live in a residential aged care facility, however she insisted to
stay at home.
The medicines taken by Mary included clopidegrol, digoxin, microzide, metformin
and warfarin. Warfarin was recommended to her prior to her cardio-version treatment.
Warfarin is associated with skin necrosis in patients who are under the warfarin treatment.
The administration of warfarin alone can cause skin necrosis but along with heparin it can
reduce the effect of warfarin (Kakagia et al., 2014; Sheng & Aronowitz, 2014). As she was an
old lady aged about 77 years her skin was very fragile and sensitive and thus, further intake
of the medicine resulted in the skin rashes. There is a need to use skin protectors that will
help the patient in reducing the skin tearing. The other requirements of the patients with
skin necrosis will include the consumption of vitamin K along with fresh plasma in the frozen
condition so that it will reverse the effects of warfarin and it will also promote the synthesis
of protein C and protein S (Pourdeyhimi & Bullard, 2014). As Mary was suffering from a
femur bone fracture due to a fall at home she had difficulty in walking. The other
complications are the osteomyelitis that is caused due to a bacterial infection. Osteomyelitis

SKIN INTEGRITY AND PRESSSURE INJURY CARE2
defined by a set of infections that are either local or distant, necrotic tissue removal, and
maintenance of a moist environment for proper wound healing or even surgery.
The skin care routine that the nurse should follow for Mary in order to prevent
the further necrosis will include the use of skin creams that will prevent the skin from
drying up when the patient is indoor. The other preventive steps that should be taken
by both the nurse and the patients are drinking a lot of water so that the skin does not
dry up much and remains hydrated for a long time (Masuoka et al., 2016). The lesions,
ulcers and skin necrosis that Mary was suffering from might be due to some inflammatory
responses that the nurse should take care and should insist Mary so as to consult a doctor so
as to get a clear picture about the disease (Faghihi et al., 2015). Mary should also take care
before going out in the sun and thus, should wear dress made from light-weight material and
that will help in absorbing the excessive sweat as Mary was suffering from diaphoresis.
All these situations focus on the fact that Mary needs pressure injury care in a
residential aged care facility. The pressure injury care is needed by Mary as she had a fracture
and the extensive use of devices and hip protectors poses potential threat in the post-fracture
period (Bluestein, 2019). As Mary had developed pressure ulcers due to increased use of
devices, use of vasoactive medicines or due to hemodynamic instability he needed pressure
injury care (Cooper, 2013).
The role of the registered nurse is also very important in this particular case. The
registered nurse is very experienced and she will be able to collect the proper cues that are
needed for the proper medical interventions of Mary. The registered nurses are also very
competent in providing primary care treatment to the patient even in the absence of the doctor
or clinicians. This way the residential aged care facility helps to develop interpersonal
relations among the healthcare workers as well as to sharpen their skills (Freund et al., 2015).