Case Studies, Chapter 32, Skin Integrity and Wound Care
1. As nurse in a medical–surgical unit in a hospital, you are caring for a 27-year-old professional football player who underwent surgery to repair a compound fracture of his femur. The surgery went smoothly and you are responsible for his postoperative care after he returns from PACU.
a. What is his skin’s role in preventing infection before surgery?
b. Describe how you would expect his wound to heal.
c. Indicate factors that could affect the healing of his surgical wound.
d. For which complications would you monitor his wound?
e. Outline signs and symptoms that might indicate his wound is infected. In what timeframe might they appear?
2. As a visiting nurse, you are caring for a 32-year-old writer who became paraplegic as a result of a motorcycle accident 1 year ago. He is recovering from a subsequent depression, and your visits are to monitor not only his emotional outlook but also to encourage his hygienic self-care and offer strategies for his success. He wears a leg bag and is incontinent of stool, and you are monitoring a red spot on his left buttock, which has progressed to a pressure ulcer in which subcutaneous fat is visible.
a. In this case, outline the mechanisms that contributed to the development of the pressure ulcer.
b. What specific assessments should be performed to prevent formation of pressure ulcers?
c. How would you stage his pressure ulcer?
d. Indicate the information that would be included in an assessment of his wound.
e. Identify appropriate outcomes for this patient’s plan of care.