Mr. Schmidt is a 56 year old male patient who presented to theemergency department with complaints of left foot pain andswelling, fever and chills for 2-3 days. The client reportedincreasing discomfort to the foot with noticeable redness that alsoseems to be worsening. He has an ulcer to the dorsum of the leftfoot. The client noted that he was seen by his family physician aweek ago and a swab was done on the ulcer which came back positivefor Staphylococcus aureus bacteria. On assessment the clientappeared fatigued and tired. As the primary nurse you noted a foulodour from the wound with swelling & erythema to the left footand leg.
Past Medical History – Hypertension, high cholesterol, Type 2diabetes mellitus, TIA , Client admits to being non-compliant withhis medications
Skin & mucous membranes – Flushed and warm to touch, drymouth & mucous membranes
Respiratory – rapid deep respiratory rate
Extremities – warm and dry peripheries, rapid and strongpalpable peripheral pulses, a foot ulcer was noted to the dorsum ofleft foot, erythema was noted around the ulcer and involving theleft ankle & left lower leg, no ulcers noted to right foot peripheral pulses diminished to +1 in both feet, numbness andparaesthesia to both feet
Wound – foul odour from the wound, purulent exudate noted, swab positive for Staphylococcus aureus
1. What might have predisposed Mr. Schmidt to developinginfection in his left foot? 2. Why was the patient at risk fordeveloping an infection? Explain in detail usingpathophysiology.
