Pressure Sores and Bladder/Bowel Rehab Flashcards
(29 cards)
Why does stroke increase the risk of developing pressure sores?
Stroke increases risk due to reduced mobility, decreased sensation, potential malnutrition, and problems with infections or incontinence.
Which patients are at greatest risk of developing pressure sores after stroke?
Those who cannot move themselves around the bed/trolley, those who are undernourished, and those with infections or incontinence.
What is a key characteristic of pressure sores?
Pressure sores are usually preventable, although they can be painful and may take months to heal.
How does decreased sensation contribute to pressure sore risk?
A person with decreased sensation may not feel uncomfortable and therefore not know to change their position regularly.
How does reduced mobility contribute to pressure sore risk?
A person with reduced mobility may be unable to physically change their position without assistance even when uncomfortable.
How does incontinence contribute to pressure sore risk?
Urine or feces on the skin can damage the skin surface, making it more susceptible to pressure sores and potential infection.
How does decreased awareness contribute to pressure sore risk?
A person with reduced awareness of one side of their body may not realize their positioning issues (e.g., hand stuck in chair) or how long they’ve been in the same position.
How does poor diet contribute to pressure sore risk?
Poor diet may lead to malnutrition that adversely affects skin health; dehydration can cause dry, fragile skin that increases damage risk.
How does infection contribute to pressure sore risk?
Infections can make a person tired, sometimes confused, and reluctant/unaware of the need to change position or eat/drink properly.
What body areas are commonly at risk for developing pressure sores?
Bony prominences: Ankles, ears, elbows, hips, sacrum, and shoulders.
What skin signs indicate underlying pressure damage?
Skin discoloration, redness, and areas that appear white under pressure and stay white when pressure is removed.
What should you do if you notice skin redness from pressure?
Remove the source of pressure immediately to prevent further damage and development of a pressure sore.
How can an Occupational Therapist help with pressure sore prevention?
They can offer advice on specialist seating, adaptations, and aids to assist movement and maintain good posture to reduce pressure damage risk.
What basic actions can be taken to reduce pressure sore risk?
Regular position changes, checking pressure areas/points, liaising with colleagues, using appropriate pressure-relieving equipment, and conducting pressure care risk assessments.
What environmental factors should be considered for pressure sore prevention?
Minimize bed sheet creases, ensure patient isn’t lying on hoist slings or catheters, check clothing isn’t too tight, maintain continence, be aware of sweating causing dampness, and ensure correct use of pressure relief cushions.
Why are bladder and bowel issues common following stroke?
They can be caused by physiological factors (brain area affected), functional factors (resulting disability), reduced cognitive levels, communication difficulties, and mood/emotional issues.
How can bladder and bowel issues affect a stroke patient’s well-being?
They may cause patients to refuse food/drink, affect mood, increase risk of pressure sores and falls, lead to social isolation, reduced self-esteem, and impact discharge destination.
How can stroke affect bladder/bowel function physiologically?
Damage to the frontal lobe or brain areas responsible for controlling bladder and bowels can result in loss of voluntary control.
How do functional factors affect continence after stroke?
Through decreased movement, poor eyesight, difficulty adjusting clothing, lack of awareness of need to void, balance problems, and environmental factors like inadequate toilet facilities.
How do cognitive factors affect continence after stroke?
Through altered level of consciousness, confusion/disorientation, and perceptual problems (may not recognize toilet).
How do communication difficulties affect continence after stroke?
Receptive aphasia (difficulty understanding when asked about toilet needs), expressive aphasia (difficulty expressing toilet needs), dysarthria (speaking difficulties), and visual disturbances can all impact toileting.
How do mood and emotions affect continence after stroke?
Anxiety about incontinence, depression leading to poor motivation, embarrassment causing non-disclosure of problems, and beliefs that problems are normal or untreatable.
What other factors can affect continence after stroke?
Pre-stroke conditions, urinary infections, and constipation (which can cause both urinary and fecal issues).
What are signs of possible bladder/bowel problems to watch for?
Difficulty using toilet, restlessness/agitation, small leaks, urgent needs, hesitancy, poor stream, dribbling, frequency, nighttime toilet needs, unawareness of need to void, and difficulties passing urine.
