Pathophysiology and Nursing Management of Clients week 1,2,3,4 discussions

The case scenario provided will be used to answer the discussion questions that follow. Case Scenario 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: 5’ 2”; Weight: 184 lbs Laboratory Results  WBC 18.3 x 1012 / L; 80% neutrophils, 12% bands  Wound culture: Staphylococcus aureus Critical Thinking Questions 1. What clinical manifestations are present in Ms. G and what recommendations would you make for continued treatment? Provide rationale for your recommendations. 2. Identify the muscle groups likely to be affected by Ms. G's condition by referring to "ARC: Anatomy Resource Center." 3. 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. 4. What factors are present in this situation that could delay wound healing, and what precautions are required to prevent delayed wound healing? Explain. This patient presents with a left lower extremity (LLE) wound that is round, measuring 2 cm in diameter and 1 cm deep and draining a moderate amount of thick yellow drainage. The left leg is red from knee to ankle (moderate to severe infection) and there is 3” difference in diameter when measured at the location of the calf. Ms. G is also febrile and complains of a painful heavy leg. Ms G. has a wound that has become infected based on her clinical manifestations which are, 102-degree fever accompanied by chills and elevated white blood cell count. Her laboratory results also show elevated neutrophils with an increase in bands (immature neutrophils). The wound culture yielded that it was Staphylococcus aureus. Staphylococcal cellulitis should be treated with dicloxacillin (Dycill/Dynapen) 250-500mg four times a day. IV naficillin 1-2g every 4-6 hours respectively. Cephalosporins such as cephalothin(Kefin), cephalexin (Keflex), and cephradine (Velosef) are also effective in treating Staphylococcal cellulitis but not against MRSA. Moderate and severe infections as seen in Ms. G require vancomycin (a glycopeptide antibiotic) 1-2g IV every day or linezolid (Zyvox) 0.6g IV every 12 hours (Ferri, 2017). The wound is yellow and red in appearance, the concerning color would be the yellow as is signals the presence of slough. If the wound had more slough than granulation tissue (red), I would ask