Pressure injury care case study of joseph russo

If the flow of blood is obstructed from flowing freely to all the areas of the body, then it prevents proper circulation of oxygenated blood which distributes nutrients to the bony tissues, resulting to cell death and ischemia. Pressure injuries are classified in four different levels which have two more categories: non-blanchable redness on the skin (stage I), partial thickness loss (Stage II), full thickness loss (stage III), full thickness loss of tissues with exposed bones (stage IV), unstageable and deep tissue injury (Cooper, 2013). Pressure injury/ulcers have become a significant global issue in the healthcare system because of their negative effects on quality of life for patients and come as a financial burden to different healthcare organizations. Research by NPUAP (National Pressure Ulcer Advisory Panel) shows that not all kinds of pressure injuries that can be avoided but most of them can be managed successfully whenever excellent assessment, technology, multidisciplinary team, and physical care have been adopted to guarantee proper perfusion (VanGilder et al.

Today, these caregiving elements are needed more than ever. Risk factors of pressure injury Research shows that the most significant risk factor of pressure injury is immobility. However, there are other factors that can expose patients to the risk of suffering from PI such as decreased oxygenation and perfusion, increased temperature and skin moisture, shear and friction, length of stay in ICU, vasoactive medications, the inability of hemodynamic as well as decrease in sensory perception(Molon and Estrella, 2011). Joseph Ross was experiencing decreased oxygen and his body temperature was even as high as 38. degrees Celsius. Such risks factors exposed him more to pressure injury. His condition was worsening and the doctor could not afford to concentrate on skin assessment first. Considering that patients are cared for while still on the transport carts at the emergency department, they are likely going to develop pressure ulcers because no protocols are observed for turning them after every two hours.

However, most of the patients move out of the ED within a very short time, making it unnecessary for the doctors to concentrate on skin assessment. Immediately after stabilizing his condition by inserting a lumen CVC into the patient’s subclavian vein and inotrope for altering muscular contraction, Russo was taken to ICU for further treatment. It at this care setting where patients contend with different medical devices that expose them to pressure injury as well as other medications that may reduce the flow of blood in some body tissues. Nursing diagnosis involves determining factors related to PI such as age, immobility, shear, moisture and poor circulation of oxygen. Such factors should be evidenced by redness, pus drainage, blisters or even open lesions (NSW Government, 2014). In the case of Russo, his condition was as a result of pressure resulting from CVC medical device and it was evidenced by redness at the insertion site of CVC.

The care plan will ensure that Russo is able to receive the right medical attention before the PI becomes worse as well as show the signs of being healed and reduction of PI. The plan will enable him to prevent future pressure injury. In order to prevent pressure injuries, Russo should have been fed with foods rich in zinc, vitamins A, and C, arginine, and protein. However, the case study does not state the kind of nutrition that was fed to Russo through the pipes during his unconscious state. It is important to ensure that proper measures are put in place at home before the patient is discharged. This involves referring the patient to an occupational therapist who will be monitoring his progress while still at home up to the moment he has fully recovered (NSW Government, 2014).

Also, Emma, who is responsible for taking care of Russo should have been educated about different ways of managing and preventing pressure injuries. aacnjournals. org/content/33/6/57. full. pdf [Accessed 11 Jan. Molon, J. Available at: https://www1. health. nsw. gov. au/pds/ActivePDSDocuments/PD2014_007. The International Pressure Ulcer Prevalence™ Survey.  Journal of Wound, Ostomy and Continence Nursing, 44(1), pp. Whiteing, N. Skin assessment of patients at risk of pressure ulcers.  Nursing Standard, 24(10), pp.