Lecture Notes on Goal Setting and Wound Care

Setting Goals

• SMART Goals
  • Specific, Measurable, Attainable, Realistic, and Timeline
  • Example: "Wound will decrease by 2 cm length, 1 cm width, and 0.5 cm depth by Thursday"
  • Importance of having a timeline for goals

Care Plans

• Components
  • Problem identification
  • Goal setting (what the patient aims to achieve)
  • Interventions (what the nurse will do to help achieve the goal)
• Example Interventions: Daily dressing changes, changing the OonaBoot every other day, monitoring wound size, ensuring proper nutrition

Wound Care

• Dressing and Treatment
  • Use of specific dressings like OonaBoot and Xero Foam based on wound type
  • Importance of matching dressing to wound type to prevent skin damage
  • Types of debridement: enzymatic, autolytic, mechanical, and sharp debridement

Documentation

• Charting
  • Importance of documenting wound care steps and dressing used
  • Challenges if previous charting is not done adequately

Drain Management

• Purpose of Drains
  • Prevent excess swelling, especially after surgeries such as mastectomy
  • Assess drainage: quantity and characteristics
• Importance of Frequent Monitoring
  • Surgeons may request drainage to be charted every 4-6 hours

Wound Vacuum-Assisted Closure (VAC)

• Use of negative pressure to promote healing and drainage removal
• Importance of fitting foam correctly to only cover the wound area

Sutures and Staples

• Assess for infection, redness, swelling
• Removed within 7-14 days to prevent tissue growth around them

Heat and Cold Therapy

• Patient Preferences
  • Heat for comfort
  • Cold often used post-surgery to reduce swelling
• Potential for Harm
  • Risk of burns or frostbite, especially in older patients
  • Importance of monitoring temperature application

Orders in Healthcare Settings

• Need for Orders
  • In nursing homes, orders are needed for most procedures
  • Hospitals offer more autonomy

Miscellaneous

• Discussion on the need for further study and exam preparation
• Mentions of class exercises and assignments related to wound care

This summary captures the main points discussed in the lecture regarding goal setting, wound care practices, and patient management in clinical settings.