Re:Topic 1 Mandatory Discussion Question
Ms. G is presenting with clinical manifestations consisting of a wound to her left medial malleolus with moderate amounts of thick yellow drainage, visible swelling to the calf which measures three inches greater than her right calf, and redness spanning from left knee to her ankle. Ms. G also presents with a temperature of 38.9 degrees (102 degrees Fahrenheit), chills, elevated WBC’s, a feeling of heaviness to the left leg, and a positive wound culture of Staphylococcus aureus all of which are suggestive of cellulitis. Cellulitis is an infection of the dermis and subcutaneous tissue arising secondary to an injury and is usually caused by the organism staphylococcus aureus (Gould, 2006). Recommendations for treatment would include intravenous antibiotics prescribed by the attending physician, immobilization and elevation of the affected leg to decrease swelling, a wound care consult by a WOCN for proper wound treatment and dressing change orders, DVT prophylaxis, blood sugar monitoring, daily lab work including blood cultures to check for a systemic infection and monitoring for a positive sepsis screening, nutritional consult for wound healing, and strict adherence to diabetic diet. A physician may order a venous ultrasound to rule out blood clots, as well as CT scan or MRI to assess the degree of infection and rule out osteomyelitis. Due to Ms. G’s immobility, obesity, degree of pain and swelling, poor circulation in affected leg, and diabetes, DVT prophylaxis may include anti-embolism stockings, sequentials, and chemical prophylaxis like heparin or lovenox. Foot pumps can be added if unable to tolerate the above on the affected leg. The ability of oxygen and nutrients to be deli...
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...t (National Diabetic Education Program, n.d.). Ms. G should be taught proper hand hygiene as well as wound care to prevent further infection or transfer of bacteria to open wounds. Ms. G should be educated on keeping and open wound clean and covered as well as off-loading pressure. Education should be provided in Ms. G’s native language utilizing teach back method for evaluating understanding and written instructions as well further reference.
American Diabetes Association. (2015). Living with diabetes: complications. Retrieved from http://www.diabetes.org/living-with-diabetes/complications/skin-complications.html
Anatomy Resource Center. (2013). Retrieved fromhttp://conhs.gcumedia.com/bio155/anatomy/arcBio155v2.swf
Gould, B. (2006). Pathophysiology for the health professionals (3rd ed.). Philadelphia, PA: Saunders Elsevier. ISBN-13:978-1-4160-0210-9
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