Question

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. please include references

Answer 1

In the Ms. G s case the clinical manifestation presents are open wound with moderate amount of thick yellow discharge which appears to be skin abcess, redness, pain. heaviness in leg, WBS 18.3 X 10 which clearly indicates some bacterial infection. The other clinical manifestation appeared to be enlargement of lymphnode and edema as the patient was also complaining about heaviness in the leg.

The remommedation i would suggest in this case is go for prescription medicine like oral or injectable antibiotics,which will prescribed by physician, may need to undergo incision and drainage.

The muscle group involved in this case is gastrocnemius and soleus.

The significance of the subjective data provided here is helping to diagnose the patient. The data indicates that the patient is having bacterial infection which is spreading and as she is staying alone she need to be hospitalized to receive better treatment and to have assistance.

The significance of objective data is that it is providing the clear idea of causing bacteria for which specific antibiotic can be started. It is also suggesting that the infection is speading and these might be lymph node involvement.

WIth regard to follow-up the patient should undergo some routine investigation like blood glucose level and WBC blood count which can be usful to know the status of recovery. The patient should be educated to control and oversee her blood glucose level so that the healing is not delayed.

The factor mentioned here is the patient is diabetic which can delay the healing process. Therefore the patient should also need to obtain her blood glucose medication regularly and have a watch.