Check the doctor orders for dressing change. What did the order say?.Follow doctor orders.Gather your supplies,and wash your hands. Explain the procedure to patient. Close the door to provide privacy. Place waterproof plastic under the patient. Place patient in a comfortable position. Open plastic red bag that can be easily reached by you. ( Working area)Open dressing carefully. Remove old dressing, if hard and adhered to surface wet the dressing for easy removal. Drop old dressing in a red bag.Assess the wound, odor,appearance and drainage amount. Remove old used gloves and place in the red plastic bag. Using aseptic techniques open sterile dressing and supplies. Open solutions and pour it over the gauze sponge in the plastic bag. Then wear your gloves. Maintaining aseptic techniques. Clean wound or surgical incision from the center to outward in a circular motion. Or you can clean from top to the bottom. You can use the forceps if you want.Use the 4×4 gauze for the wipe.Clean wound well,use each gauze once and discard into the red trash bag.Dry the wound using same circular motion. Apply ointment if ordered. Apply dressing on wound as ordered, cover with abdominal dressing and tape. Remove your gloves and discard it to the red trash bag, wash your hands. Make patient comfortable. Remove all supplies away from patient and keep the area clean. Documentation, documentation. As a nurse you are responsible for caring for the patient wound and documenting your findings.Abdominal incision to the right lower abdomen 6×4 incision cleaned with 0.9normal saline. The staples are intact, wound edges well approximated.Tiny crust along incision sites removed and cleaned.Skin around incision intact but edematous. Hemovac present in the lower side of the incision with serosanguineous drainage. Dressing change Every Shift.Medicated patient for pain as ordered and per patient request. Every facility is different. Some facilities have WOUND CARE team.Follow your hospital policy and procedures. As the frequency of dressing change cannot be emphatically stated since it depends on doctor choices or preferences, wound type,dressing types, wound drainage and location of the wound.Must not over pack wound because it will impede blood flow and prevent wounds from healing. When Do you Remove Staples and Sutures?.It is removed when the wound tensile strength has developed and be able to hold the wound edges together. Every patient is different and it also depends on nutritional values, location of wound,and age.Collagen formation and remodeling will often take 21days.TYPES OF WOUND DRESSING FOR CHRONIC WOUND. Hydrogel Dressings: For wounds not deep.And are oxygen permeable, maintain moisture and nonadhesive.Transparent Adhesive Dressing: For minimal drainage wounds. Allowing exchange of oxygen in the wound and surrounding environment maintains moisture in the wound. Keep the wound bed moist and prevent contamination. ABSORBENT DRESSING:Absorbent dressing provides effective exudate control, and skin contact gently. Examples of absorptive dressings are karaya powder, polymer starch. Maintain moist surface by formation of gelatinous mass.They are for heavy exudate and deep wounds.Minimize maceration of wounds and keep exudate at the middle of the wound.
HEAT VERSUS COLD APPLICATION. It is done to create therapeutic effects on the affected areas of the body. Our body temperature is regulated by the cells in the hypothalamus in response from the heat or cold receptors which are located close under the surface of the skin. When these receptors are stimulated, it will signal cells of the anterior hypothalamus to spread heat to the body by vasodilation and sweating.Or to the cells of posterior hypothalamus to conserve heat leading to vasoconstriction and shivering. Pain receptors are also activated if temperature are to cold or too hot.HEAT BENEFITS . Will raise body temperature and promote healing. Reduce the need for anti inflammatory medications. Reduce infection. Decrease pain.Increase circulation. Relieve painful menstruation involving abdominal cramps. COLD BENEFITS. It reduces swelling and prevent edema. Relaxes the muscle on affected areas. Decreases Circulation. Decreases pain to the affected areas. Acts as anesthetic to the affected area. It decreases metabolism and oxygenation to the affected areas. Heat and Cold therapy have systemic and localized effects. They are both used as a therapeutic methods for the treatment of traumatic body injuries. Before the application of cold or heat patient should be assessed on the physical and mental status of patient and the influence of the therapy on the individual .Questions The nurse is changing dressing on the flank side of the abdominal wound and she note the drainage to be light pink and thin.The nurse will document this drainage as?.A Serosanguineous drainage. B Purulent drainage. C Serous drainage. D Sanguineous drainage. Correct answer A.Rationale: Serosanguinous drainage is a mixture of blood and serum and very common in surgical wounds. Purulent drainage is thick and discolored, infection. Serous drainage is clear and watery. While Sanguineous drainage is mainly blood.(2) Your husband has sprained his right ankle and asks you how long should he leave the ice bag on his right ankle. Your response will be?.(A )Keep it there until you start to shiver. (B) 3hours on and 4hours off.(C )2hours on and 1hour off.(D) For 30minutes and you will leave it off for 1 hour.Correct answer D.Rationale: An ice bag should be applied for 30minutes and removed for 1hour.Because it will help to prevent the effects of prolonged cold.A,B,and C are all wrong. Caruso, C.C Hadley, B.J.,Shukla,R.,Frame,P.,&Khoury,J.Cooling effects and comfort of four cooling blanket temperatures in humans with fever.Nursing Research 41(2) 69 to 71.