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Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care,

9th Edition
Lesson Plan
Chapter 32, Skin Integrity and Wound Care

Goals of the Lesson:

Cognitive: Students will be able to discuss the processes involved in wound healing and list factors that affect it. They will be
able to identify patients at risk for pressure injury development, explain the method of staging of pressure injuries, and provide
nursing interventions to prevent pressure injuries. Students will be able to accurately assess and document the condition of
wounds, implement appropriate dressing changes for different kinds of wounds, and provide information to patients and
caregivers for self-care of wounds at home. They will be able to apply hot and cold therapy effectively and safely.

Learning Objectives:

The lesson plan for each objective starts on the next page.
32.1 Discuss the processes involved in wound healing.......................................................................................................2
32.2 Identify factors that affect wound healing.................................................................................................................5
32.3 Identify patients at risk for pressure injury development.............................................................................................7
32.4 Describe the method of staging of pressure injuries...................................................................................................9
32.5 Accurately assess and document the condition of wounds.........................................................................................12
32.6 Provide nursing interventions to prevent pressure injuries.........................................................................................14
32.7 Implement appropriate dressing changes for different kinds of wounds.......................................................................18
32.8 Provide information to patients and caregivers for self-care of wounds at home...........................................................21
32.9 Apply hot and cold therapy effectively and safely.....................................................................................................22

IR, Instructor’s Resource; SR, Student’s Resource; PPT, PowerPoint (IR); *Premium content: additional purchase required.

© Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

32.1 Discuss the processes involved in wound healing.

Lecture Outline Figures, Resources and In- Outside Instructor’s


Tables, and Class Activities Assignments/Ev Notes
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 Discuss the anatomy 104 2– Figure Pre-Lecture Written
and physiology of the 2, 20 32-1 A cross Quizzes Assignments
integumentary system 104 section of normal True/False Visit a health care
and how the state of a 7-- skin, p. 1044,  Wounds that heal facility to assess
person’s health and 105 PPT slide 5 by tertiary and document the
therapeutic treatments 0 intention are condition of a
have a direct effect on Tables wounds left open patient recovering
the condition of the 32-1 Functions of for several days to from a serious
skin. the Skin, p. 1045 allow edema or wound. Write a
 Teach your students infection to resolve brief report
how wounds occur 32-2 Factors or fluid to drain. discussing the
(mechanical forces or Placing a Person  Granulation tissue process of wound
physical injury). at Risk for Skin forms the healing, the
Discuss types of Alterations, p. foundation for scar factors that affect
wounds (intentional, 1046 tissue this process, and
unintentional, open and development the condition of
closed, acute and 32-3 Types of during the the wound
chronic, partial Wounds, p. 1048 proliferation phase assessed.
thickness, full of wound healing.
thickness, complex) Box Test Generator
and their causes. 32-1 Principles of Discussion Topics Questions
 Make sure your Wound Healing, Compare and contrast Use the test
students understand p. 1049 the healing process generator
the physiology of (including factors that software to
wound healing and can Reflective will affect that identify questions
describe the four Practice: process) between the related

Page 2 of 37
Copyright © 2019 Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

Lecture Outline Figures, Resources and In- Outside Instructor’s


Tables, and Class Activities Assignments/Ev Notes
Features aluation
Content Text PPT
pag slid
e(s) e(s)
phases of wound Cultivating following two specifically to this
healing (hemostasis, QSEN patients: An elderly objective.
inflammatory, Competencies patient who presented
proliferation, Challenge to with a stage I *Adaptive
maturation). Ethical and Legal pressure injury last Learning
Brainstorm with the Skills, week and a 25-year- Powered by
class to develop a list of pp. 1043, 1044 old with an abdominal prepU
the characteristics of stab wound that was Individualized,
each phase. Focus on the surgically repaired 2 adaptive learning
 Discuss the Older Adult days ago. through quizzing
interventions that help Nursing and remediation
support the healing Strategies to Case Studies is available for
process of a wound. Address Age- You are a nurse in a this chapter.
Related Changes medical–surgical unit
in Skin, in a hospital caring *Study Guide
p. 960 for a 27-year-old
professional football
player who underwent
surgery to repair a
compound fracture of
his femur. The
surgery went
smoothly, and you
are responsible for his
postoperative care
after he returns from
PACU.
 What is his skin’s

Page 3 of 37
Copyright © 2019 Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

Lecture Outline Figures, Resources and In- Outside Instructor’s


Tables, and Class Activities Assignments/Ev Notes
Features aluation
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role in preventing
infection before
surgery?
 Describe how you
would expect his
wound to heal.
 Indicate factors
that could affect
the healing of his
surgical wound.
 For which
complications
would you monitor
his wound?
 Outline signs and
symptoms that
might indicate his
wound is infected.
In what time
frame might they
appear?

Apply the Concepts


NCLEX-Style Review
Questions: Students
can use the NCLEX-
Style Review
Questions to review

Page 4 of 37
Copyright © 2019 Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

Lecture Outline Figures, Resources and In- Outside Instructor’s


Tables, and Class Activities Assignments/Ev Notes
Features aluation
Content Text PPT
pag slid
e(s) e(s)
and practice for the
NCLEX.

Concepts in Action
Animations
 Hemostasis
 Wound Healing

Journal Article
Medical Adhesives
and Patient Safety
Consensus
Statements for the
Assessment,
Prevention, and
Treatment of
Adhesive-Related Skin
Injuries. Journal of
the Dermatology
Nurses' Association.

Spanish-English
Audio Glossary
IR, Instructor’s Resource; SR, Student’s Resource; PPT, PowerPoint (IR); *Premium content: additional purchase required.

Page 5 of 37
Copyright © 2019 Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

32.2 Identify factors that affect wound healing.

Lecture Outline Figures, Resources and In- Outside Instructor’s


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Content Text PPT
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 Discuss the factors that 105 21– Figures Pre-Lecture Quizzes Written
affect wound healing 0– 27 32-2 Wound Fill-in-the-Blank Assignments
(age, circulation to and 105 complications,  The partial or total Visit a health care
oxygenation of tissues, 3, p. 1053, PPT separation of facility to assess
nutritional status, 105 slide 26 wound layers is and document the
condition of the wound, 9 known as condition of a
immunosuppression, 32-3 Fistula, p. _______________ patient recovering
medications, overall 1053 _, the result of from a serious
patient health). excessive stress on wound. Write a brief
 Review the Focus on the wounds that are report discussing
complications that may Older Adult not healed. the process of
occur with wound Nursing wound healing, the
healing (infection, Strategies to Discussion Topics factors that affect
hemorrhage, Address Age- Compare and contrast this process, and
dehiscence and Related the healing process the condition of the
evisceration, fistula Changes in (including factors that wound assessed.
formation) and the Wound Healing, will affect that
psychological effects of p. 1051 process) between the Group
wounds on the patient following two patients: Assignments
(pain, anxiety, fear, An elderly patient who Interview
impact on activities of presented with a stage experienced nurses
daily living, change in I pressure injury last in various health
body image). week and a 25-year- care settings about
old with an abdominal their experience
stab wound that was with caring for
surgically repaired 2 patients with

Page 6 of 37
Copyright © 2019 Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

Lecture Outline Figures, Resources and In- Outside Instructor’s


Tables, and Class Activities Assignments/Eval Notes
Features uation
Content Text PPT
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days ago. pressure injuries.
Then, answer the
List all the physical following related
factors you can think questions and share
of that can affect your findings in a
wound healing, and class discussion:
provide a strategy to  What types of
facilitate healing for patients may be
each factor. predisposed to
the condition?
Case Studies  What factors
You are a nurse in a contribute to the
medical–surgical unit development of
in a hospital caring for pressure
a 27-year-old injuries?
professional football  What treatment
player who underwent do you find most
surgery to repair a effective?
compound fracture of  How do you
his femur. The surgery attempt to
went smoothly, and prevent pressure
you are responsible for injuries in your
his postoperative care patients?
after he returns from  Have you
PACU. incorporated any
 What is his skin’s new methods for
role in preventing treating pressure
infection before injuries in your

Page 7 of 37
Copyright © 2019 Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

Lecture Outline Figures, Resources and In- Outside Instructor’s


Tables, and Class Activities Assignments/Eval Notes
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surgery? care plan?
 Describe how you  What is the
would expect his psychological
wound to heal. effect of pressure
 Indicate factors injuries on the
that could affect patient?
the healing of his
surgical wound. Test Generator
 For which Questions
complications Use the test
would you monitor generator software
his wound? to identify questions
 Outline signs and related specifically
symptoms that to this objective.
might indicate his
wound is infected. *Adaptive
In what time frame Learning Powered
might they appear? by prepU
Individualized,
Apply the Concepts adaptive learning
NCLEX-Style Review through quizzing
Questions: Students and remediation is
can use the NCLEX- available for this
Style Review chapter.
Questions to review
and practice for the *Study Guide
NCLEX.

Page 8 of 37
Copyright © 2019 Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

Lecture Outline Figures, Resources and In- Outside Instructor’s


Tables, and Class Activities Assignments/Eval Notes
Features uation
Content Text PPT
pag slid
e(s) e(s)
Spanish-English
Audio Glossary
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Page 9 of 37
Copyright © 2019 Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

32.3 Identify patients at risk for pressure injury development.

Lecture Outline Figures, Resources and In- Outside Instructor’s


Tables, and Class Activities Assignments/Eva Notes
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 Make sure your 105 28, Figures Pre-Lecture Quizzes Written
students understand 3-- 29 32-4 Common Fill-in-the-Blank Assignments
pressure injury 105 sites for  A __________ Visit a health care
formation and the 5 development of injury, a localized facility to assess
underlying causes of pressure area of injury to the and document the
pressure injuries. injuries, p. skin, may develop condition of a
Review the factors that 1054 when soft tissue is patient recovering
place patients at risk compressed from a serious
for pressure injuries 32-5 Shearing between a bony wound. Write a
(aging skin, chronic forces can prominence and an brief report
illnesses, immobility, occur when a external surface. discussing the
malnutrition, fecal and patient is  Patients who are process of wound
urinary incontinence, moved pulled, rather than healing, the factors
altered level of carelessly or lifted, when being that affect this
consciousness, spinal slides down in moved up in bed or process, and the
cord and brain injuries, bed, p. 1055 from the bed to the condition of the
neuromuscular chair are at risk for wound assessed.
disorders). Box injury from
 Discuss the 32-2 Risk ____________ Group
mechanisms that Factors for forces. Assignments
contribute to pressure Pressure Injury Discussion Topics Interview
injury development Development, Outline strategies to experienced nurses
including external p. 1055 prevent pressure injury in various health
pressure, friction, and development in care settings about
shearing forces. patients. their experience
with caring for

Page 10 of 37
Copyright © 2019 Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

Lecture Outline Figures, Resources and In- Outside Instructor’s


Tables, and Class Activities Assignments/Eva Notes
Features luation
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Case Studies patients with
You are a visiting nurse pressure injuries.
caring for a 32-year-old Then, answer the
writer who became following related
paraplegic as a result of questions and
a motorcycle accident 1 share your findings
year ago. He is in a class
recovering from a discussion:
subsequent depression;  What types of
your visits are to patients may be
monitor not only his predisposed to
emotional outlook but the condition?
also to encourage his  What factors
hygienic self-care and contribute to
offer strategies for his the
success. He wears a leg development of
bag and is incontinent pressure
of stool. You are injuries?
monitoring a red spot  What treatment
on his left buttock, do you find
which has progressed most effective?
to a pressure injury in  How do you
which subcutaneous fat attempt to
is visible. prevent
 Outline the pressure injuries
mechanisms that in your
contributed to the patients?
development of the  Have you

Page 11 of 37
Copyright © 2019 Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

Lecture Outline Figures, Resources and In- Outside Instructor’s


Tables, and Class Activities Assignments/Eva Notes
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pressure injury. incorporated
 What specific any new
assessments should methods for
be performed to treating
prevent formation of pressure injuries
pressure injuries? in your care
 How would you plan?
stage his pressure  What is the
injury? psychological
 Indicate the effect of
information that pressure injuries
would be included in on the patient?
an assessment of
his wound. Test Generator
 Identify appropriate Questions
outcomes for this Use the test
patient’s care plan. generator software
to identify
Apply the Concepts questions related
NCLEX-Style Review specifically to this
Questions: Students objective.
can use the NCLEX-
Style Review Questions *Adaptive
to review and practice Learning
for the NCLEX. Powered by
prepU
Spanish-English Individualized,
Audio Glossary adaptive learning

Page 12 of 37
Copyright © 2019 Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

Lecture Outline Figures, Resources and In- Outside Instructor’s


Tables, and Class Activities Assignments/Eva Notes
Features luation
Content Text PPT
pag slid
e(s) e(s)
through quizzing
and remediation is
available for this
chapter.

*Study Guide
IR, Instructor’s Resource; SR, Student’s Resource; PPT, PowerPoint (IR); *Premium content: additional purchase required.

Page 13 of 37
Copyright © 2019 Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

32.4 Describe the method of staging of pressure injuries.

Lecture Outline Figures, Resources and In- Outside Instructor’s Notes


Tables, and Class Activities Assignments/Ev
Features aluation
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 Be sure your students 105 30– Box Pre-Lecture Written
understand how 6– 35 32-3 Pressure Quizzes Assignments
pressure injuries 105 Injury Stages, True/False Visit a health care
develop from blanching 9 pp. 1057–1059  The first indication facility to assess
of the skin through the that a pressure and document the
four stages of pressure Research in injury may be condition of a
injury development. Nursing developing is a patient recovering
 Review the process for Bridging the blanching of the from a serious
cleaning and dressing a Gap to skin over the area wound. Write a
pressure injury. Evidence-Based under pressure. brief report
Practice, discussing the
p. 1070 Case Studies process of wound
You are a visiting healing, the
nurse caring for a 32- factors that affect
year-old writer who this process, and
became paraplegic as the condition of
a result of a the wound
motorcycle accident 1 assessed.
year ago. He is
recovering from a Make a list of the
subsequent type of blended
depression; your skills you will
visits are to monitor need to diagnose
not only his emotional and treat patients
outlook but also to with alterations in
encourage his skin integrity.

Page 14 of 37
Copyright © 2019 Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

Lecture Outline Figures, Resources and In- Outside Instructor’s Notes


Tables, and Class Activities Assignments/Ev
Features aluation
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hygienic self-care and
offer strategies for his Group
success. He wears a Assignments
leg bag and is Interview
incontinent of stool. experienced
You are monitoring a nurses in various
red spot on his left health care
buttock, which has settings about
progressed to a their experience
pressure injury in with caring for
which subcutaneous patients with
fat is visible. pressure injuries.
 Outline the Then, answer the
mechanisms that following related
contributed to the questions and
development of share your
the pressure findings in a class
injury. discussion:
 What specific  What types of
assessments patients may
should be be predisposed
performed to to the
prevent formation condition?
of pressure  What factors
injuries? contribute to
 How would you the
stage his pressure development
injury? of pressure

Page 15 of 37
Copyright © 2019 Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

Lecture Outline Figures, Resources and In- Outside Instructor’s Notes


Tables, and Class Activities Assignments/Ev
Features aluation
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 Indicate the injuries?
information that  What
would be included treatment do
in an assessment you find most
of his wound. effective?
 Identify  How do you
appropriate attempt to
outcomes for this prevent
patient’s care plan. pressure
injuries in your
Apply the Concepts patients?
NCLEX-Style Review  Have you
Questions: Students incorporated
can use the NCLEX- any new
Style Review methods for
Questions to review treating
and practice for the pressure
NCLEX. injuries in your
care plan?
Spanish-English  What is the
Audio Glossary psychological
effect of
pressure
injuries on the
patient?

Clinical
Assignments

Page 16 of 37
Copyright © 2019 Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

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Work in pairs to
identify the
pressure points
on the body most
susceptible to the
development of a
pressure injury.
Devise positions
to alleviate
specific pressure
injuries and
eliminate the
effect of friction
and shearing
forces.

Test Generator
Questions
Use the test
generator
software to
identify questions
related
specifically to this
objective.

*Adaptive
Learning

Page 17 of 37
Copyright © 2019 Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

Lecture Outline Figures, Resources and In- Outside Instructor’s Notes


Tables, and Class Activities Assignments/Ev
Features aluation
Content Text PPT
pag slid
e(s) e(s)
Powered by
prepU
Individualized,
adaptive learning
through quizzing
and remediation
is available for
this chapter.

*Study Guide
IR, Instructor’s Resource; SR, Student’s Resource; PPT, PowerPoint (IR); *Premium content: additional purchase required.

Page 18 of 37
Copyright © 2019 Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

32.5 Accurately assess and document the condition of wounds.

Lecture Outline Figures, Resources and In- Outside Instructor’s


Tables, and Class Activities Assignments/Ev Notes
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 Teach your students to 106 32, Figures Pre-Lectures Written
use the nursing process 2– 36– 32-6 Incision Quizzes Assignments
for wound assessment. 106 37 with sutures, p. True/False Visit a health care
Discuss the techniques 4, 1064  Serosanguineous facility to assess
(inspection and 106 drainage, which is and document the
palpation) used to 8 32-7 Braden clear and watery, is condition of a
assess wounds and scale for composed primarily patient recovering
make other important predicting of the clear, serous from a serious
assessment pressure sore portion of the blood wound. Write a
observations (such as risk, p. 1065 and from serous brief report
the existence of membranes. discussing the
sutures, drains or 32-8 Pressure  There is no process of wound
tubes, manifestations of Ulcer Scale for standard frequency healing, the
complications). Healing (PUSH) for how often factors that affect
 Review the NANDA PUSH Tool 3.0, dressings should be this process, and
nursing diagnoses in p. 1067, PPT changed. the condition of
the textbook and slide 32 the wound
brainstorm with the Fill-in-the-Blank assessed.
class to develop a list of 32-19 Wound  Dead tissue that
possible diagnoses for and skin appears as dry, Make a list of the
patients with wounds. assessment/ black, and leathery type of blended
documentation is known as skills you will
tool, p. 1084 ________, which need to diagnose
delays wound and treat patients
32-20 Electronic healing. with alterations in
wound and skin skin integrity.

Page 19 of 37
Copyright © 2019 Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

Lecture Outline Figures, Resources and In- Outside Instructor’s


Tables, and Class Activities Assignments/Ev Notes
Features aluation
Content Text PPT
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assessment/ Case Studies
documentation You are a visiting Test Generator
tool, p. 1085 nurse caring for a 32- Questions
year-old writer who Use the test
Table became paraplegic as generator
32-4 Common a result of a software to
Types of Drains, motorcycle accident 1 identify questions
p. 1064 year ago. He is related
recovering from a specifically to this
Box subsequent objective.
32-4 RYB depression; your visits
Wound are to monitor not only *Adaptive
Classification, p. his emotional outlook Learning
976 but also to encourage Powered by
his hygienic self-care prepU
Focused and offer strategies for Individualized,
Assessment his success. He wears adaptive learning
Guide a leg bag and is through quizzing
Skin Integrity, incontinent of stool. and remediation
p. 974 You are monitoring a is available for
red spot on his left this chapter.
Guidelines for buttock, which has
Nursing progressed to a *Lippincott
32-1 Measuring pressure injury in DocuCare:
Wounds and which subcutaneous Fundamentals:
Pressure fat is visible. Wound Care:
Injuries, p. 975  Outline the Irwina
mechanisms that Russellinski

Page 20 of 37
Copyright © 2019 Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

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Features aluation
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Examples of contributed to the
NANDA-I development of the *Study Guide
Nursing pressure injury.
Diagnoses  What specific
Patient With a assessments should
Wound or be performed to
Pressure Injury, prevent formation
p. 980 of pressure
injuries?
Examples of  How would you
Nursing stage his pressure
Interventions injury?
and Nursing  Indicate the
Outcomes information that
Classifications would be included
(NIC/NOC) in an assessment of
Risk for his wound.
Impaired Skin  Identify appropriate
Integrity, p. 981 outcomes for this
patient’s care plan.
Promoting
Health Apply the Concepts
Literacy NCLEX-Style Review
In Patients With Questions: Students
Breast Cancer, can use the NCLEX-
p. 981 Style Review
Questions to review
and practice for the

Page 21 of 37
Copyright © 2019 Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

Lecture Outline Figures, Resources and In- Outside Instructor’s


Tables, and Class Activities Assignments/Ev Notes
Features aluation
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NCLEX.

Spanish-English
Audio Glossary
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Page 22 of 37
Copyright © 2019 Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

32.6 Provide nursing interventions to prevent pressure injuries.

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 Teach your students to 106 Guidelines for Discussion Topics Written
use the nursing process 1, Nursing Care Outline strategies to Assignments
to develop a care plan 106 32-2 prevent pressure injury Make a list of the
to prevent or minimize 4– Preventing development in type of blended
pressure injuries. 106 Pressure patients. skills you will
Explain to your 8-- Injuries, need to diagnose
students how to use 107 p. 1069 Case Studies and treat patients
risk assessment forms 0 You are a visiting nurse with alterations in
such as the Norton caring for a 32-year-old skin integrity.
scale and the Braden Skill writer who became
scale. 32-1 paraplegic as a result of Group
 Discuss the type of Preventing a motorcycle accident 1 Assignments
information that should Pressure year ago. He is Interview
be collected in a Injury, pp. recovering from a experienced
nursing history 1093--1096 subsequent depression; nurses in various
designed to assess for your visits are to health care
skin integrity. monitor not only his settings about
 Discuss nursing emotional outlook but their experience
interventions to prevent also to encourage his with caring for
injury to the skin and to hygienic self-care and patients with
promote optimal health. offer strategies for his pressure injuries.
success. He wears a leg Then, answer the
bag and is incontinent following related
of stool. You are questions and
monitoring a red spot share your
on his left buttock, findings in a class

Page 23 of 37
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Chapter 32, Skin Integrity and Wound Care

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which has progressed discussion:
to a pressure injury in  What types of
which subcutaneous fat patients may
is visible. be predisposed
 Outline the to the
mechanisms that condition?
contributed to the  What factors
development of the contribute to
pressure injury. the
 What specific development
assessments should of pressure
be performed to injuries?
prevent formation of  What
pressure injuries? treatment do
 How would you you find most
stage his pressure effective?
injury?  How do you
 Indicate the attempt to
information that prevent
would be included in pressure
an assessment of injuries in your
his wound. patients?
 Identify appropriate  Have you
outcomes for this incorporated
patient’s care plan. any new
methods for
Apply the Concepts treating
NCLEX-Style Review pressure

Page 24 of 37
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Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

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Questions: Students injuries in your
can use the NCLEX- care plan?
Style Review Questions  What is the
to review and practice psychological
for the NCLEX. effect of
pressure
Spanish-English injuries on the
Audio Glossary patient?

Interview
someone with a
skin alteration
regarding the
psychological
effects that
person is
experiencing as
well as the effect
of the wound on
the person’s
activities of daily
living. After
preparing a list of
possible effects,
identify nursing
interventions to
minimize these
complications. In

Page 25 of 37
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Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

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a class discussion,
express whether
you feel
comfortable
taking care of a
patient with a
skin alteration
and what you
could do to
improve your
skills in this area.

Clinical
Assignments
Work in pairs to
identify the
pressure points
on the body most
susceptible to the
development of a
pressure injury.
Devise positions
to alleviate
specific pressure
injuries and
eliminate the
effect of friction
and shearing

Page 26 of 37
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Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

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e(s) e
forces.

Web
Assignments
Search the
Internet for
nursing articles
discussing new
methods of
treating pressure
injuries. Identify
information
patients may
need to care for
their wounds at
home. Report
your findings to
the class.

Test Generator
Questions
Use the test
generator
software to
identify questions
related
specifically to this
objective.

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Chapter 32, Skin Integrity and Wound Care

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*Adaptive
Learning
Powered by
prepU
Individualized,
adaptive learning
through quizzing
and remediation
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this chapter.

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Page 28 of 37
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Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

32.7 Implement appropriate dressing changes for different kinds of wounds.

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 Describe the two 1071- 35– Figures Pre-Lecture Quizzes Group
methods of caring 1082 46 32-9 Surgical Fill-in-the-Blank Assignments
for wounds (closed pad applied as  Ties attached to an Interview someone
method and open last layer of adhesive backing to with a skin
method) and review wound dressing, hold dressings in alteration
when and why each p. 1071 place are known as regarding the
method is used. _____________ psychological
 Discuss the types 3-10 Precut straps. effects that the
and purposes of dressing placed person is
dressings available around surgical Apply the Concepts experiencing as
for wound healing. drain, p. 1072 NCLEX-Style Review well as the effect
Make sure the Questions: Students of the wound on
students understand 32-11 can use the NCLEX- the person’s
that the number and Transparent film Style Review activities of daily
types of dressings dressing placed Questions to review living. After
used depend on the on intravenous and practice for the preparing a list of
location and size of access site, p. NCLEX. possible effects,
the wound and the 1072 identify nursing
amount and type of Watch & Learn interventions to
drainage. 32-12 Videos minimize these
 Review the Hydrocolloid  Skin Integrity and complications. In a
procedure for dressing in place Wound Care: class discussion,
cleaning a wound on wound, p. Irrigating a Wound express whether
and changing a 1072 Using Sterile you feel
dressing. Technique comfortable taking
Demonstrate the 32-13 care of a patient

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Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

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procedure and have Techniques for Practice & Learn with a skin
the students applying various Interactive Case alteration and
practice it with a bandages, p. Studies what you could do
partner. 1078  Cleaning a Wound to improve your
 Discuss the use of and Applying skills in this area.
wound drains, 32-14 Sterile Dressing
tubes, and catheters Montgomery Clinical
and how to care for straps make it Spanish-English Assignments
them. possible to care Audio Glossary Your teacher will
 Review the for a wound provide a variety
procedure for without of bandages,
obtaining a wound removing binders, and/or
culture. adhesive strips other wound care
 Discuss the care of with each products. Take
open wounds, dressing turns
infected wounds, change, p. 1079 demonstrating
and chronic wounds. their use by
Review the color 32-15 Penrose applying them to a
classification system drain, p. 1079, partner while
for care of an open PPT slide 44 ensuring asepsis.
wound (RYB).
32-16 Jackson-- Test Generator
Pratt drain, p. Questions
1080, PPT slide Use the test
45 generator software
to identify
32-17 Hemovac questions related
drain, p. 1080 specifically to this

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Chapter 32, Skin Integrity and Wound Care

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objective.
32-18 Applying
Steri-Strips on *Adaptive
an incision, Learning
p. 1081 Powered by
prepU
Tables Individualized,
32-5 Examples adaptive learning
of Wound through quizzing
Dressings/Produ and remediation is
cts, available for this
pp. 1073, 1074 chapter.

32-6 Types of *Study Guide


Tape, p. 1076

Guidelines for
Nursing Care
32-3 Cleaning
Wounds, p.
1076

32-4 Applying
Bandages and
Binders, p. 1077

32-5 Removing
Staples and

Page 31 of 37
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Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

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Sutures, p.
1082

Skills
 32-1
Preventing
Pressure
Injury, pp.
1093–1096
 32-2
Cleaning a
Wound and
Applying a
Dressing
(General
Guidelines),
pp. 1096–
1101
 32-3
Performing
Irrigation of
a Wound, pp.
1101–1105
 32-4 Caring
for a

Page 32 of 37
Copyright © 2019 Wolters Kluwer
Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

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Jackson--
Pratt Drain,
pp. 1106–
1108
 32-5 Caring
for a
Hemovac
Drain, pp.
1109–1111
 32-6
Collecting a
Wound
Culture, pp.
1112–1116
 32-7
Applying
Negative
Pressure
Wound
Therapy, pp.
1116–1121

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Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

32.8 Provide information to patients and caregivers for self-care of wounds at home.

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 Review the methods for 108 47, Focused Apply the Concepts Web
obtaining dressing 3 48 Critical NCLEX-Style Review Assignments
supplies and Thinking Questions: Students Search the
reimbursement for Guide can use the NCLEX- Internet for
these supplies. Discuss 32-1 Wound Style Review nursing articles
infection prevention in Care: Questions to review discussing new
the home, and Promoting and practice for the methods of
interventions to Acceptance of NCLEX. treating pressure
promote wound Changes in injuries. Identify
healing. Body Image, p. Spanish-English information
 Discuss the following 1060 Audio Glossary patients may need
sentence: “Education is to care for their
a vital component in Teaching Tips wounds at home.
the treatment of 32-1 Wound Report your
pressure injuries.” What Care and findings to the
is the nurse's role in Healing, p. class.
educating the patient 1083
and family regarding Test Generator
management and Questions
treatment strategies? Use the test
generator software
to identify
questions related
specifically to this
objective.

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Chapter 32, Skin Integrity and Wound Care

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*Adaptive
Learning
Powered by
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Individualized,
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and remediation is
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Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

32.9 Apply hot and cold therapy effectively and safely.

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 Teach your students 108 49– Figure Apply the Concepts Web
how to apply heat and 1, 53 32-21 Cloth- NCLEX-Style Review Assignments
cold to a specific part or 108 wrapped ice Questions: Students Use the Internet to
all of a patient's body 7-- bag, p. 1089 can use the NCLEX- research the use
to bring about local or 108 Style Review of hot and cold
systemic change in 9– Guidelines for Questions to review therapy for
body temperature. 100 Nursing Care and practice for the bringing about a
Discuss the various 3 32-6 Assisting NCLEX. change in body
devices for applying With a Sitz temperature. Note
heat or cold. Bath, p. 1088 Spanish-English any new therapies
 Explain the physiologic Audio Glossary regarding this
effects of the Nursing Care practice, and
application of heat and plan report your
cold and the nursing 32-1 For Mary findings to the
care necessary for Biesicker, pp. class.
patients receiving heat 1091, 1092
and cold therapy. Test Generator
Features Questions
Concept map Use the test
displaying the generator software
nursing process to identify
for Lucius questions related
Everly, p. 1090 specifically to this
objective.
Skill
 32-8 *Adaptive

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Taylor, Lynn & Bartlett: Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition
Chapter 32, Skin Integrity and Wound Care

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Applying an Learning
External Powered by
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adaptive learning
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