RG is 74 years old. He has a 14 year history of coronary artery disease. He underwent quadruple bypass surgery about a month ago. You are admitting him to home health for wound care.
He has developed some small ulcers on the tips of his 1st and 2nd toes. There is a scab on the tip of his third toe. You are unable to palpate a pedal pulse, and his foot feels cool to touch.
He has been suffering from depression, and has lost 20 lbs. in the last two months.
During your assessment, you find that he has smoked 1-2 pack a day since he was 20 years old. He quit a month before his surgery, but his wife says he had a few cigarettes since returning home.
In the comments below, please discuss the probable cause of his wound, and patient factors that you think will affect healing. How can you mitigate those?