Question

Scenario:

Mr. Smith is a 65-year-old man who presents to the ED with a complaint of pain in his left foot. He states, “I just don’t feel well. I was fine when I came back from Florida last week. My foot hurt a little, but I wasn’t worried about it. Now, the pain is becoming worse and I feel awful. I think I might have the flu”

Pt states his blood pressure normally is around 118/74 and his pulse is usually only 60 when he is resting. He states his current medication is:

• Glipizide (PO) BID before meals

The emergency room physician gives Mr. Smith a diagnosis of cellulitis of the left foot.

He orders:

• Levofloxacin ( IV)
• Tramadol ( PO)
• NovoLog insulin subcutaneous per sliding scale orders
• Elevate the left foot and apply warm aquathermia pad every 2 hours

Assessment:

Vitals: B/P 132/70, P 94, RR 24, Temp. 101.4◦F

Blood Glucose: 220mg/dl

HEENT: WNL

Respiratory: Tachypneic

Cardiac: Tachycardic, well perfused, +2 edema left ankle

Abdominal: WNL

Elimination: WNL

Integumentary: small laceration on the bottom of left foot, area surrounding is red and warm to touch. Redness is spreading up his left ankle into his calf. Multiple bruises ULE

Musculoskeletal: unsteady gait

Neuro: Oriented x 4

Question 1:

What is cellulitis? Explain to the patient the clinical manifestations of cellulitis and what likely caused it.

Question 2:

In priority order, identify at least three nursing diagnosis (including goals, and at least 3 nursing interventions)

Answer 1

Questions 1

Cellulitis is a common and sometimes painful bacterial skin infection.It may first appear as a red,swollen areas that feels hot and tender to touch.the redness and swelling can spread quickly.It most often affects the skin of the lower legs,although the infection can occur anywhere on person's body or face.Cellulitis usually happens on the surface of the skin,but it may also affect the tissues underneath.The infection can spread to lymph nodes and bloodstream.

Here the patient diagnosed cellulitis of left foot.Signs and symptoms here seen are small lacerations on the bottom of left food,area surrounding is red and warm to touch.redness is spreading up his left ankle into his calf.multiple bruises ULE.Take appropriate treatment in time otherwise it will spread to lymph nodes and bloodstream that condition is life threatening.

Question 2

Nursing Diagnosis

1.Acute pain related to irritation on the skin,impaired skin integrity,

2 Knowledge deficit

3..Axienty related to lack of knowledge about the disease

1.Nusing interventions for acute pain--Asses the skin for lesions,note presence of excoriations,erosions,fissures or thickening.Keep the area clean and dry.To limit pain advice the patient take a comfortable position and take bed rest.Advice to apply cold package if necessary.Advice him to take medications in proper time.

2.Nursing Interventions for knowldge deficit-Teaching give about the level of patient knowledge about this disease process.explain the pathophysiology and how it relates to anatomy and physiology in the right way.Describe the usual signs and symptoms ,identify possible causes.Provide information regarding thr current patient condition.Discuss treatment options.

3.Nursing interventions for anxiety-Asses the clients level of anxiety.Engage the patient to teach stress reduction techniques or relaxation techniques such as listening to music or watching TV.This will heip the client feel more relaxed until the pain can be reduced.Provide a calm environment.Give emotional support to the patient.