I am a home health nurse. I have a patient who is bed bound. Her caregiver is wonderful to her. takes great care of the patient, but at the same time calls for every little thing. This patient has a feeding tube, and everything is great with that. We change her cath once a month.....we try...but it seems we do it every 3weeks. It "leaks" she will call at 3am. We have to tell her...that the patient is having spasams and that it will happen, this patient has had a cath now for over 1.5 years. chronic UTIs, so the dr has ordered that we change the cath every month....but can every 3 weeks...but no less.... Pt of course cannot use bed pan or commode. has at least 3-4 BM's a day. Caregive is usually pretty good in cleaning her up when she has them. But these last few weeks the patient has gotten these...I guess I call the pimples...on her buttocks. The caregiver says Boils? did I even spell that right ?? anyways....he buttocks is not really red at all...a little pink if anything. but they just all the sudden appear...with a white raised head, and "pop" and the caregiver squeezes them and white pus comes out, and it seems to bother the patient? what kind of care do I do to these things? what do you call them? they are any where from 3cm from her rectum to middle of her buttocks. I have her clean them and keep them dry. At times the caregive had applied ultra thin duoderm. Due to she had them from a previous pressure ulcer.
Any suggestions? She uses the barrier cream/ keeps her turned...I am not sure what they really are? and they have just started maybe this last month. No new meds, no new infections. I have had this patient for a year and a half. this is new.....and weird! any information would be great!!!!!
Hi. sorry you're having so much trouble with this patient. I would like to suggest culturing these "boils" to rule out MRSA. If positive, antibiotics would help heal the current ones and prevent new sores. By your description, I would suggest iodasorb or accuzyme (as indicated) to open areas, cover with polymem, skin prep, and secure with mefix. Hope things settle down soon. Good luck.
When I worked in LTC, we used to irrigate pond scum bladders with Renacidin solution. 20-50cc in, clamp 20min then release. Often with the thick urine that you describe...we'd see results in just 2-3 irrigations (one a day), then could cut back to PRN, usually about once a week. :)
When I worked in LTC, we used to irrigate pond scum bladders with Renacidin solution. 20-50cc in, clamp 20min then release. Often with the thick urine that you describe...we'd see results in just 2-3 irrigations (one a day), then could cut back to PRN, usually about once a week. :)
she has this just Rx like a month ago....she was doing great on it...then developed bladder stones. and just last week....had another UTI...and then it went in to sepsis! she is back home....and now we change her cath q2w.......and increased the size of her cath.....I guess this is just going to be a chroic prob....thank you for your info! I really don't don't too much about the renacidin....does it usually work weel?
Staph and Strep bacterial infections are commonly termed impetigo. Classic descriptions of impetigo include small (1-2 mm) tiny blisters (vesicles) and pustules that tend to easily rupture leaving multiple erosions in a sea of generalized skin irritation.
LUMPYPUDDIN
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Hi. sorry you're having so much trouble with this patient. I would like to suggest culturing these "boils" to rule out MRSA. If positive, antibiotics would help heal the current ones and prevent new sores. By your description, I would suggest iodasorb or accuzyme (as indicated) to open areas, cover with polymem, skin prep, and secure with mefix. Hope things settle down soon. Good luck.
Kat