Bruises

Homework?

Yep. :: ding-ding-ding ::

My husband's grandmother always put hydrogen peroxide on her bruises.

This OP is a new nurse, has asked several questions appropriate to new nurse situations in subacute care.

For patients, bruises are what they are, I've never known ANYONE to 'treat' them. They actually are a neat little visual marker pointing out where some kind of tissue trauma occured, sort of a natural "HEY LOOK HERE!" for you :)

I can tell you that something that works wonders in PREVENTING a bruise, once you know you've slammed your arm/leg/head into something hard enough to cause a bruise, is topical gel Arnica. I bought tubes of it and had it strewn around the house when my boys were younger; the stuff was a godsend! Instead of getting what I KNEW would be giant black/purple marks, they barely got a yellowish discoloration, if even that. I'm talking head-slammed-to-desk kind of impact....grab and slap on the arnica....voila. No bruise

Hydrogen peroxide...?? Sounds a tad nutty to me, but then, I've never tried it :)

I've worked in a few SNFs and we've always documented, measured, and monitored bruises. No further treatment.

Arnica works and so does a warm moist compress; it does something to help the old blood to be reabsorbed.

Document the bruise, or any injury to the patient's skin....If it's an ER type situation, find out where the bruise care came from as some bruising can be signs of further injury to underlying organs.

If bruising is chronic, check out blood clotting labs.

Are there any treatment for bruises. What do we need to do when we see bruising?

Haha! One of my coworkers came in with a nice shiner - eye completely black and blue. She and her husband both went to pick up the TV remote, and apparently he has a mirror image of her injury. The joke's going around that she didn't make the "sammich" right (explains her black eye) and he had the nerve to complain about her cooking (takes care of his black eye). It's hilarious because anyone who knows them as a couple would never even dream of them getting into a physical fight!

That being said, the previous posters have given some good advice (I would add to check liver enzymes if the bruising is extensive, esp in peds cases). My background is chiefly ER, so depending on the location/extent of the bruise, we would either do a FAST scan (Ultrasound of the ABD/Thoracic/Pelvic cavities), call in X-ray, or simply start the RICE method (Rest Ice Compression Elevation). We provide warm moist towels to help dissipate the trapped blood after the initial hours following injury in between administration of ice packs. We note the measurements of the bruise, and continue to track until discharge. One other important step (I think Katie alluded to it) is to assess for abuse - "do you feel safe at home/are you currently in an abusive relationship?"

The bruise is an indication of injury. You don't treat the bruise itself but the underlying injury. Is it just a bruise over a shin of a 9 year old boy, or a "bruise" over the right upper quadrant of an accident victim?

The hydrogen peroxide was absolutely nutty. It didn't do a thing but she was convinced it did. She was always having me put peroxide on cotton balls and rub it on her bruises. You know, because I'm "the nurse in the family."

I haven't heard of Arnica so thanks for sharing that. I'll try the warm compress on my kids that get shiners. It's worth a shot!