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Wound Care vSimulation Reflection

Ferreira, B.

School of Nursing, Nipissing University

NSGD-2106-FA814: Clinical Practicum – RPN to BScN

Marion Nguyen-Huu

November 26, 2023

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Wound Care vSimulation Reflection

1. Consider what health teaching you would provide to your client to reduce the risk of

reoccurrence.

In my health teaching, I would provide steps to reduce the risk of reoccurrence of

venous ulcers. This would include the benefits of compression stockings, and how they

promote venous return (Tyerman et al., 2022). This would also include the use of leg

exercises to improve and promote blood flow to the lower extremities (Tyerman et al.,

2022). Since the patient is a diabetic, teaching would also include going over their care

plan for their diabetes, as uncontrolled diabetes is a risk factor of poor wound healing

(Tyerman et al., 2022). So, adhering to a strict medication regimen, proper diet (both to

manage blood glucose and high in protein to promote wound healing), and blood glucose

monitoring should be discussed as well (Tyerman et al., 2022). Health teaching should

also involve self-assessment of the patient’s skin, and the proper measures and actions to

take when breakdown is noticed (i.e. seeking medical attention), and the signs and

symptoms of infection (Tyerman et al., 2022). It should be stressed to the patient to take

action as soon as breakdown is noted so as not to prolong treatment and allow the

ulceration to progress (Tyerman et al., 2022).

2. What educational resources related to the care of a venous ulcer would you recommend

for a client with low literacy versus high literacy (college/university educated)?

For a client with lower literacy, I have noticed in my practice that the use of

images and videos is very helpful in communicating information and instructions. In this

case, I would use images and diagrams of the different stages of venous ulcers so the

patient is aware of the appearance and can identify them themselves. Also, peer-reviewed
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videos of wound care and dressings can be used to help teach the patient how to complete

their own dressing changes, in addition to in-person instruction on how their dressing is

changed, and using the teach-back method with nurse supervision. Whereas for clients

with higher literacy, I have used written lists of signs and symptoms, and lists of

instructions for dressing changes.

3. What did you learn from completing this simulation?

This simulation was a good reminder of wound care and dressings as I have not

had much personal experience in my current employment. One new thing I learned was

the use of the Ankle Brachial Index in assessing appropriate blood flow to the foot. I have

not heard of this measurement before, nor have I seen it in practice, so I have never had

any exposure to this method. The Ankle Brachial Index includes getting a doppler blood

pressure on both the arm and ankle and dividing the systolic pressure of the ankle by the

systolic pressure of the arm. I am not very familiar with the clinical interpretation of the

results of this test, so this is something I plan on researching more. I plan on doing this by

using Nipissing’s library to read up-to-date peer-reviewed articles on the interpretation of

results and clinical indications of these results in determining the appropriate treatment

plans.
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References

Tyerman, J., Cobbett, S., Harding, M. M., Kwong, J., Roberts, D., Hagler, D., & Reinisch, C.

(2022). Lewis's medical-surgical nursing in Canada: Assessment and management of

clinical problems (5th ed.). Elsevier.