Module 10 Nursing Clinical Rounds

Clinical Requirement:

Introduction The integumentary system is vital in protecting the body, regulating temperature, and enabling sensory perception. Disorders affecting the skin, hair, and nails range from mild to life-threatening and require comprehensive nursing care that integrates assessment, risk identification, and interventions to support tissue integrity and wound healing. Nurses must be vigilant in evaluating at-risk clients, implementing evidence-based prevention strategies, and managing complications such as infections, pressure injuries, and delayed healing. This discussion guides students through the nursing process in promoting skin health across diverse patient populations. ???? Case Study: Pressure Injury Risk and Complications in a Bedbound Client Client: Ms. Helen Foster, 76 years old Background: Recently admitted to skilled nursing facility following hospitalization for pneumonia and sepsis Medical history: Type 2 diabetes, obesity (BMI 34), peripheral vascular disease Bedbound; dependent on staff for repositioning and hygiene Assessment Findings: Dry, fragile skin with decreased turgor Non-blanching erythema over coccyx Urinary incontinence managed with adult briefs Decreased sensation in feet; healing diabetic ulcer on right heel Albumin: 2.9 g/dL Nursing Care Plan: Assessment: Daily skin checks (focus on bony prominences) Wound measurement and staging Braden Scale scoring Diagnosis: Impaired Skin Integrity Risk for Infection Imbalanced Nutrition: Less than Body Requirements Interventions: Reposition every 2 hours; use pressure-relieving mattress Maintain moisture barrier; perform perineal care post-incontinence Coordinate protein-rich nutrition with dietitian Encourage hydration; monitor intake/output Educate client and family on prevention, diabetic foot care Evaluation: Monitor healing of coccyx area and foot ulcer Assess for new areas of breakdown Revise care plan based on skin and nutritional status ???? Discussion Prompt Choose ONE of the following topic areas and respond thoroughly: 1. Assessment and Risk Identification in Skin Integrity What data should nurses collect during routine assessments to identify integumentary system disorders? Which client populations are most at risk for skin breakdown, and what risk factors should prompt immediate preventive action? 2. Nursing Interventions and Promotion of Skin Health What are evidence-based nursing interventions that prevent or manage pressure injuries and skin disorders such as dermatitis or fungal infections? How can nurses evaluate the effectiveness of repositioning, moisture control, and nutritional support? 3. Understanding Alterations and Complications in the Integumentary System What are common alterations in skin structure and function across the lifespan, particularly in older adults? What complications can arise from untreated wounds, burns, or chronic skin conditions, and how can nurses intervene? ???? Instructions for Participation Post your initial discussion by Saturday at 11:59 PM CST.