Topic 1 DQ 3

Please respond with a paragraph to the following post, add citations and references

It appears that Ms. G is experiencing symptoms related to lower extremity cellulitis; leg pain redness and swelling ( Mayo Clinic, 2018) . She has a temperature and complains of chills, along with an increased white count of 18.3 with 12% bands, indicative of an infection. She needs IV antibiotics and should be admitted to the hospital since she is unable to bear weight and lives alone. With the presence of Staph Aureus, I would suggest Vancomycin until sensitivities have resulted and MRSA is ruled out. Due to the swelling, a venous doppler study to rule out a DVT should be performed, since this could also be contributing to the diminished blood flow in the area. The muscle groups affected are above the medial malleolus where the wound is noted; soleus muscle, as well as the gastrocnemius and extensor digitorum longus muscles ( Anatomy Resource Center, n.d.) .

Subjective and objective data are both significant; piecing them together helps to create a clear starting point for her diagnosis. For example, this wound could be a diabetic ulceration or swelling caused by a DVT, but because she also presents with fever, chills, pain, and elevated WBC, so infection is suspected. Overall, diabetic patients have an outright higher risk of infection (American Diabetes Association, 2014). With the addition of positive Staph Aureus culture results, it completes the infection diagnosis, and treatment can be quickly initiated.

Follow up should include monitoring culture sensitivities to confirm correct antibiotic treatment, as well as tracking WBC count to verify that she is responding to therapy. To comparatively visualize the changes in observed redness, a black marker can be used to mark the perimeter of the affected area. She needs to be educated about the cellulitis diagnosis, risk of MRSA, with quality attention spent on controlling her blood sugar and how it affects her health. If available, a diabetic educator would be helpful in this situation, if she is receptive to further learning.

Neuropathies can be present, which can prevent the patient from knowing if they have a skin wound that needs to be tended to, leading to its unknowing advancement. Therefore, regular foot care and preventative assessments are crucial. Additionally, the disease itself can also delay wound healing, causing reduced blood flow and poor angiogenesis. Assessing extremity and pedal pulses would alert the caregiver if impaired arterial flow were present, requiring further studies. Because her wound is open and draining, an I&D would aide in mechanically removing infection, as well as a clear view of the amount of tissue damage.

American Diabetes Association. (2014). Retrieved from http://www.diabetes.org/living-with-diabetes/complications/skin-complications.html

Anatomy Resource Center.(n.d.). Retrieved from https://lc.gcumedia.com/bio155l/anatomy-resource-c…

Mayo Clinic. (2018). Retrieved from https://www.mayoclinic.org/diseases-conditions/cel…

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