Concepts in care plans and a rant - page 2

Ok. Today was a very frustrating day for me - We had our first day on care plans. We had a 3 hour lecture then we were supposed to go back and write care plans in lab about 3 cases. I'm just... Read More

  1. by   Daytonite
    Quote from LilPeanut
    Jane Smith has double above the knee amputations, is diabetic, obese and confined to a wheelchair. She is very active and often agitated. During her periods of agitation, she waves her arms around wildly and tends to sweat heavily. She has developed a 7cm x 3cm injury to her skin underneath one of her abdominal folds.
    Think, for a bit, in terms of the patient's medical diagnoses. She is diabetic. That is a big ticket item. Any chronic disease that wreaks so much havoc on a person cannot be ignored in the care planning process. Her obesity is a contributing factor to the diabetes. Her amputations are complications of the diabetes. Skin breakdown in the abdominal folds is partly because of the obesity and sweating and is a problem because of the diabetes (diabetics don't heal well and are more prone to developing infections). Who knows where the agitation comes from, but it's not as major as the diabetes and skin problem--it's a safety issue more than anything, I feel. The things that the doctors will pretty much pass off to the realm of nurses are the sweating (contributes to the skin fold problem), amputation and confinement to a wheelchair (mobility and safety issues) and agitation (safety issue). There's a lot to care plan for this patient. However, the overall major problem would be the skin condition and/or the diabetes.