Case Study – Concept Map and Plan of Care for Mrs Y, an 84-year-old Client

 

Concept Map

Nursing Plan of Care



Prioritized Nursing Diagnoses
Goal
Nursing Interventions


Risk for infection
Patients maintain freedom from infection.
1. Provide appropriate wound care to the patients. This may hasten the healing process and prevent reinfection (Rodrigues et al., 2019). 

2. Help the patients clean their environment to eliminate environmental pathogens that may increase their likelihood of being reinfected.

3. Ensure all equipment used for catheterization is properly disinfected prior to use to guarantee freedom from external pathogens.


Impaired skin integrity
The goal is for the patient to demonstrate proper foot care to prevent further ulcer formation or reinfection of the already-developed ulcers.
1.      Assess the wound for necrotic tissues and an unusual odor to determine its responsiveness to medications. Necrotic tissues may hinder the healing process and must, therefore, be removed for healing to occur. Necrotic tissue debridement eliminates conditions that favor optimal bacterial growth and is, therefore, important in wound care (Thomas et al., 2021). Odor signifies infection progression and may inform the need to revise the medication. 

2.     Educate the patients on foot protection and the need to avoid walking on bare feet. Walking on her feet may increase her chances of her wound being reinfected.

3.     Educate the patients on the likely causes of foot ulcers. This may enhance the patient’s ability to care for themselves.


Ineffective health management
The patient should verbalize factors that are contributing to their health and how they can address these factors.
1.  Assess the patient’s and her daughter’s skills and wound care knowledge. This determines their capacity to provide local wound care without a caregiver. 

2. Educate the patients on local wound care and instruct her daughter to clean the house and walkways frequently. This will enhance their accountability in lessening environmental pathogens that may precipitate the infection.

3. Educate the patient on the significance of nutrition in lessening their symptom severity. Appropriate nutrition may optimize diabetes management and lower the patient’s chances of developing complications.



References
Rodrigues, M., Kosaric, N., Bonham, C. A., & Gurtner, G. C. (2019). Wound healing: A cellular perspective. Physiological Reviews, 99(1), 665–706. https://doi.org/10.1152/physrev.00067.2017.

Thomas, D. C., Tsu, C. L., Nain, R. A., Arsat, N., Fun, S. S., & Sahid Nik Lah, N. A. (2021). The role of debridement in wound bed preparation in chronic wound: A narrative review. Annals of Medicine and Surgery, 71, 102876. https://doi.org/10.1016/j.amsu.2021.102876.