HLTENN006: Diploma of Nursing - Wound Management Plan - Mrs Noel Case Study - Nursing Assignment Help

Assignment Task:

Task:
You are required to write an individualised wound management plan for 1 case scenarios above. For each scenario you are required to address all the points below: 

1. Holistic assessment of the patient that includes:

• medical history and examination of the patient and the wounds
• type of wounds with definition and the causes of wounds (i.e. injury, fungal infection, micro-organism, viral infection, disease, e.t.c).     
• any investigation re choired for the wound
• management principles

2. Evaluation of each type of wound :

• wound bed status (include colour/s) 
• wound characteristics
• wound measurements
• condition of surrounding skin (ie intact, breaking down) 
• wound exudate (colour, consistency, odour)
• any further assessment required

3. The expectation of healing process for each type of wound; taking into consideration the wound and any factors that may impact on the healing process (ie chronic health conditions, location of wound, infection, mobility, age, nutrition, etc). Provide the physiology of wound healing, a chain of infection (infection transmission, defences, immunity and host factors).

4. Wound management plan (for each type of wound), includes: 

• moist wound healing
• skin & risk assessment
• wound cleansing
• pressure support and relieving devices ( if there is a pressure injury what support can you give it pressure bed, elevate pressure bandage.
• prevention programs do on the pt to prevent progression nutria pressure position dressing 
• selection of wound dressing products (choose 1 product as a primary dressing for each wound).  Directly 
• secondary dressing (if required) on top of the primary 
• pain management timeframes appropriate to wound care (if required) managed because  regular basis healing could be delayed

    
5. Health education for the patient regarding the wound. (ie. nutrition, elimination, mobility and any preventative measures)

6. Pain management relating to the wound including:

• medication/s accurately discussed
• frequency and dose 
• justification for using a medication 
• patients education about pain management

Case Scenario

Mrs Noel is a 70 years old female patient, was referred with an acute abdomen, presenting with severe abdominal pain and tenderness, accompanied by an absence of bowel sounds and mild generalized abdominal swelling 1 month after a hysterectomy had been performed.
 
Mrs Noel had an exploratory surgery which revealed multiple abscesses which were drained. A surgical drain was placed within the abdominal cavity and the abdomen was closed with nylon sutures. Cultures of the abscesses showed Escherichia coli.

Seven days postoperatively, Mrs Noel developed an infection and wound dehiscence (see Picture 1). Because of her poor general condition, the surgeons decided to repair the abdominal wall using Split Thickness Skin Graft. The skin graft usually takes approximately 3 weeks to heal.

While in hospital, Mrs Noel had a burn injury 2nd degree from her hot coffee on her L) arm. She accidentally spilt it. Also, the patient developed a pressure ulcer stage 2 on her sacrum while in hospital.
 
The patient received intense supportive treatment postoperatively, intravenous antibiotics (metronidazole), nutritional support and meticulous wound care management under sterile precautions and close monitoring.
 
Mrs Noel was well enough to be discharged 5weeks later. A district nursing was arranged for a close supervision wound care management.

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