Braden Score: Case Studies 1 & 2

Case study # 1 75-year-old male with Non-Hodgkins lymphoma, Alert and oriented Height 5’9”, Weight 160 lbs.

Braden Score Moisture 3

Braden Score Activity 2

Braden Score Nutrition 2

Braden Score Friction/Shear 2

Braden Score Case Study # 2

Case study #2 Mrs. West is a 79- year old widowed female admitted to the nursing home after a right hip fracture. She lives alone. Her daughter lives close by and visits frequently.

Case study #2 Past Medical History includes: Hypertension DM Type II insulin dependent Anxiety Disorder Osteoarthritis

Case study #2 During hospitalization: Her anti-hypertension medications were restarted and adjusted. After surgical hip pinning, PT and OT were ordered on the first day post-op for exercises, ROM, transfer, and ADL training. She refused therapy due “I just don’t want to get out of bed yet”.

Case study #2 Post-Op day 1 PT reports that when she allows them to get her out of bed she requires assistance of two for safe transfers. OOB usually only once a day. Staff often find her slumped in the chair and have to put her back to bed.

Case study #2 She reports pain in right hip 5/10 and 2/10 in left knee from arthritis. She is refusing any pain meds , “its too much trouble for those little girls, they are busy.”

Case study #2 She only consumes 50% of her food at each meal. She able to feed herself. Her height and weight are: 63 inches (5 foot ,3 inches) 105 pounds

Case study #2 She is continent of urine but has occasionally has been found to be wet when staff have turned her.

Case study #2 Preferred position is supine with head of bed elevated with pillow under right leg.

Case study #2 Post-Op day Night shift nurse noted that there is a 1.0 CM X 2.0 cm non-blanchable reddened area on coccyx.

Case study #2 Discharge Day She is discharged to NH for PT/OT

Braden Score What is the total score?

Case study # 1 Spends most of the day in bed. Makes occasional slight changes in body or extremity position but unable to make frequent or significant changes independently. Occasionally slides down to foot of bed, requiring some assistance to move back to the top.

Case Study: # 2 Able to walk a short distance to the chair with assistance Hgb = 8.5, Serum Albumin 3.1

Case Study: # 2 Incontinent of stool Continent of urine – uses urinal as needed Skin occasionally moist from incontinence

Case Study # 2 Admitting Orders: Tube feeding formula 400cc q 4 hours per PEG Dietician consult for tube feeding recommendations Up in chair daily

Case study # 2 Using the Braden Scale, what is Mr. W.G.’s sensory perception score? 1 (Completely Limited) 2 (Very Limited) 3 (Slightly Limited) 4 (No Impairment)

Sensory Perception 4 (No Impairment)

Case study # 2 Using the Braden Scale, what is Mr. W.G.’s moisture score? 1 (Constantly Moist) 2 (Very Moist) 3 (Occasionally Moist) 4 (Rarely Moist)

Moisture 3 (Occasionally Moist)

Case study # 2 Using the Braden Scale, what is Mr. W.G.’s activity score? 1 (Bedfast) 2 (Chairfast) 3 (Walks Occasionally) 4 (Walks Frequently)

Activity 2 (Chair fast)

Using the Braden Scale, what is Mr. W.G.’s mobility score? 1 (Completely Immobile) 2 (Very Limited) 3 (Slightly Limited) 4 (No Limitations)

Mobility score 2 (Very Limited)

Using the Braden Scale, what is Mr. W.G.’s nutrition score? 1 (Very Poor) 2 (Probably Inadequate) 3 (Adequate) 4 (Excellent)

Nutrition 3 (Adequate)

Braden Score Sensory 4

Case study # 1 Using the Braden Scale, what is Mr. W.G.’s friction and shear score? 1 (Problem) 2 (Potential Problem) 3 (No Apparent Problem)

Friction and Shear 2 (Potential Problem)

Case study # 1 Based on Mr. W.G.’s total Braden Scale Score, indicate his level of risk for developing a pressure ulcer. 9 or less = Very high risk 10-12 = High risk 13-14 = Moderate risk 15-18 = Mild risk 19-23 = Generally not at risk

Based on Mr. W.G.’s total Braden Scale Score, indicate his level of risk for developing a pressure ulcer. 9 or less = Very high risk 10-12 = High risk 13-14 = Moderate risk 15-18 = Mild risk 19-23 = Generally not at risk