75 yr old African American with skin ulcer

[ksurette]

See where I am heading on my answers for this case study.. and I'm on the right track?

The nurse visits a 75-year-old African-American woman to evaluate healing of a pressure ulcer on her left hip. The patient is upbeat but feels that the ulcer is taking too long to heal in comparison to others she has had in this same area. The woman's children are also present at the visit and inform the nurse that they have been encouraging their mother to sit out in direct sunlight in her backyard, where she can expose the ulcer area to light. The children read on the Internet that this is the quickest way to heal an ulcer and feel that other treatments are not needed at this time. The patient listens to her children but voices her disinterest in their treatment choice, stating that she prefers traditional treatments.

Identify the clinical problem(s) in the case study. Provide the rationale for your answer. (2 marks)

My answer: Patient has an ulcer she feels are not healing fast enough. (should I be including something about the family treatments)

The nurse assesses the ulcer by examining the skin color and determines that healing is progressing well. The patient has dark skin, with some areas around the ulcer that appear blue in color; no redness is seen. Based on these statements, is the nurse making an accurate assessment? Why or why not? Provide the rationale for your answer. (3 marks)

Skin color can reflect a patient's overall health and is an important part of assessing skin breakdown and wound healing. , dark skin takes on a dark bluish-purple tint at the site of early pressure-ulcer development. So when caring for a dark-skinned patient at risk for pressure ulcers, keep in mind that assessing by touch is as important as visual inspection. I don't believe the rationale is correct.

How should the nurse address the conflict between the patient and family? Provide the rationale for your answer. (5 marks)

The case study didn't make it seem like a large conflict just a difference of opinion on treatment. After the conflict is identified, it must be managed specifically and immediately. Breaking down issues and dealing with each one from the easiest to handle to the most difficult will get the best result.

[LightMyFire]

You're on the right track as far as your physical assessment goes. Are there educational needs? Assessment needs to include other factors besides just physical needs.

[AliNajaCat]

Her feelings about its not healing are not a clinical problem. What do you think about the fact that she has had a pressure ulcer before, and why do you think she got this one, and why this one isnt healing as well as the other(s)?

My answer: Patient has an ulcer she feels are not healing fast enough.

[ksurette]

This really makes me wonder about conflict for the last question --and how often a nurse may find themselves between various opinions of what is right... that has to be hard to deal with. Have you been in this situation?

I love the insight on the ulcer not healing and having them before.. the nurse seemed very quick to decide it was healing fine.