SUPPORTIVE CARE OF BEDRIDDEN PATIENTS

Bedridden patient

Disease Trauma Ageing

Nursing care for the bed ridden Personal hygiene ( Mouth care, Eye care, Bed

bath, Back care, Head bath, Perineal care ) Nutrition Mobility Communication Treatment Education & empowerment Regular follow up

Personal Hygiene Bath Nail care Care of eye,ear,nose Hair care Oral care Perineal care Skin care

Nutrition Assistance for feeding Assessment& management of

problems in feeding Dealing of misconceptions Utilisation of locally available food

Mobility Motivate movement Simple exercises Encourage activities

Pressure sore: Definition

Pressure sores are localised tissue death and is the result of impairment of vascular & lymphatic system of the skin and tissues caused by compression , tension or shear

Etiology Pressure for a long time

Collapse of blood vessels

Nutrition ,Oxygen & tissue perfusion

Tissue ischaemia & hypoxia & cell death

Stress

Breakdown of skin

Causes

Intrinsic Age Neurological

disease Vascular disease Nutritional status

Extrinsic Pressure Shear Friction Moisture Immobility Pathogenic

organisms

High Risk Groups Bed ridden (old age, pain, sedated, ascitis, oedema,

coma, Depression, agitated,dementia,fracture, paralysed )

Obese , very thin and emaciated Diabetic pts Incontinence-Bowel & Bladder Excessive sweat or exudates Hyperpyrexia Malnourished

Preventive Measures Maintenance of skin integrity Daily examination of skin integrity /

pressure points Pressure relief techniques Promote pt movement Improve nutrition & hydration Education of pt & family Minimise extrinsic factors

Common sites

Depending on common position of patient

Supine (occiput, elbows, saccral region, heels,scapula )

Side lying (ear, acromion process, ribs, greater trochanter, medial & lateral maleolus,lateral condyles )

Sitting (isschial tuberosity )

Common sites of bedsores

Common sites-1

Common sites-2

4 Stages of bedsore

Assessment of pressure sores

Site Size Shape Stage Presence of Necrotic or sluff tissue Exudates Undermining & Tunneling Granulation & epithelial Tissue Wound Edge Surrounding Skin

Management

AIM Remove source of irritation Necrotic tissue Infection control Protect new healthy tissue Team work Improve quality of life

Factors helping to cope with aging

Physical health & activities Mental health Social activities Prevention of accidents & Abuse Health Teaching Financial resources

Thank You!!