APN108: Apply Nursing Practice - Implement and Monitor Care for a Person with Chronic Health Problems - Nursing Assignment Help

Assignment Task :

Task Instructions

To complete Assessment 1, Part B, you must respond to a number of questions based on the case scenario below. You are also required to complete a wound care assessment, develop a plan of care for the client and document using a clinical record on the assessment response template provided. These questions must be answered in full. When responding to the questions, please pay attention to the entire question being asked, as well as the prescribed word count, if provided. Use the correct medical terminology when assessing, reporting and recording data while answering all questions. Your answers should be reflective, analytical and based on critical assessments and the Enrolled Nurse standards for practice and Codes of Ethics for Nursing.

You will be assessed on the responses to the questions and will be deemed as either satisfactory or not satisfactory. ALL of the responses must be marked as satisfactory in order to pass the assessment. If your assessment is not deemed satisfactory, you will be re-assessed as per the THINK Education Assessment Policy for Vocational Education and Training (VET), before being awarded a Non Satisfactory mark for the assessment and the unit.

Case Scenario:

Mr George McFarlane is a 53 year old Caucasian Male, admitted to hospital after seeing his General Practitioner (GP) for an infected Left (L) toe, caused by a blister/ lesion, possibly from ill-fitting shoes. When Mr McFarlane realised there was a lesion present, he initially did not consider it serious and did not seek medical treatment straight away. After a week, the smell disturbed him and he sought advice from his General Practitioner (GP) who prescribed oral antibiotics and stressed the importance of cleansing and changing the dressing on his wound regularly. Due to Mr McFarlane’s job which required being on the road for long hours at a time, these regular dressing changes did not occur. Subsequently, due to irregular dressing changes, Mr McFarlane’s Methicillin-resistant Staphylococcus Aureus (MRSA) positive status and Type II diabetes, the lesion failed to heal and became larger and deeper. Mr McFarlane returned to his GP five (5) weeks later. The GP immediately referred him to a specialist wound clinic. Investigations included a full blood count (FBC). The white blood cell (WBC) count was 17x 10?/L, predominantly neutrophils. The erythrocyte sedimentation rate (ESR) was 75mm/hr. An x-ray showed changes consistent with osteomyelitis.

Mr George McFarlane was admitted to hospital for surgical debridement of his wound. A large amount of tissue was excised from his left foot, which resulted in amputation of all 5 toes. The wound was packed and placed on a suction wound dressing (negative-pressure wound therapy), to minimise the exudate at the wound surface and promote healing by granulation. Post-operatively, he initially did well. However, on the seventh day after surgery, he developed pyrexia and his diabetic control deteriorated. His left foot had swollen above the bandaging. The dressing was removed and there was tissue engorgement and cellulitis surrounding the wound and evidence of necrosis (as shown in the photograph below).

Mr McFarlane has a Past Medical History (PMHx):

• Type ll Diabetes needing close management

• Osteoarthritis in L) Knee

• Peripheral Vascular Disease (PVD)

• Chronic Obstructive Pulmonary Disease (COPD)

• Methicillin-resistant Staphylococcus Aureus (MRSA) positive 

• peripheral neuropathy

Social History (SHx):

• Second marriage

• Occupation - Long Haul truck driver

• ETOH (Alcohol) usage on a regular basis

• Smoker, averages 15/20 cigarettes per day

• Often consumes take away/ fast food diet as away from home regularly

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