Signs and symptoms of hemorrhoids may include:

 Painless bleeding during bowel movements — you might notice

small amounts of bright red blood on your toilet tissue or in the
toilet

 Itching or irritation in your anal region

 Pain or discomfort

 Swelling around your anus

 A lump near your anus, which may be sensitive or painful (may be

a thrombosed hemorrhoid)

 Activities:
 • Remove dressing and adhesive tape
 • Shave the hair surrounding the affected area, as needed
 • Monitor characteristics of the wound, including drainage,
 color, size, and odor
 • Measure the wound bed, as appropriate
 • Remove embedded material (e.g., splinter, tick, glass, gravel,
 metal), as needed
 • Cleanse with normal saline or a nontoxic cleanser, as appropriate
 • Place affected area in a whirlpool bath, as appropriate
 • Provide incision site care, as needed
 • Administer skin ulcer care, as needed
 • Apply an appropriate ointment to the skin/lesion, as appropriate
 • Apply a dressing, appropriate for wound type
 • Reinforce the dressing, as needed
 • Maintain sterile dressing technique when doing wound care, as
 appropriate
 • Change dressing according to amount of exudate and drainage
 3660
 417
 W
 Wound Care: Burns (3661)
 • Inspect the wound with each dressing change
 • Regularly compare and record any changes in the wound
 • Position to avoid placing tension on the wound, as appropriate
 • Reposition patient at least every 2 hours, as appropriate
 • Encourage fluids, as appropriate
 • Refer to wound ostomy clinician, as appropriate
 • Refer to dietitian, as appropriate
 • Apply TENS (transcutaneous electrical nerve stimulation) unit
 for wound healing enhancement, as appropriate
 • Place pressure-relieving devices (i.e., low air-loss, foam, or gel
 mattresses; heel or elbow pads; chair cushion), as appropriate
 • Assist patient and family to obtain supplies
 • Instruct patient and family on storage and disposal of dressings
 and supplies
 • Instruct patient or family member(s) on wound care procedures
 • Instruct patient and family on signs and symptoms of infection
 • Document wound location, size, and appearance
 1st edition 1992; revised 2000, 2004
 Background Readings:
 Bryant, R. A. (2000). Acute and chronic wounds: Nursing management.
 St. Louis: Mosby.
 Dwyer, F. M., & Keeler, D. (1997). Protocols for wound management.
Nursing
 Management, 28(7), 45–49.
 Hall, P., & Schumann, L. (2001). Wound care: Meeting the challenge.
Journal
 of the American Academy of Nurse Practitioners, 13(6), 258–266.
 Thompson, J. (2000). A practical guide to wound care. RN, 63(1), 48–52.