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Patient Profile Kate G., a 23-year-old diabetic, is admitted to the hospital with cellulitis of her left lower leg. She had been applying heating pads to the leg for the last 48 hours, but the leg has become more painful and she has developed chilling. Subjective Data Complains of pain and heaviness in her leg States she cannot bear weight on her leg and has been in bed for 3 days Lives alone and has not had anyone to help her with meals Objective Data Physical examination Round, yellow-red, 2-cm diameter, 1-cm deep, open wound above the medial malleolus with moderate amount of thick yellow drainage. Left leg red from knee to ankle Calf measurement on left 3 in larger than right Temperature: 102°F (38.9°C) Height: 5’4″ (160 cm); weight 184 lb (83.7 kg) Labs WBC: 18,300 ul: neutrophils 80% bands 12% Height: 5’4″ (160 cm); weight 184 lb (83.7 kg) Labs WBC: 18,300 uL; neutrophils 80%; bands 12% Wound culture: Staphylococcus aureus Lab Reference Normal Values WBC: 4,500-11,000 uL Neutrophils: 50-70% ; Bands 0-5% Disease Information: Cellulitis Cellulitis is a bacterial infection, most commonly from streptococcus or staphylococcus, which enters through a break in the skin. It can occur anywhere on the body, but most often on the lower leg. It is important to treat it early as it can spread rapidly throughout the body. Left untreated, it can become a life-threatening infection of the blood and lymph nodes. Critical Thinking Questions 1. What clinical manifestations of inflammation are present in Kate? 2. What type of exudate is draining from the open wound? 3. What is significant of Kate’s WBC count and differential? 4. What factors are present in this situation that could delay wound healing?
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