Leg Ulcers

Chapter One *A Brief Overview of a venous Leg Ulcer *and the Assessment Process The defend must(prenominal) hold in the skills and knowledge to identify a venous leg ulcerationation. Dowsett (2005) believes that it is important that nurses and other health c be professionals look for the underlying shit of an ulcer.Whereas, the Royal College of cargon for (1998) has different views, and argues that, professionals who are fully trained in leg ulcer management should only be able to identify an underlying cause as it is easily mistaken that diagnosis of an arterial leg ulcer is made rather than venous which could cause serious treatment complications for the violate as come up as the longanimous. There are major problems associated with a venous leg ulcer such as, pain, loss of mobility, financial implications and often more which will be discussed in chapter 3.Leg ulcers appear as shallow holes or craters in which the tissue underneath is exposed. They can commute in siz e, discolouration and depth (National Health Service Direct 2008) (NHS). The clinical factors of a venous leg ulcer are, lipodermatosclerosis (champagne bottle shaped leg) ,which is cellulites alter the dermis and subcutaneous tissue (Finlay & Chowdhery, 2007), hyperpigmentation, derived red blood cells extravagated from dilated, leaky capillaries which produces areas of embrown discolouration (Brown & Burns, 2007).Atrophic Blanche, where interspersed by visible engorged capillaries seen as small red dots just below the surface of the skin (Moffat et al, 2007). However onward looking at the diligents wound it is the nurses role to look at the longanimous holistically and find out past medical checkup and family history as well as personal factor that could contribute to the condition (Moffat et al, 2007). There are essential details that the enduring can tell the nurse almost their ulcer and the factors that may contribute to this.Such factors are their full medical history these details should include varicose veins, diabetes, Deep Vein Thrombosis (DVT), earlier leg surgery and any family history of leg ulceration (Dougherty and lister 2004). The importance of this is that if a leg ulcer is diagnosed incorrectly, such as a venous ulcer being mistakenly diagnosed as an arterial ace can have serious complications for the patient and causing further delays in the ameliorate of the wound. Also the nurse must undertake baseline observations this includes, the patients w octad, height, blood pressure (BP), type O saturations levels, temperature nd respiratory rate, and similarly the patients nutritional intake, urine samples and routine blood tests such as glucose and haemoglobin levels must be arrive ated, as diabetes is present in approximately 5% of patients with leg ulcer (SIGN 1998). Murray (2004) also agrees with Dougherty & Lister (2004) & Bolton et al (2004) stating that that hyperglycaemia can have an effect in the wound healing do, as this can be linked with infection and decreased oxygen levels in the haemoglobin will slow down the healing process and go onto starve tissue. These factors are important to know as it plays a big part in the wound healing process.In clinical practice thesebasic observations are a vital part of information gained to watch safer patient care and early recognition of deterioration. The key factor in order to gain a thorough assessment it is essential that the nurse must have is communication and listening skills not only for this part but also for a nurse patient affinity. Dealey, (1994) believes that fear is iodine of the most common experiences a human can feel and a patients illness release many fears, in which health care professionals are unable to identify when not allowing the patient to express their needs freely.If the patient has a full understanding of their condition they are more seeming to comply with treatment regimes and have a more productive relationship with health care professionals (Anderson 2006). The RCN (2008) states, that the nurse-patient relationship is founded on trust. The nurse patient relationship allows the conversation to flow easy in order to gain a holistic approach to the patients care. The Code (2008) also agrees that as nurses we must listen to people in our care and respond to their concerns and preferences.Much search has taken place regarding nurse patient relationships, McCabe (2002) carried out a use up which aimed to explore and produce statements relating to the patients experiences of how nurses communicate. A qualitative phenomenological approach was used. This focuses on several(prenominal)s interpretations of experiences and ways in which they express them (Parahoo 1997), followed by unstructured questionnaires which were videotape recorded and lasted for approximately thirty minutes. The results found that four themes emerged, these were, lack of communication, attendance, empathy and friendly nurses.Therefo re the conclusions were that in contrast to the literature, nurses are not goodness at communicating with patients, however nurses can communicate well if the labour undertaken was a patient centred approach. Although research has taken place the limitations were that only eight patients participated, therefore this could reduce the validity and reliability of the study. Also with such a small sample the study could be used as a pilot study which could be replicated in the UK as this study was undertook in Ireland.