MDS Alert
This resident developed a Stage 4 decub.
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A resident with a reddened area developed a Stage 4 pressure ulcer (see the case study on p. 16). Assessment data included the following: • Braden Scale completed on admission. Score = 16 (mild risk) - No impaired sensory perception - Rarely moist - Chair-fast - Very limited mobility - Adequate nutrition - • Fall Risk = Borderline • Bowel & Bladder = Foley, continent bowel • Pain assessment = no pain • Side rails = indicated as enabler • Assessments done by RN • Chronic diagnoses include venous insufficiency, hypothyroidism, weight loss, GERD, HTN • Meds: Levoxyl, Aldactone, Prevacid, Lasix, Lovenox, Prilosec Hospital Information: • Admit Diagnoses S/P ORIF Lt Hip fx & Pinning Lt Humeral Fx - Hypothyroidism - Recent weight loss? Etiology - GERD - Bilateral venous insufficiency - Venous stasis changes - History of venous stasis ulcers - s/p Hepatitis - s/p Breast CA (in remission) - Foley catheter care RAPs: - ADL functional/rehabilitation - Urinary incontinence & indwelling catheter - Locomotion deficit/use of wheelchair, incongruent with previous lifestyle - At risk for falls - At risk poor nutrition, only eats 25 percent - Dehydration - diuretic/laxative use - Pressure ulcers, turning & repositioning, ulcer care, dressings, pressure relieving devices Source: Excerpted from a handout provided as part of an Advancing Excellence Webinar presentation by Debra Bakerjian, RN, MSN, PhD.
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