Question

You are caring for a 58-year-old electrician admitted to your emergency room for purulent drainage from his incision site. He is a one-week post-CABG. His cardiologist reports positive blood cultures. Hospital admission reports no health insurance, and the patient shares he has been having difficulties paying for his medications. His wife is at the bedside.

Case Study Analysis Assignment Outline:

Introduction Brief overview of the pathophysiology of the disease.

Include: What lab abnormalities would you look for? What diagnostics would you expect to see? Give a rationale.

Implications for Self-Care How does this disease process impact the patient’s and/or their care provider’s ability to care for themselves?

Consider Maslow’s hierarchy of needs Application of Orem’s Theory of Self-Care. Patient Education Strategy Consider educational strategies and a plan of care for your patient based on the implications for the self-care section. Support with rationale.

Interdisciplinary Collaboration What interdisciplinary team members need to be included. Include rationale.

Consider nutrition, discharge, transition, and financial implications Conclusion

Answer 1

Answer:Patients who have cardiac surgery are at risk of sternal wound infection,which can be fatal in up to 40% of cases. It lengthens the hospital stays or /readmisson and increase the cost of surgery.The patient may require extended use of antibiotics and more surgeries such as debridement or flap closure of the chest

Pathophysiology: An infected wound is a localized defect or excavation of the skin or underlying soft tissue in which pathogenic organisms have invaded into viable tissue surrounding the wound.Infection of the wound triggers the body’s immune response,causing inflammation and tissue damage,as well as slowing the healing process.

Lab abnormalities will look for a Complete  Blood Count may show lukocytosis, positive blood culture report expect the presence of staphylococcus aureus or staphylococcus epidermis which are the causes of most sternal wound infection.

Expected diagnostics: Computed tomography or magnetic resonance imaging scan,and culture of wound and fluid if collection is present.

Rationale: To determine sternal separation,degree of soft-tissue inflammation,and presence of suspicions fluid collection. Wound culture for the presence of bacteria to determine SSI

Implications of self care: ADL in the areas of feeding,bathing/hygiene, dressing/grooming,and toileting.Patients are better able to recover when they maintain some independent over their own self care.

Orem’s theory of self care defined as the practice of activities that individuals initiate and perform on their own behalf in maintaining life,health and well being.

Setting priorities with Maslow’s theory of hierarchy safety,psychological needs  and financial needs.

Interdesiplinary team should include,nurses,physiotherapist, dieticians,resident doctors and social worker

Rationale: patient education on ADL,ambulation,nutritional needs, discharge pland financial needs.