You are admitting RS to home health for wound care. She is a 65 year old woman with a history of varicose veins and venous stasis ulcers. She has been trying to avoid going to the doctor until she qualified for Medicare, so she has been self treating with various creams, salves and bandages. She worked as a waitress for many years, but eventually had to retire from that due to her ulcers. She is 5’4″ tall and weighs 204 lbs. She has recently quit smoking, but smoked long enough to develop severe COPD. Between the COPD and the leg ulcers, she is limited in mobility, making her homebound. She keeps saying, “Well, at least I don’t have diabetes!”
Please discuss, in the comment section, the cause of this wound, the comorbidities, and your plan of care for her leg ulcer.
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?
Here is your first case study. You are to read it, look at the picture, and then discuss it in the comments section below.
Mrs. Smith is a 78 year old woman who was recently discharged from the hospital after an exacerbation of CHF. Mrs. Smith is incontinent, and while in the hospital her incontinence was managed by the use of disposable incontinence garments. Mrs. Smith can only get out of bed by transferring with the assist of one. You are admitting her to home health today. When you do her assessment, here is what you find.
Please discuss the probable cause of this skin condition, and what you would recommend for treatment.
You have arrived at the right place to find case studies for the Wound Care for Home Health Nurses class. There will be links to the correct case studies in the modules. You will interact with other nurses using the comment section of the post. The assignments will be assessments and treatment planning, so you will be able to discuss these things with the other nurses via the comments.