Assessment of Client The client is 84 years of age. Was well educated and is still and avid reader.

Client appears orientated to person, place and time during each encounter. Client has exceptional vocabulary and language usage and skills. The assessment of the clients motivation to learning is minimal, due to previous teachings during a total hip replacement in March of the same year. Need to review the signs and symptoms of infection, to ensure nothing has been overlooked or changed since the client was last in medical setting. Should also ensure that the information is in print form along with large print due to client being 84, wears glasses and also has Glaucoma. Teaching Plan: Goals First goal is to speak to client about the signs and symptoms of infection. Ask client to say the list of signs and symptoms back at end of teaching session, to ensure retention and explain that writer is providing them a written list of the signs and symptoms so that she has hard copy with her at home and that her spouse can read them as well. The large print is incase glasses are misplaced or that the clients glaucoma suddenly progresses and visual acuity decreases. Give the written list to the client and have them read them aloud. This reinforces the learning to long term memory and is an optical learning method verses auditory. Teaching plan: Intervention The first teaching method will be verbal, reciting the signs and symptoms to the client each day while in care to ensure the information has been retained to long term memory. Will supply the client with a written form of the signs and symptoms to take home for all family members to read and also send large print for client and husband. Husbands reading level unknown. Send home a page with pictures of each of the signs and symptoms. In the middle of teaching and at the end

ask client to repeat the list of signs and symptom back to ensure comprehension, this also becomes part of the active participation, to aid the client in feeling of control over her own recovery process. Will include the signs and symptoms in two different formats increasing the likelihood that one will be remembered. Also include in the signs and symptoms some basic wound care so that the wound does not become infected such as explain that showering is an excellent method to clean the site as the water and soap wash over the incision. Do not soak as in having a tub instead because the wound site will become soft and can then become a point of entry for infections. Explain that continued deep breathing exercises are beneficial to increase oxygen levels in body and that oxygen is essential for the promotion of wound healing, and even good nutrition will assist in the healing process. Teaching Plan: Evaluation My strategy to evaluating if the goals have been met or not is the client can verbally repeat the signs and symptoms back. They need not be in order or in medical terms, as long as the concept is correct. Instead of saying hot, edema, red, purulent drainage, and intensity of pain one can say, change in heat at site, more swelling, some drainage from site, and gets more sore. Both are correct. If the client can identify which leg is the infected one on the picture.

Signs and Symptoms of An Infected Surgical Incision Hot Incision: An infected incision may feel hot to the touch. This happens as the body sends infection fighting blood cells to the site of infection. Proper care of your surgical incision plays a significant role in preventing infection. Swelling/Hardening of the Incision: An infected incision may begin to harden as the tissue underneath are inflamed. The incision itself may begin to appear swollen or puffy as well. Redness: An incision that gets red, or has red streaks radiating from it to the surrounding skin may be infected. Some redness is normal at the incision site, but it should decrease over time, rather than becoming more red as the incision heals. Drainage From the Incision: Foul-smelling drainage or pus may begin to appear on an infected incision. It can range in color from blood-tinged to green, white or yellow. The drainage from an infected wound may also be thick, and in rare cases, chunky. Pain: Your pain should slowly and steadily diminish as you heal. If your pain level at the surgery site increases for no apparent reason, you may be developing an infection in the wound. It is normal for increased pain if you overdo it with activity or you decrease your pain

medication, but a significant and unexplained increase in pain should be discussed with your surgeon.

Hot DRoPS
The capital letters are the letters for the beginning of the words for signs and symptoms of infection.

Instructions
o

1
Watch for any signs of redness around a surgical wound within 3 to 10 days following surgery. In some cases, signs of infection, including redness in surrounding tissues, may not become apparent for weeks. Periodically examine the surgical site until the healing process has ended.

2
Sensations of pain are common in many surgical sites, but pain associated with infection may produce throbbing or intense, sharp pain. Such pain may also be accompanied by redness such as already mentioned, as well as a sensation of heat from the skin surrounding the wound area.

3
Examine the wound carefully for signs of pus or collection of fluids around the surgical site. Pus may be a white-yellowish-tinge, or even discolored. Often, an infected wound will emit a strong, unpleasant odor.

4
Watch for signs of red streaks leaving the wound site and traveling away from the incision. These streaks are definite signs that infection is traveling through the blood stream. Treatment for infections generally involves the use of antibiotics.

5
Take the temperature of the patient. In most cases, infection will be accompanied by mild to moderate temperatures. When left untreated, it may rise to dangerous levels. Fever may or may not be accompanied by chills.

Eating and drinking properly

Your body needs energy to heal quickly so it's important that you eat well. Your body will use a lot of energy, vitamins and protein when healing so make sure that you eat a balanced diet. You should also make sure that you drink enough water. If you're dehydrated, your wound may take longer to heal. It's important that you lose any excess weight before your operation, as being overweight can increase the time it takes for your wound to heal.

Bathing and showering

It's usually possible for you to have a bath or a shower about 48 hours after surgery, but this will depend on the particular operation you have ask your nurse at the hospital for advice. Some general points to remember are as follows.

Showering is preferable to bathing, so that your wound doesn't soak in water. Remove any dressing before you have a bath or shower, unless your doctor gives you different advice. Some dressings are waterproof and can be left in place. Don't use any soap, shower gel, body lotion, talcum powder or other bathing products directly over your healing wound. You can let the shower water gently splash on to your healing wound. However, don't rub the area, as this might be painful and could delay the healing process. Only have a bath if your wound can be kept out of the water. Don't soak the area as this might soften the scar tissue and re-open your wound. Dry the surrounding area carefully by patting it gently with a clean towel but allow your wound to air dry. If you had surgery on your face, don't wear make-up over the scar until it has fully healed.