Help with a Project

[rpnmaggie]

Hello!

I'm a new member on these boards, and I was looking to pick your brilliant brains regarding a project I have to do this week. I've brainstormed, and come up with some ideas but I just want to be sure I'm on the right track...I'm too embarassed to ask my fellow classmates, I'd rather look like an idiot anonymousl. lol.

Anyways, my project is regarding a patient who has parkinsons, needs total assistance, and has stage one pressure ulcers on both heals and coccyx. The nurse chooses to estimate his weight as oppsed to actually placing him on a scale. The result is she estimates his weight to be 154lbs(overweight) when he is actually 92.4lbs (underweight). His height is 170cm.

The question I'm struggling with is "Identify and discuss ALL priority nursing care issues in the above scenario."

Now, thus far, if left to my own devices, the issue here would ultimately be the failure in accurate communication of patient information between health care providers leading to medical errors and poor quality if patient care. Overestimating his weight has resulted in the client being classified as overweight, when in fact, according to the BMI chart, he is underweight. This has major implications for both the clients diagnoses of parkinsons and pressure ulcers (despite only being stage 1) in that his nutrition will be directly affected in terms if caloric intake. From my understanding, where parkinsons and pressure ulcers are concerned, proper nutritional intake is a intregal part of the healing process (pressure ulcers) and malnutrition is a major risk associated with parkinsons due to dysphagia, etc.

I'm a first year, but I want to cover all my bases. Any other ideas you feel would be good to include? I have the remainder of the paper mapped out (Best way to advocate for the client, members to help resolve the issue, and discussion of practice standards). I'm not looking for a handout here, I just would like some guidance from nurses who have a broader knowledge than me.

Thank you!

[classicdame, MSN, EdD]

I think you are on the right track. The patient may need protein supplements to increase healing. Some meds are based on weight. Wonder if the nurse is also "estimating" the stage of the wound or how ogten the patient needs turning?