Systematic Goal Oriented Patient Care

Question: Discuss about the Systematic Goal Oriented Patient Care. Answer: The patient Zhi Mei Huang is a 65 year old female, who have undergone a skin burn 1 week ago and used a traditional Chinese healing bum to relief pain. Upon her assessment at hospital, the wound appears to be a 4 % total body surface area deep partial thickness burn to the right anterior leg. She has neglected the wound since 1 week. Mrs. Huang has recently lost her husband and has little assistance since then. She lives alone in an apartment on 3rd floor without life, which enhances fall risk at this age. In addition, it has also revealed that she underwent rapid weight loss and declined capacity of care. Pathophysiology Mrs. Huang has undergone deep partial thickness skin burn on her right anterior leg, which has been classified as second-degree burn. The burn has been extended into deep reticular dermis. The reticular region of dermis contains connective tissue, blood vessels, sweat glands, which are damaged due to burn. In these burn cases, skin becomes splotchy red or waxen and white (Krasner et al. 2012). It appears as yellow or white, less blanching may occur with blistering. Deep partial thickness burn may be painless, dependent on the level of nerve damage. The patient may feel pressure and discomfort. Mrs. Huang was experiencing significant pain and discomfort, which was evident through her difficulties to walk. Goal Assessing Mrs. Huang, it has been revealed that she has 4 % deep partial thickness burn on her right anterior leg and having difficulties to walk with significant pain. Based on her current condition the following goals will be made by adopting a person-centred approach: To undertake a proper wound management process, with relieving pain and discomfort To reduce the risk of infection To educate her about requirements of her well being To ensure adequate assistance for her elderly care and support Course of action Secondary- Secondary prevention plan include proper wound management and infection control. Mrs. Huang has already neglected the wound for 1 week, which has increased the chance of infection at wound site. Thus, the silver dressing can be undertaken for wound healing, as silver dressing has shown significant positive impact upon chronic wound healing in recent days (Aziz, ZAbu Chong, 2012). In addition, assessing and keeping the burnt area cool is crucial for healing preventing progression of severity. For preventing infection, non-stick bandage should be used for protecting the burnt area. Monitoring the burnt condition would be monitored regularly. To prevent shock, IV fluid therapy would be initiated. The pain severity would be accessed through pain scale and based on score, pain medication would be administered. Tertiary- Mrs. Huang lives alone at 3rd floor of her apartment. An educational session would be arranged for her, where she would be empathized for promoting her understanding related to the requirement of her well being. She would be made aware of the negative consequences of living alone (Rafla Tredget, 2011). She would be advised to change her accommodation and take assistance from her extended family, to reduce her loneliness. Clinical Skills Being a nurse, to deal with elderly like Mrs. Huang, good communication skills, problem solving skills, critical thinking skills are needed. In addition, to support the patient morally and ethically is crucial in person-centred care framework (Reuben Tinetti, 2012). Reference List Aziz, Z. S. F. A., Abu, S. F., Chong, N. J. (2012). A systematic review of silver-containing dressings and topical silver agents (used with dressings) for burn wounds. Burns, 38(3), 307-318. Krasner, D., Rodeheaver, G., Woo, K., Sibbald, G. (2012). Chronic Wound Care 5. BookBaby. Rafla, K., Tredget, E. E. (2011). Infection control in the burn unit. Burns, 37(1), 5-15. Reuben, D. B., Tinetti, M. E. (2012). Goal-oriented patient carean alternative health outcomes paradigm. New England Journal of Medicine, 366(9), 777-779.