What clinical manifestations are present in Ms. G and what recommendations would you make for continued treatment? Provide rationale for your recommendations.
My recommendations for continued treatment would be:
Start antibiotics “Patients with diabetes mellitus are at increased risk of invasive S. aureus infections.” (Hakeem, L., Laing, R. et al, 2013).
Tylenol to reduce the fever.
Pain medicine should be administered as needed.
Order wound consult so that the wound can be assessed appropriately and recommendations for wound care can be made. The wound may require debridement in order to promote healing.
Elevate the legs to promote venous blood return and apply compression stocking to the other extremity.
Appropriate high protein diet to promote wound healing.
Case management should be consulted to start discharge plan.
2) Identify the muscle groups likely to be affected by Ms. G’s condition by referring to “ARC: Anatomy Resource Center.”
Muscle groups affected by Ms.G condition are: flexor hallucis longus, flexor digitorum longus, and tibialis anterior.
3) What is the significance of the subjective and objective data provided with regard to follow-up diagnostic/laboratory testing, education, and future preventative care? Provide rationale for your answer.
The subjective and objective data is vital in prevention of future worsening or recurring of infection. Information that MS. G presented with should be indication for future recommendations for her. With Ms. G’s young age and diabetes we know that she is more prone to have venous ulcers; therefore education and prevention will be crucial in her case. Understanding disease process, controlling her blood sugar level, proper diet with right amount of protein, weight loss and wearing compression stockings will be information that patient needs to be provided and followed up with.
4) What factors are present in this situation that could delay wound healing, and what precautions are required to prevent delayed wound healing? Explain.
The main factor present in this situation that could prevent wound healing is diabetes disease. “Healing problems are caused by the peripheral arterial diseases and peripheral neuropathy that can occur with diabetes”
Brem, H., Tomic-Canic, M, 2007). One of the characteristics of patients with diabetes is poor circulation, especially to extremities. Reduced amount of oxygen and nutrients delays healing. Ms G. needs consistent blood sugar control along with medication available for her to decrease high blood sugar. Another risk factor is that MS G. lives alone and does not have help with meal preparation. Proper diet high in protein is crucial in wound healing. Education along with case management involvement will be priority to ensure right nutrition.
Brem, H., & Tomic-Canic, M. (2007). Cellular and molecular basis of wound healing in diabetes. Journal of Clinical Investigation, 117(5), 1219–1222. http://doi.org/10.1172/JCI32169
Hakeem, L., Laing, R. et al (August 21, 2013). Invasive Staphylococcus aureus infections in diabetes mellitus.Retrieved from http://journals.sagepub.com/doi/abs/10.1177/1474651413500830#articleCitationDownloadContainer