Wound Care

78 Nurse to Nurse
— Use antifungal topical treatments such as Lotrimin 1%
with physician order and supervision
— Use acetic acid 0.25% on fungal rash; cools the itching
and burning
— Do not cover rashes with dressings.
If clothing is necessary in the area of the rash, advise
wearing 100% cotton.
Clothing and bedding must be washed in hot water
and white household vinegar added to the rinse cycle
(1–2 cups for large loads).
If using antifungals for foot rashes, the shoes must be
cleansed with acetic acid solution, allowed to dry in
direct sunlight, and recleansed after every use.
Use of an over-the-counter antifungal foot powder in
the shoes is also advisable.
— Physical therapy and occupational therapy referral
— Home rehabilitation program
— Restorative nursing program
Include nursing assistants and home health aides in
the POC for patient assistance with training, reporting,
and recording of results
— Medical social worker for assistance with cost of products
and durable medical equipment, psychosocial interventions,
and long-term planning
— Speech language pathologist referral for communication
and swallowing.
• Endocrine system: infection and basement membrane thickening
retards healing. Treatment includes
— Evaluation of blood sugars; fasting 90 mg/dL to 110 mg/dL
is the target range according to the American Association
of Clinical Endocrinologists (ACE) (http://www.aace.com/)
— Medical social worker referral for assistance with costs of
products and durable medical equipment, psychosocial
interventions, and long-term planning