Question

1. A 32-year-old Asian American construction worker visits his primary care physician with a 2-inch cut on the anterior aspect of his right hand. He lacerated his hand while fixing a barbed-wire fence 5 days ago. He told his wife that he did not have time to go to his primary care provider for such a small cut. The primary care provider noted the wound bed to be erythemic, swollen, and with a small amount of purulent greenish drainage on the Band-Aid the wife had placed on cut. The patient had an oral temperature of 100°F. The primary care provider cleaned the wound, applied a clean dressing, administered Tdap, and called in a prescription for 10 day-courses of an antibiotic.
2. A 5-year old was playing on his family's farm when he accidently tripped over a fallen fence suffering a similar injury as the first patient. This child suffered a 2-inch cut to the anterior aspect of his right hand. His father cleaned the wound, covered the site, and made an appointment for the following week (about 3 days later) to see the pediatrician. The pediatrician examined the wound and noted the wound bed to be erythemic, swollen, and with a small amount of purulent drainage on the Band-Aid the father had placed on the cut. The patient had an oral temperature of 100°F. The primary care provider cleaned the wound, applied a clean dressing, administered dTAP, and called in a prescription for 10 day-course of an antibiotic.

• Identify some potential concerns based on the findings of the wounds and provide a rationale for the healthcare provider's treatment choices. Include the mechanism of wounds healing in your discussion. In addition, briefly discuss this individual's risk for shock and what type of shock he is at most risk for based on the information presented.

Answer 1

32 year old patient with cut injury with rhythmic, swollen with purulent discharge indicate infection, barbed wire carries the potential bacteria, because it contain the elements that may be rusted eduges there will be most chance for major infection. there is ann easy for germs to go inside the broken wound. germ spread into the tissue and cause infection. it causes rhythmic, swollen wound with purulent discharge. the patient is more prone to septicemia or septic shock if it is untreated. the bacteria that present inside the wound can spread into the blood and carry infection for the whole body and become inflamed. cleaning the wound and applied clean dressing can remove dead or infected tissues. antibiotic treatment for wound infection it takes 24 to 48 hours to start healing the infection by stopping fever and heal the erythematic area. Tdap is a tetanus,diphtheria and acellular pertussis vaccine. this vaccine should be given for the age of 2,4,6,15,18months and age between 4 to 6 years and 11 to 12 years and adults who are not had a tetanus shot within 10years must have a single dose of Tdap. it is recommended every 10 years. As an active immunization, this Tdap should be given for this patient for the immune system to make antibodies to kill infecting germ.
5year old patient wound more than half inches cut injury need attention when it is not healing well and increasing the area with purulent discharge, this patient has an infection due to cut wound. child dirty cut at 5 years needs a routine immunization.DTaP vaccine diphtheria, tetanus and acellular, pertusis recommdned only for child age less than 5years to make protection against  check the parents about the child the last vaccine records it tetanus shot given over 5 years age need a booster dose. electric fence convert of power energizer for standards electricity with strong wire between the post. it makes the chance for a child when contacting the fence the electric shock pass through the child. so there is a chance for electric shock.