care needs

Question 1

Care of Skin
When a pt is admitted to your ward, what would you need to do to care for their skin?

Answer 1

• Assess–>Waterlow/Braden - weekly unless recommended otherwise
• OBSERVE - skin assessment
• Body map - changes (breaks, sores)
• Provision and use of pressure-relieving equipment
  Asking pt/relative about skin, routines and medications.
• Documentation in care plan about reassessment, dressings etc
• Knowing that some meds can affect skin e.g. steroids
• Hygiene- typical routine/products that could affect skin e.g. use of emollients

Question 2

Care of the bowels and bladder
What sort of things do you need to ask on admission and observe for during stay?

Answer 2

• Normal bowel function at home/prior to illness
• Incontinence ?- both - supportive methods?
• Catheters/stomas
• Any continence aids used?
• FH/PMH
• Medications taken to assist or that impact e.g. laxatives diuretics
• FBC needed?
• Catheter/stoma in situ?
• Signs of infection
• Changes- frequency, pain, smell consistency etc

Question 3

Care of Nutritional Needs
When you have a patient on your ward who is unwell generally how do you know if their nutritional needs are being met?

Answer 3

• MUST score
• Weight - on admission and later
• Asking patient/relative if they have lost weight recently
• Possible swallow assessment by SALT
• Aids req? e.g. cutlery/plate guards
• Assistance needed?
• Food chart required?
• Possible nutritional supplements –dietician
• Check care plan and ensure changes recorded
• ? vomit
• NG/PEG?
• Daily care log to document
• Thickener/modified foods - dysphagia

Question 4

Care of Fluid Intake
If a pt is on your ward how would you know if they were getting enough fluids?

Answer 4

• Ask pt what they normally drink and how often
• Observe for signs of dehydration –>confusion, dark/strong urine, dry mouth and lips, lethargy, decreased urine output, dry skin
• FBC –> also on food diary
• Possible IV or SC fluids if pt is unable to take enough oral fluids
• Mouthcare
• Consider dehydration to occur more easily if there are underlying conditions - diabetes, d&v, heatstroke, high temp, diuretics
• Accessible fluids
• Options
• Regular drinks
• Straw
• Beaker/feeding cup
• Temp

Question 5

Risk assessment and pt safety
- If a pt is in hospital and you are looking to discharge them what do you need to do to ensure a safe discharge?
- what needs to be considered to keep a pt safe on the ward?

Answer 5

• Ensure pt’s ADL’s are assessed on admission e.g. mobility, comprehension etc
• Ensure referred to physio as required for mobility –> including exercise plan and aids req
• Refer to OT - home assessment, aids etc
• Discuss goals with pt and family
• Consider MC and if LPA in place
• Ensure pt has correct aids on ward
• Check care plan is up to date with current needs
• Bedsides needed? risk? Anything else?
• Footwear/slipping
• Trip hazards/Environment - spillages
• SS - lifeline
• Care
• Discharge plan/CGA