NRSG 490 Interview and examine a digital patient to practice communication and physical assessment skills

NRSG 490 Interview and examine a digital patient to practice communication and physical assessment skills

NRSG 490 Interview and examine a digital patient to practice communication and physical assessment skills

Ms. Jones, the patient in the provided case study, is a 28-year-old African American woman who presents herself for treatment of a recent right foot injury. According to Ms. Jones, she slipped on concrete steps outdoors a week ago, twisting her right ankle and scraping the ball of her foot. The purpose of this paper is to determine the potential differential diagnoses for this patient and to justify them with evidence.

Localized infection of the right foot’s wound and severe right foot pain are the two potential nursing diagnoses. Since Tina Jones said that her right foot had an open wound, local infection of the wound is a possible diagnosis. There is purulent discharge coming from the red, painful, and damaged area. Additionally, the patient mentioned swelling around the foot wound. Pup frequently forms and there is swelling around the afflicted region after foot infections (Reina-Bueno et al., 2021). The patient also reports having a fever last night, with a temperature of 1020F, while having a temperature of 101.10F right now. A wound culture would be required for this patient. It would help by revealing details about the sort of bacteria that is developing in the foot wound. Clinicians may more precisely administer the right antibiotic therapy by isolating the microorganism.

The prevalence of antibiotic resistance is on the rise in the United States, particularly in the context of pustular diabetic foot infections. According to Atkin (2019), the prevalence of S. Aureus resistance poses a challenge in the treatment of diabetic foot ulcers. Therefore, healthcare providers should exercise caution and consider the type of bacteria present in the wound before administering therapy. Based on the patient’s symptomatic presentation, it may be advisable to initiate antibiotic therapy for the foot infection. Azithromycin is a potential antibiotic that could be initiated for the patient. Empirical evidence suggests that the cost-effective and readily available antibiotic has demonstrated efficacy in the treatment of cutaneous infections. As a nursing professional, my recommended course of action would involve cleansing the wound with a sterile saline solution, followed by the application of fresh gauze to cover the affected area. Finally, I would suggest the use of triple antibiotic cream to promote healing.

The research conducted by Lutter et al. (2019) also presents evidence-based guidelines for the treatment and care of diabetic foot infections. The research investigated a sequential process for managing infection in the foot of a patient with diabetes. The treatment process comprised four distinct steps, which involved employing diverse forms of debridement based on the nature of the wound, administering antibiotic therapy that was specifically aimed at the affected area, utilizing negative pressure healing, and performing reconstructive surgery. The treatment regimen exhibited remarkable outcomes in the management of foot infections in both the general population and those with diabetes mellitus-related foot infections.

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Another possible diagnosis is acute pain in the right foot. According to Lipsky et al. (2020), the pain in question

NRSG 490 Interview and examine a digital patient to practice communication and physical assessment skills
NRSG 490 Interview and examine a digital patient to practice communication and physical assessment skills

typically abates within a period of three to six months or is predominantly experienced in the soft tissues. Considering the patient’s report of an open laceration on their right foot accompanied by severe discomfort, it is a plausible diagnosis. The individual reported a pain rating of 7 out of 10 for discomfort in her leg, which she described as radiating. The female individual further expressed her incapacity to endure the excruciating pain beyond the present moment. Additionally, she asserts that the physical discomfort has impeded her mobility, ability to attend work and participate in academic coursework.

The patient purportedly utilized Tramadol for pain management. According to Reina-Bueno et al. (2021), Tramadol is a prevalent analgesic employed for the management of moderate to severe pain in patients. As a nurse, my recommendation would be to uphold Tina Jones’s current Tramadol pain medication regimen. As a nurse, I would perform manual manipulation on the affected area to alleviate tissue edema and stimulate the production of endorphins. Furthermore, I will employ hot and cold compresses. According to Lipsky et al. (2020), the application of cold to the affected area can effectively alleviate pain by regulating the conduction of pain signals and mitigating the production of pain-inducing substances. According to Lutter et al. (2019), the application of cold and compression is a common practice in post-surgical or acute injury cases to expedite functional recovery, alleviate discomfort, and reduce swelling.

References

‌Atkin, L. (2019). Chronic wounds: the challenges of appropriate management. British Journal of Community Nursing24(Sup9), S26–S32. https://doi.org/10.12968/bjcn.2019.24.sup9.s26

‌Lipsky, B. A., Senneville, É., Abbas, Z. G., Aragón‐Sánchez, J., Diggle, M., Embil, J. M., Kono, S., Lavery, L. A., Malone, M., Asten, S. A., Urbančič‐Rovan, V., & Peters, E. J. G. (2020). Guidelines on diagnosing and treating foot infection in persons with diabetes (IWGDF 2019 update). Diabetes/Metabolism Research and Reviews36(S1). https://doi.org/10.1002/dmrr.3280

‌Lutter, C., Schöffl, V., Hotfiel, T., Simon, M., & Maffulli, N. (2019). Compartment Syndrome of the Foot: An Evidence-Based Review. The Journal of Foot and Ankle Surgery58(4), 632–640. https://doi.org/10.1053/j.jfas.2018.12.026

Reina-Bueno, M., Munuera-Martínez, P. V., Pérez-García, S., Vázquez-Bautista, M. del C., Domínguez-Maldonado, G., & Palomo-Toucedo, I. C. (2021). Foot Pain and Morphofunctional Foot Disorders in Patients with Rheumatoid Arthritis: A Multicenter Cross-Sectional Study. International Journal of Environmental Research and Public Health18(9), 5042. https://doi.org/10.3390/ijerph18095042