Pamela J. Carter, Essentials for Nursing Assistants: A Humanistic Approach to Caregiving
Lesson Plan for Chapter 19 – Preventing Pressure Ulcers and Assisting With Wound Care
INTRODUCTORY MATERIALS
Overview
The quality of health care given by long-term care facilities is evaluated in part by the health care team’s ability to prevent residents from getting pressure ulcers. Preventing pressure ulcers is a major concern of the nursing team because these ulcers are painful, hard to treat, and potentially fatal. Nursing assistants are often the first members of the health care team to notice a change in a patient’s or resident’s skin that could be the beginning of a pressure ulcer. In this chapter, students will learn about their role in preventing pressure ulcers and assisting the nurse with wound care.
Materials and Resources
Computer and PowerPoint projector (all Objectives)
Guest Lecture:Invite a nurse who works as a wound care specialist to speak to the class (Objective 19-3)
Journals (Objective 19-5)
Wound drain equipment (Objective 19-8)
Materials for dressing wounds (Objective 19-9)
Features and Figures
Figure 19-1: Pressure points are areas where pressure ulcers are likely to form.
Figure 19-2: There are many things you can do to help prevent a person from getting a pressure ulcer.
Figure 19-3: Devices such as elbow pads and heel booties help to prevent the skin from rubbing against sheets and other surfaces.
Figure 19-4: A bed cradle prevents the top linens from putting pressure on the person’s feet.
Figure 19-5: A footboard keeps the person’s feet in proper alignment.
Figure 19-6: Specialty beds for preventing pressure ulcers.
Figure 19-7: Many different types of wound drains are used. A Hemovac drain is shown here.
Figure 19-8: Wound dressings can be secured using tape or ties.
Box 19-1: Stages of Pressure Ulcer Development
Guidelines Box 19-1: Guidelines for Preventing Pressure Ulcers
Procedure 19-1: Assisting the Nurse With a Dressing Change
Tell the Nurse!: Pressure Ulcers
Tell the Nurse!: Wound Care
Legends
You will see the following legends throughout the lesson plans:
<WL>
The Watch & Learn icon alerts you to the fact that a video related to the topic can be found on both thePoint and the Student Resource CD-ROM.
<TP>
thePoint icon lets you know that this information can be found online at
<CT>
This icon designates a critical thinking question.
<LL>
Listen & Learn using our audio glossary when you see this icon.
<WB>
When you see this icon, refer students to a corresponding activity in their workbooks.
Learning Objective 19-1: Explain how pressure ulcers form.
Page range: 444–447
Lecture Notes / Features / Activities / Assessments<TP>- Explain how pressure ulcers develop. (PPt 7)
Box 19-1 / <WB>Student Workbook
Preventing Pressure Ulcers: Activities B & C, pp. 131–132
Test Generator
Question 6
Learning Objective 19-2: Discuss what conditions may increase a person’s risk of developing a pressure ulcer.
Page range: 444–447
Lecture Notes / Features / Activities / Assessments<TP>- Explain why people with limited mobility are the most affected. Explain the other risk factors, such as advanced age, poor nutrition and hydration, incontinence, cardiovascular and respiratory problems, and friction and shearing injuries, that place the person at a greater risk of getting pressure ulcers. (PPt 8)
Preventing Pressure Ulcers: Activity A, p. 131; Activity E, p. 132; Activity I, p. 134
Test Generator
Question 1
Question 4
Learning Objective 19-3: Describe why preventing pressure ulcers is so important.
Page range: 448–449
Lecture Notes / Features / Activities<TP> / Assessments<TP>- Explain that the health care team may be evaluated on the basis of its ability to prevent residents from getting pressure ulcers. (PPt 9)
- Emphasize that the nursing team must make every effort to prevent a pressure ulcer from forming. Stress why prevention of pressure ulcers is always the best approach. Discuss the different ways a nursing assistant can help keep a person’s skin healthy. (PPt 11–13)
Invite a nurse who works as a wound care specialist to speak to the class about a nursing assistant’s role as part of the health care team that works to heal existing pressure ulcers and prevent new ones from forming. / <WB>Student Workbook
Preventing Pressure Ulcers: Activity F, p. 132
Learning Objective 19-4: Describe changes in the skin that could be an early sign of a pressure ulcer.
Page range: 448–449
Lecture Notes / Features / Activities<TP> / Assessments<TP>- Explain the four stages in which pressure ulcers develop. (PPt 10)
Review examples of what a nursing assistant should tell a nurse regarding problems with pressure ulcers.
<CT>Discussion Topic
Richard is providing care to Mr. O’Meara, who uses a wheelchair. While giving Mr. O’Meara a back massage as part of evening care, Richard notices a reddened area at the base of his spine. What are the possible explanations for this finding? / Test Generator
Question 2
Learning Objective 19-5: Describe how nursing assistants help to prevent residents and patients from developing pressure ulcers.
Page range: 448–449
Lecture Notes / Features / Activities<TP> / Assessments<TP>Figure 19-2
Guidelines Box 19-1 / <CT>Discussion Topic
Discuss measures that Richard (from the last discussion) can take to help keep Mr. O’Meara from developing a pressure ulcer. / Group Assignment
Assign students to research current journals and the Internet and then write a short essay on the prevention of pressure ulcers and the care of wounds.
<WB>Student Workbook
Preventing Pressure Ulcers: Activity D, p. 132; Activity G, p. 133
Test Generator
Question 3
Learning Objective 19-6: Describe special equipment that may be used to help prevent pressure ulcers.
Page range: 450–452
Lecture Notes / Features / Activities / Assessments<TP>- Describe the special equipment used for preventing pressure ulcers and the uses of each. (PPt 14)
Figure 19-4
Figure 19-5
Figure 19-6 / <WB>Student Workbook
Preventing Pressure Ulcers: Activity H, p. 133
Test Generator
Question 5
Question 10
Learning Objective 19-7: Define the words pressure ulcer and pressure points.
Page 444
Lecture Notes / Features / Activities<TP> / Assessments- Explain the term pressure ulcer. Discuss other terms that may also be used, such as bedsore or decubitus ulcer. (PPt 3–4)
- Define the term pressure points and list the most common sites for pressure ulcers to form. (PPt 5–6)
- pressure ulcer
- pressure points
Learning Objective 19-8: State observations that you may make related to wound care that should be reported to the nurse.
Page 453
Lecture Notes / Features / Activities<TP> / Assessments<TP>- Explain the importance of wound healing. Discuss the wound-healing process and list the factors that affect it. (PPt 16)
- Explain why wound drains are often used to allow blood and other fluids to flow out of the wound. Also discuss the nursing assistant’s duty regarding wound care for a person who has a drain. (PPt 17–18)
Review examples of what a nursing assistant should tell a nurse regarding problems with wound care.
Group Activity
Show students examples of different wound drains you have in the lab. / <WB>Student Workbook
Assisting With Wound Care: Activities A–C, p. 134
Test Generator
Question 7
Learning Objective 19-9: Demonstrate proper technique for assisting a nurse with a dressing change.
Page range: 453–454; 456–457
Lecture Notes / Features / Activities<TP> / Assessments<TP>Figure 19-8
Procedure 19-1 / Group Activity
Demonstrate and have students practice Procedure 19-1, Assisting a Nurse With a Dressing Change. / <WB>Student Workbook
Assisting With Wound Care: Activity D, p. 134
Test Generator
Question 8
Question 9
Learning Objective 19-10: Define the word wound.
Page 453
Lecture Notes / Features / Activities<TP> / Assessments<TP>- Define the term wound and list the types of wounds that a patient or a resident might have. (PPt 15)
- wound
Assisting With Wound Care: Activity E, p. 135