George Esposito is a 79-year-old male admitted to a medicalward. George was taken to the emergency department by his daughterfollowing a fall at home. George tells the staff it was “nothingbut a bit of a dizzy spell”.
George lives alone and his daughter, Angela describes him as avery private man who prefers his own company. George owns his ownsmall weatherboard home on a small farm. He has tank water only atthe property. He has a vegetable garden, three chickens and hisJack Russel dog, Bella. George and Bella are inseparable.
George enjoys watching sport and news programs on television,loves a good strong cup of black tea with three teaspoons of sugarand chocolate biscuits. He likes to get up early and go to bedearly. He does not like the recent hot weather.
Angela visits once a week and has been dropping off his meals,but she reports he says that he has not been eating them recentlybecause he is not hungry, and things seem to get stuck in histhroat. She notes her father has lost weight in recent months andthere has been a significant decrease in his intake. She has beencleaning the bathroom and vacuuming the house when she visits,which her father has never let her do before but now seems happy tolet her.
Angela tells you “Dad just seems to have really slowed down – hehas always been such an active man, but he is just nothimself”.
George has chronic pain from osteoarthritis and suffers fromconstipation. Hearing loss is also becoming a significant issue forGeorge. He visits his GP once a year for his influenza vaccination,he takes no prescribed medication. His GP has spoken to Georgeabout analgesia and options to manage constipation, but he doesn’twant to ‘rattle with all those pills and potions’. He does takecastor oil for his constipation and paracetamol and aspirin for hispain, which he buys from the local supermarket on his weekly tripto the shops. George has not visited the dentist for over 25years.
George is a tall, thin gentleman (185cm and 53kg), he is pale,and his skin is dry, and you note poor skin turgor.
Question 7
Identify problems /issues & takeaction.
On day two of his admission, George has a fall in the bathroomand sustains a large skin tear to his right forearm (STARclassification 2b.). The wound is 14cm in length.
Question 7a. Short answer
- Can this skin tear be realigned? Yes or no, provide a briefrationale for your response.
- The first priority in the management of this skin tear is tocheck for signs of infection True or false, provide a briefrationale for your response.
(1/5 mark per question)
Question 7b. How could George’s skin tear havebeen prevented? (maximum 200 words) Ensure you support yourresponse with at least one scholarly source.
