Reflect on geriatric patients from your practicum site. Consider frail elder patients that you have assessed for skin wounds such as shingles. Explain the consequences of these types of wounds for frail elders. Then, describe a patient case including the care plan for assessment, diagnoses, treatment, management, and patient education. Explain whether the patient’s care plan was effective. Include how you might proceed differently in the future. If you did not have an opportunity to evaluate a patient with this background during the last 8 weeks, you can select a related case study or reflect on previous clinical experiences. Wounds in Geriatrics Essay Paper
Please include: intro and conclusion
include the following reference as one of the 4
Resnick, B. (Ed.). (2016). Geriatric nursing review syllabus: A core curriculum in advanced practice geriatric nursing (5th ed.). New York, NY: American Geriatrics Society.
Wounds in Geriatrics
During my practicum, I had the opportunity of seeing an elderly patient with a Herpes zoster (shingles). The patient was a 78-year-old Africa American male who presented to the clinic with complaints about painful blisters on the face and fever for the past 6 days. The blisters were extremely painful and the blisters had increased to cover half of the left side of the face with a watery discharge. The patient reported an inability to eat food or brush his teeth. The skin surrounding the blisters was red and tender on palpation. Shingles is a sporadic disease that occurs when latent Varicella-zoster virus is reactivated. Symptoms of shingles include numerous, painful, one-sided vesicles, and ulcerations that demonstrate a characteristic of sole dermatome involvement. The geriatric population is at high risk of developing shingles due to weaker immunity. This skin condition causes significant distress and pain to the elderly and significantly reduces the quality of life (Resnick, 2016).
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Care Plan
Nursing Diagnosis
- Pain
- Deficient Knowledge
- Risk for Infection
| Nursing Interventions | Rationale |
| Pain management
Assessment of the pain and discomfort: severity, quality, relieving or precipitating factors Assessing for the nonverbal signs of discomfort and pain Administration of treatments as indicated
|
The client’s description of pain will provide information on pain sensations and the intensity The nonverbal signs can help in evaluating the pain
Oral opioid analgesics have been shown to be effective for acute shingle infection such as in the patient Tramadol hydrochloride & acetaminophen were administered to lessen pain and fever (Cohen et al, 2014) |
| Patient education
The patient was educated to avoid extreme temperatures and also avoid rubbing the skin or lesions
Educate the patient and the caregiver regarding the disease, the need for isolation, signs, and symptoms of herpes zoster and the need for the client getting a herpes zoster vaccination |
This is because extreme temperatures cause itching and more pain and also scratching the lesions increases itching and the likelihood of secondary infection
This was done to ensure the patient was well informed and had complete understanding of the skin condition to ensure his active participation in his care. The client was educated on how the shingles infection is spread to avoid direct contact with people and hence avoid spreading the virus. Finally, the information about herpes zoster (Reeves et al, 2015) Vaccination aimed to encourage him to get vaccinated. Herpes zoster vaccination is recommended for people aged 60 years and above (Reeves et al, 2015) |
| Risk for infection
Assessing for irritations from the lesions and any rubbing. Assessment of any sign of infection such as redness Evaluating lesions near eyes and ears
Obtaining fluid from the lesions as indicated
|
This is because rubbing the lesions can cause secondary infection
This is because the virus may cause blindness or deafness A sensitivity test can guide a suitable antibiotic for the patient (Cohen et al, 2014) |
The care plan was effective in ensuring adequate and effective care for the patient. This is because, after the treatment period, the client reported satisfactory pain control at 2/10. The patient also did not contract any secondary infection. Lastly, the patient was able to verbalize the required information regarding singles, treatment, and likely complications. In the future, when handling patients will shingles, I will always keep in mind the possible complications like James Ramsay Hunt’s syndrome to ensure immediate attention when in case such complications occur.
References
Cohen K, Salbu R, Frank J 7 Israel I. (2014). Presentation and Management of Herpes Zoster (Shingles) in the Geriatric Population. P T. 38(4), 217-224, 227.
Nair P, Gharote H, Singh P & Palak J. (2014). Herpes zoster on the face in the elderly. BMJ Case Rep. 2014(2014), bcr2013200101.
Resnick, B. (Ed.). (2016). Geriatric nursing review syllabus: A core curriculum in advanced practice geriatric nursing (5th ed.). New York, NY: American Geriatrics Society.
Reeves G, Beuscher L & Metrics P. (2015). Herpes Zoster in Older Adults: An Educational Approach. The Journal of Nurse Practitioner. 11(5), 538–543. Wounds in Geriatrics Essay Paper