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Ronan Castronuevo

Independent Study Mentorship – Spring 2018


Mrs. Click
Some of the information and research is taken from
outside resources.
MY MENTOR Mentorship Site
Mrs. Cherry Abuy BSN Mainland Medical Center
• Works at Mainland Medical • Texas City
Center • Galveston County
• RN in the ICU
• 223 beds
• 6 operating rooms
• Studied at Mary Chile’s
College for 4 years

“Mainland Medical Center, 6801 Emmett Lowry Expressway, Texas City | Hospital in Texas City - Reviews.” Rate
Hospitals, www.ratehospitals.com/hospitals/texas-city/mainland-medical-center-14470/.
Course Description:
The Independent Study Mentorship (ISM) Advanced Academic course is designed for students wishing to mentor an adult professional in a
chosen career. With the mentor and the teacher-facilitator, each student will create a unique plan of study and receive individual
instruction. Students leave the high school campus and go to the mentor’s place of business to study with professionals. This course is ideal
for the self-motivated student with a passion for a particular area of study. ISM is a full year course. Students in this course must perform at
a collegiate or professional level. Students must provide their own transportation to mentorship sites. This course is recommended for
students in grades 11-12
Requirements:
1. Complete an in-depth mentorship/study in an area of interest (must be approved by ISM teacher)
2. Document a minimum of 3 hours of mentorship each week (Mentorship Activity Log)
3. Complete a Journal Entry each week documenting mentorship experiences (ISM Journal)
4. Complete an ISM Professional Portfolio (online format/Weebly) showcasing assignments completed during the course and the final
project
5. Complete all of the required assignments (See YAG and ISM Grading Sheet)
6. Complete a Mid-Term Presentation (must include PowerPoint or Prezi)
7. Develop a final product and presentation at the collegiate/professional level that is presented to a panel of graders at the conclusion
of the semester (must include PowerPoint, visuals, completed product, portfolio and handouts (See Product Guidelines section for
guidance). The final presentation will count as the FINAL EXAM Grade for this course. The grade is based on the Mentor’s Evaluation
50% and Grader Evaluations 25% each of the presentation.
What is it?
Nurses will be required to learn a variety of skills in order to provide care for a
patient—wound care is one of them. This topic will go over things such as assessing
open wounds, cleaning wounds, changing dressings, and controlling infections.
Why?
Whenever I go to the ICU for my mentorship days, I frequently encounter patients
with some sort of open wound, the most common being pressure ulcers. This is
because most of the patients are older, and they are much more susceptible to
ulcers. I often find myself helping my mentor with moving and holding the patient
on their side, while my mentor changes their dressings or assess it.
Current Event
Treating Trauma | Behind the curtain look inside Arkansas's only Level 1 Trauma Center

• My project goes over wound care, so the stories from the trauma center provides a perspective
of wound and trauma care at a high level.
• In the article, Laura Monteverdi with THV11 goes behind the scenes at the health care facility to
get a closer look at what it is like in the daily routine of the UAMS trauma unit, by interviewing a
variety of doctors and nurse.
• UAMS is classified as a level 1 trauma center; level 1 classification for trauma units indicate that
they provide the highest level of care possible for the most life-threatening conditions.
Open Wound – An injury involving an external or internal break in body tissue, usually
involving the skin
 There are four main types of wounds: abrasion wounds, laceration wounds,
puncture wounds, and avulsion wounds.
 An abrasion is caused by the rubbing or scraping of the skin on a rough or hard
surface—for example, a road rash.
 A laceration is considered a tear or deep cut in the skin tissue

“Home Remedies for Skin Abrasions.” YouTube, YouTube, 3 Sept. Labby, Mz. “PREPPING: Food Storage and Being Prepared
2015, www.youtube.com/watch?v=I9nYTjP9ORs. for Anything.” Pinterest, 20 Mar. 2013,
www.pinterest.com/pin/164733298842343913/.
 A puncture wound is a small opening caused by a narrow, pointed object.
 Avulsions are complete or partial tearing of the superficial skin from the deep
tissue.
 The main concern with open wounds is that they pose a high risk of infection.

“Tending to a Puncture Wound.” sc0rn3d, 1 Oct. 2013, Jithendran, N. “SKIN AVULSION MEDIAL ASPECT OF LEFT ANKLE.” CRUSH INJURY FOOT,
sc0rn3d.wordpress.com/2013/10/01/tending-to-a-puncture-wound/ LOWER LIMB INJURIES AND LIMB SALVAGE,
crushinjury.blogspot.com/2012/05/skin-avulsion-medial-aspect-of-left.html.
 A good way to remember wound assessment is with the HATT acronym.
History – Ensure you get a good history of the wound and cause of injury.
Anatomy – Clearly document the body part or location of the wound.
Tissue type – Identify the worst type of tissue damage and extent of the damage.
Touch/View – Document characteristics such as warmth, softness, firmness, etc.

“Medline NE1 Tool.” CIA Medical, Central Infusion Alliance, www.ciamedical.com/medline-


mscne1tool-box-tool-wound-assessment-ne1-100-bx-100-ea-bx.
https://www.youtube.com/watch?v=EWXeT7xwZMo&feature=youtu.be
 The integumentary layers, from superficial to deep, are: the epidermis, dermis,
and subcutaneous tissue.
 The four phases of wound healing are hemostasis, the inflammatory phase, the
proliferative phase, and the maturation phase.
 During hemostasis, the body tries to stem the bleeding in the injury by constricting
blood vessels and clotting with platelets.
 In the inflammatory phase, white blood cells travel to the wound and begin
digesting dead tissue, cell debris, and bacterial strands to prevent infection and
clean up the wound.
The proliferative phase, which includes granulation and epithelialization, usually lasts
2-3 weeks.
 Inflammation subsides, wound is clean, and new blood vessels form.

 Connective tissue forms at the edge of the wound, which are produced by
fibroblasts.
 Granulation tissue begins to fill the wound, while epithelial cells at the edge begin
to multiply and migrate across the wound to close it.
 The maturation phase can take up to two years to complete, where scar tissue
aligns its structure to increase durability.
Infection – The invasion of a susceptible host by pathogens or microorganisms
resulting in disease
 More than likely, a patient with an open wound will have some sort of infection as
a result of it, which will be treated with antibiotics.
 Necrotic or dead tissue is often a response to infections, but can also be from
toxins or trauma.
 The most effective way to manage infections is to wear PPE, or personal protective
equipment.
 These are gowns, masks/respirators, protective eyewear, and gloves.
 There are seven types of wound dressings and they are hydrocolloid, hydrogel,
alginate, collagen, foam, transparent, and cloth dressings.
 Select dressings based on the following criteria:

-Provides appropriate moisture -Comfortable


-Prevents infection -Doesn’t cause pain
-Conforms to applied area -Cost-effective
-Doesn’t damage the wound or surrounding skin
Appropriate care of the wound bed is essential for wounds to progress through the
healing phases.
 Keep skin intact and reduce any pressure/friction on the affected area.

 Devitalized tissue impedes the healing process and can contributes to infections.

 Retain a moist and clean environment in the wound, unless stated.

 Moist environments decrease pain and increases cell activity—speeding up the


healing process.
 Remove necrotic tissue from the wound through debridement.
It was a very enlightening experience during my time in mentorship at
Mainland Medical Center’s ICU. I was able to learn a lot from my mentor
and the nurses there, and to get a glimpse of the kind of job that nurses
and other medical professionals do for a living. Being able to help my
mentor and the staff care for their patients has been a rewarding
experience, that solidified my intent of becoming a nurse.
Mrs. Cherry Abuy – Mentor
Sara Thomas – Secondary Mentor
Mrs. Click – ISM Teacher
Mrs. Daffern
Mrs. Seghers
Tiffany Tran – Product
“Featured Products.” VataINC, VATA Anatomical Healthcare Models, www.vatainc.com/.
“Home Remedies for Skin Abrasions.” YouTube, YouTube, 3 Sept. 2015, www.youtube.com/watch?v=I9nYTjP9ORs.
Jithendran, N. “SKIN AVULSION MEDIAL ASPECT OF LEFT ANKLE.” CRUSH INJURY FOOT, LOWER LIMB INJURIES AND LIMB
SALVAGE, crushinjury.blogspot.com/2012/05/skin-avulsion-medial-aspect-of-left.html.
Labby, Mz. “PREPPING: Food Storage and Being Prepared for Anything.” Pinterest, 20 Mar. 2013,
www.pinterest.com/pin/164733298842343913/.
“Mainland Medical Center, 6801 Emmett Lowry Expressway, Texas City | Hospital in Texas City - Reviews.” Rate Hospitals,
www.ratehospitals.com/hospitals/texas-city/mainland-medical-center-14470/.
“Medline NE1 Tool.” CIA Medical, Central Infusion Alliance, www.ciamedical.com/medline-mscne1tool-box-tool-wound-
assessment-ne1-100-bx-100-ea-bx.
Monteverdi, Laura, and Lara Woloszyn. “Treating Trauma | Behind the Curtain Look inside Arkansas's Only Level 1 Trauma
Center.” KTHV, Tegna, 14 Feb. 2018, www.thv11.com/news/health/treating-trauma-behind-the-curtain-look-inside-
arkansass-only-level-1-trauma-center/517785384.
“Tending to a Puncture Wound.” sc0rn3d, 1 Oct. 2013, sc0rn3d.wordpress.com/2013/10/01/tending-to-a-puncture-wound/.