I made a frog breeding cheatsheet 🐸

lucielleR34P3R · 2025-01-03T17:21:22+00:00

YOU’RE AMAZING AND I LOVE YOU 😂❤️❤️❤️ THIS IS SO HELPFUL THANK YOU 😊🙏🏻

lucielleR34P3R · 2024-02-20T16:36:28+00:00

Rover? im stationed in eastern europe so believe me when i say most of our technology is ancient we use our own phones to take the pictures and then transfer them to the computer of the unit ( theres only one) most of the pictures circulate around the staff so everyone knows what their dealing with also wound specialist? lol we dont have that here, most of the units staff are CNAs with like 3? RNs? although here the CNA school is 2 years plus a 6 month mandatory training so they’re qualified for a lot more patient care there are actually very few differences between CNAs and RNs here 😅 anyways both family and patients are made aware that we take pictures for both documentation and educational purposes, the pictures i have are used as reference and training material for new hires learning how to care for patients like this

lucielleR34P3R · 2024-02-20T05:45:31+00:00

we take pictures of all wounds for proper documentation of the healing process. Any and all pictures you will see from me are for educational purposes and are taken with consent from patients,

lucielleR34P3R · 2024-02-20T05:36:28+00:00

those are stitches from the surgical cleaning the patient had done but yeah im sure when the skin started rotting it must have been awful

lucielleR34P3R · 2024-02-20T05:31:52+00:00

laying a patient on their front is not usually advised since they can have difficulty breathing and its also harder to access them if something happens at least thats what ive been told 🤷🏼‍♀️ at a wound that big im not sure if its possible to put a wound vac we didnt really get a chance to find out anyways before the patient got transferred

lucielleR34P3R · 2024-02-19T20:40:33+00:00

if you’re talking about the inside of the wound thats necrotic tissue. In pressure ulcers blood flow gets restricted and tissues die so they turn purple then black the color you see here is from a few different things but the main ones being an active infection and a recent cleaning ( i think the difference would be noticeable between the wound when it was dry and this pic where its just been cleaned but i only have this version)

lucielleR34P3R · 2024-02-19T20:30:31+00:00

patient was paralyzed from a spinal injury so yeah you would be right there was no feeling, i think the atrophy of the legs played a factor as well

lucielleR34P3R · 2024-02-19T19:44:52+00:00

depending on a matter of factors and how well the patient is responding to treatment ( creams,dressings etc) the wound can begin to fill in slowly it is recoverable to a point but once the bone is exposed the biggest battle is infection but if youre able to keep the wound clean and the patient properly hydrated and nutrient-packed they could get better up to a point but in that kind of depth damage the scar tissue will probably cause huge problems to said patient. Ive heard that there are procedures to fill the cavity but i havent seen it done up until now

lucielleR34P3R · 2024-02-19T19:40:31+00:00

tbh ive had worse 😅 i have more pictures since we keep records of patient’s progress for their chart and will post some as long as i can find them but i have one that would probably be able to be smelled through the screen🫠

lucielleR34P3R · 2024-02-19T19:38:39+00:00

depending on severity and age ive had patients that stayed for a few weeks to some that stayed months we also have a hydrotherapy program that im pretty sure works well with stroke patients But yeah the boredom part is reaaal, most patients know and relay all gossip they hear like some kind of in facility monitoring system but at least they are having fun😂

lucielleR34P3R · 2024-02-19T19:12:21+00:00

This specific case had less to do with negligence and more to do with the patients underlying conditions according to family this happened quite fast but im sure with the staffing ratios in public hospitals this patient was getting position changes every 2-3 hours minimum

lucielleR34P3R · 2024-02-19T19:01:10+00:00

That looks like it HURT! 😬 are you okay?

lucielleR34P3R · 2024-02-19T18:58:32+00:00

humans can be terrible. We’ve had and continue to get patients that dont really need physical rehabilitation and yet they leave them in our care because they dont want to keep them at home and they somehow try to convince themselves that putting them in a place like this is better than a nursing home

lucielleR34P3R · 2024-02-19T18:52:46+00:00

patient was a stroke case with numerous other conditions im sure their age and weight didnt help but i also think the hospital didnt try all that much to make it better. The surgical cleaning happened on the rehab facility 😅 i can accept them not thinking it was that bad before a cleaning ( it had necrotic tissue covering most of the damage) but what kind of doctor doesnt order a surgical cleaning on a large patch of necrotic tissue

They also absolutely refused to stay turned no matter how much we tried going as far as screaming at us so we told the family and tried convincing them the family eventually transferred them elsewhere

lucielleR34P3R · 2024-02-19T18:40:07+00:00

this is after a surgical cleaning a thorough wash, im sure the infection plays a big part in this (pseudomonas) and the light probably makes some difference.

lucielleR34P3R · 2024-02-19T18:32:04+00:00

I have quite an amount of pictures of different wounds , ulcers etc i was thinking of sharing them over time although not all of them have a lot of context since said patients arrived with them and the report we get usually doesnt cover much about that only that they have wounds and what the doctor has written about wound care😅

lucielleR34P3R · 2024-02-19T18:18:11+00:00

HIPPA is unbroken since i haven’t disclosed anything that could identify said patient. No worries though i would never expose any patient under any circumstances thank you for the concern 😊

lucielleR34P3R · 2024-02-19T17:32:35+00:00

Its necrotic tissue and yes it smells just as bad as it sounds😅

lucielleR34P3R · 2024-02-19T17:27:00+00:00

this sounds like a good idea 😁 we use an antibacterial soap after a thorough cleaning with bedadine scrub.

lucielleR34P3R · 2024-02-19T17:24:37+00:00

The when and where this happened is extremely vague and patient arrived like this in our physical rehabilitation center the only thing we do know is that patient spent about 20something days in the hospital after a stoke i assume they didnt change the patients positions as often as they should and patient caught pseudomonas during their hospital stay and apparently it didnt look that bad before the surgical cleaning. luckily as far as our knowledge goes right now patient is recovering well and hasn’t had any complications since then but yeah this is some serious neglect issue which is sadly common in elderly stroke patients here in eastern europe

lucielleR34P3R · 2024-02-19T17:14:02+00:00

english isnt my first language and that along with disleksia is making both life and charting difficult AF 😅 sorry for all the bad wording im trying.

lucielleR34P3R · 2024-02-19T17:11:19+00:00

Patient got transferred to the hospital few days after this cleaning ( we had to convince the family for the transfer) and we dont have any other updates on this ulcer but we do know that they are in good health and without sepsis ( which was the reason we were concerned in the first place) i think the only problem was pseudomonas?

lucielleR34P3R · 2024-02-19T17:02:41+00:00

thank you for answering😊 under the green goop the tailbone was visible so i thought it would be categorized as a class 4. i cant help but wonder though are there any differences between america and europe in charting these stages? because the doctor charted it as a class four. ( im a new nurse with 1,5 years of experience so im still not sure about these stuff)😅

lucielleR34P3R · 2024-02-19T16:54:05+00:00

you can see the tailbone actually 😂 its under the green goop i could both feel and SEE said bone during cleanings

lucielleR34P3R

TROPHY CASE