A 73-year-old male patient is transferred to the cardiac surgery unitfrom the cardiac intensive care unit (ICU). He had an aortic valve replacement with a mechanical valve and a two-vessel coronary artery bypass graft (CABG) 15 days ago, which was complicated by an intraoperative left cerebrovascular accident (CVA). His postsurgical course was complicated by delirium while he was in the intensive care unit, and he is now on Ativan around the clock. His nursing admission assessment documents that he was alert and oriented to person, time, and place and independent in all activities of daily living (ADLs). He has a past medical history of hypertension, atrial fibrillation, and congestive heart failure.On admission to the cardiac surgery unit, you note that he is oriented to person only, needs maximum assistance in ADLs, and needs a two-person assist to get out of bed to the chair and to the bedside commode, which means he is incontinent because it takes too long to get to the commode. The transfer summary states that he needs to be fed and that he consumes approximately 50% of his meals. The only significant changes in his medical condition are worsened CHF, requiring an increase in his diuretic. His medications include Lasix, digoxin, captopril, and Tylenol for pain. His skin assessment reveals the following: stage III pressure ulcer on his sacrum, eschar on left heel, and a right heel that feels “boggy” to touch. His Braden Scale score is 13. -Identify the factors that make this patient at high risk of developing pressure ulcers. -How often should this patient have skin assessments? -List the six risk factors that are part of the Braden Scale for Predicting Pressure Sore Risk. -Provide at least one nursing intervention that will address nutritional status, mobility, and positioning. Health Science Science NursingNUR 357
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