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Case Study: Wound Care in the Home Setting Your client is a 79-year-old male living at home with his 84- year-old wife. You arrive at his home at 10:00 AM and his wife answers the door. Your patient appears disheveled, obese, and has trouble walking. You observe petal edema and a drainage soaked dressing to his left heel. He sits down in an electric recliner, there is a small pillow he uses to place under his foot. He states his foot is “more puffy” than usual and the wound is draining more than usual. Your client has a history of diabetes, PVD, 40-year history of smoking, and hypertension. On removal of his dressing you discover green foul drainage on the old dressing, and what appears to be a stage 3 pressure ulcer to his left heel Answer the following questions. 1. Describe the signs and symptoms of an infected stage 3 pressure ulcer. 2. Correlate the signs and symptoms of infection to the pathophysiology of the inflammatory response. 3. Identify factors in the patient’s history that increase his risk to wound infection and pressure ulcers. 4. Identify factors in the patient’s current condition that increases his risk to infection and pressure ulcers. 5. Identify the proper home health interventions for you client as a community nurse related to: a. physical environment b. safety c. education d. health care service e. wound care Answer the Review questions related to this case study Community Health 10-1
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