Problem
Case Study Scenario: Infected Surgical Wound
Ms Maggie Malone is an obese 52-year-old female, who was admitted to the orthopaedic ward for a total left knee replacement. Staples were the method of wound closure.
Ms Malones' medical history reveals that she is a heavy smoker, smoking at least 30 cigarettes / day and was diagnosed with Diabetes type 2 around 4 years ago, but has not been following a recommended diet.
Day 5 post-op: Maggie is complaining of pain in her left knee, she is febrile 38.7C and an increase in discharge from her wound on her dressings is apparent. On removal of the wound dressings, the wound appeared reddened and inflamed; staples are insitu; an open 1.3cm gap at the lower end of the wound was obvious and is oozing purulent fluid. A wound swab is taken and results show a Methicillin-resistant Staphylococcus aureus (MRSA) infection
On reading the surgeons' instructions: "Antibiotics to be commenced; Wound cavity to be dressed daily with Dressing as per directed by wound specialist
Ms Malone is reviewed by the wound management nurse who documented the following:
Nursing: Wound to heal by secondary intention. Wound cavity measures 13mm long x 10mm wide and 8mm deep, extending to the subcutaneous tissue layer. Wound bed consists of 100% granulation tissue; is malodorous and is oozing a moderate amount of haemopurulent exudate. Staples to remain insitu until day 10 post-op.
Develop a nursing plan of care for Ms Malone. Your care plan must follow a nursing problem solving approach using the table below
Give one nursing intervention for each problem stated below i.e. a total of 5 nursing interventions that you would put into place to assist Ms Malone with the following problems.
Support each intervention with a rationale/reason, evaluation and a reference
Problems:
1. the location of her wound
2. activities of daily living
3. reduced mobility
4. Pain.