The case scenario provided will be used to answer the discussion questions that

Question

The case scenario provided will be used to answer the discussion questions that follow. Case Scenario Ms. G., a 23-year-old diabetic, is admitted to the hospital with a cellulitis of her left lower leg. She has been applying heating pads to the leg for the last 48 hours, but the leg has become more painful and she has developed chilling. Subjective Data Complains of pain and heaviness in her leg. States she cannot bear weight on her leg and has been in bed for 3 days. Lives alone and has not had anyone to help her with meals. Objective Data Round, yellow-red, 2 cm diameter, 1 cm deep, open wound above medial malleolus with moderate amount of thick yellow drainage Left leg red from knee to ankle Calf measurement on left 3 in > than right Temperature: 38.9 degrees C Height: 160 cm; Weight: 83.7 kg Laboratory Results WBC 18.3 x 10¹² / L; 80% neutrophils, 12% bands Wound culture: Staphylococcus aureus Critical Thinking Questions What clinical manifestations are present in Ms. G and what recommendations would you make for continued treatment? Provide rationale for your recommendations. Identify the muscle groups likely to be affected by Ms. G's condition by referring to "ARC: Anatomy Resource Center." 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. What factors are present in this situation that could delay wound healing, and what precautions are required to prevent delayed wound healing? Explain.

Explanation / Answer

Ms. G is diabetic and having cellulitis in leg. The manifestations are pain, fever, chills, heaviness in leg, swelling, wound with drainage, redness in leg, inability to bear weight on left leg. This type of infectious cellulitis in case of diabetes is very harmful for patient. The recommended treatment is: debridement should be done and proper dressing to assist wound healing. The infection should be treated with antibiotic drug therapy intravenously. Analgesics should be used for pain management.

Muscles involved may be flexor digitorum longus muscle or soleus muscle because these muscles are present above media malleolus.

Subjective and objective data both are important in follow-up diagnostic/laboratory testing, education, and future preventative care. Subjective data about the complains of patient regarding the problem such as pain, heaviness, inability to bear weight etc. are helpful in deciding the laboratory testing to be done. It also helps in planning the treatment and educating the patient to overcome the manifestations.

Objective data such as height, weight, size and type of wound, are important to reach diagnosis by performing proper test procedure based on the data. The data is also helpful in taking preventive steps during care. Example, in this case the patient is having higher weight which must be considered during future care.

The factor which will delay wound healing is overweight. The weight of patient is 83.7 kg. A wound can be healed effectively if there is minimum load on it. But due to presence of higher weight, the load on wound will increase leading to delayed healing. To prevent this problem, precaution should be taken to avoid load on wound, pressure offloading device may be used to reduce the load of weight at particular area.

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