The Care Plan For Patient With Diabetes Mellitus
Question
A 69-year-old patient with diabetes mellitus living in a skilled nursing facility is hospitalized for a right below the knee amputation (BKA). The patient spends most of the day in a wheelchair, but she can shift her position and move herself from the wheelchair to the bed with some assistance. She is incontinent of urine and wears a diaper. The patient often slides out of her wheelchair, and by the end of the day she does not have much energy to move herself up, so the nursing assistants slide her up in the chair, so she does not fall out. Once in bed, she often moves the head of the bed up and sits up to read or do crafts. During an assessment while the patient was in bed, the nurse notices an open area on the patient’s coccyx. When the nurse informs the patient, she is surprised and states: “I always move around, I hardly ever lie in bed during the day. I don’t see how I could have developed a pressure ulcer.” How should the nurse respond?
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Step 1/2
The nurse should respond to the patient with empathy and understanding, while also educating her about pressure ulcers and the risk factors associated with them. The nurse could say something like:
“I understand that you’re surprised to hear about the pressure ulcer on your coccyx, but it’s important to know that pressure ulcers can develop even if you’re not lying in bed all day. They can be caused by prolonged sitting or lying in one position, which can put pressure on certain areas of the body and restrict blood flow. People with diabetes are also at higher risk for developing pressure ulcers because of changes in their skin and blood vessels. It’s possible that your wheelchair and incontinence may have contributed to the development of the pressure ulcer.”
Step 2/2
The nurse should also reassure the patient that the pressure ulcer can be treated and prevented from getting worse by implementing a care plan, which may include frequent position changes, pressure relief cushions, and skin care. The nurse should involve the patient in the development of the care plan and encourage her to ask questions and express any concerns she may have.
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Final answer
The nurse should respond with empathy and educate the patient about pressure ulcers and their risk factors, reassure her that the pressure ulcer can be treated, and involve her in the development of a care plan The Care Plan For Patient With Diabetes Mellitus