clinical

1. Clinical case study:
Bedsores
Presented by
Arooj Fatima
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2.  Case Study Objectives:
By the end of this case study,students will be able to :
 Understand bedsores and their causes
 Acquire enough insight about treatment and care for patients with
bedsores.
 Design a care plan that provides healthcare for bedsores patient.
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3. Bedsores
Definition:
A Bedsore is a localized injury to the skin
and other underlying tissue, usually over a
body prominence, as a result of prolonged
unrelieved pressure.
A bedsore develops when blood supply to
the skin is cut off for more than 2 to 3 hours.
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5.  Ethiology:
 People most at risk of bedsores have medical
conditions (impaired ones) that limit their ability to
change positions:
• Pressure:Constant pressure on any part of your body
can lessen the blood flow to tissues
• Friction: Friction occurs when the skin rubs against
clothing or bedding
• Shear: Shear occurs when two surfaces move in the
opposite direction
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7. Assessment of assigned patient
A female patient is diagnosed with bilateral
buttocks pressure ulcers :
 a wound on bilateral buttocks With an open ulcer
and damage of epidermis.(2 years wound -stage 2)
 The Patient suffers from imobbility (legs problem
since 20 years )
Signs and Symptoms:
• Swelling and feeling suffocated
• Skin infection with a red pink Wound
• Tender bilateral area.
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8. TREATMENT
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 Scarred skin debridement surgery and secondary suturing done on
belateral side and on skin around the wound.
 Post operative medications analgesia and antibiotics were given
 Taking and tolerating a regular healthy diet.

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Nursing Interventions:
Before surgery:
 Changing positions often : every 15 minutes if in a wheelchair
and at least once every two hours when in bed
 Determine presence of incontinence
 Monitor vital signs and evaluate level of mobility
 Use comfort devices appropriately.
Post surgery:
 vitals monitoring and continue anti-biotic medication
 Encourage mobilization
 Inspect body pains (shoulder...) and skin condition (pale,dry...)
 clean open sore with a saltwater (saline) solution each time the
dressing is changed
 Educating the caregiver (family education).

10. FAMILY EDUCATION ABOUT
BEDSORES
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Using support surfaces: special mattresses that relieve pressure
Repositioning of patient and cushions
Look into a specialty wheelchair which can relieve pressure.
Consult dietitian for nutritional evaluation
Evaluate the ulcer progress every 4-6 days