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NUR2447 Assignment 2: Wound Case Study
Margaret Brinley is a 69-year-old retired secretary living at home with her husband. They have three children and six grandchildren who live nearby.
Mrs. Brinley has suffered for many years with painful joints in her legs from osteoarthritis and poor mobility and sometimes uses a walking stick for support. She does little exercise and her weight has significantly increased in the last few years; she now weighs 90 kgs and is 160cm. She has a family history of heart disease. Her high blood pressure and cholesterol are slightly elevated but at this stage do not require medication. Mrs. Brinley says she drinks one to three whiskies each night and smokes 10 cigarettes a day. Mrs. Brinley and her husband do not like to cook, so they eat a lot of “quick meals” such as toasted cheese sandwiches or a can of soup.
Mrs. Brinley underwent an appendicectomy several weeks ago. Her appendix was inflamed and ruptured during the surgery. She returned to the ward with a 20cm suture wound, closed with staples. Mrs. Brinley was discharged after a week, with removal of the staples prior to going home. She was referred to the post-acute nursing program and commenced an outpatient rehabilitation program to promote her mobility.
Three weeks after surgery during one of the sessions at the physiotherapy department she complained of feeling “feverish” and had sharp pain over her suture line. She was transferred to the emergency department where they discovered that her suture line had started to separate and there was a large bulging area beneath the skin. The surgeon reviewed the wound and discovered an abscess that subsequently ruptured, revealing a cavity (depth 10mm). There was a large amount of purulent, offensive smelling exudate and the site was painful. Mrs. Brinley is going to be re-admitted to hospital for wound management, pain relief and antibiotic therapy.
- Age: 69 years
- Gender: Female
- Medical: osteoarthritis to both knees, mildly elevated blood pressure and cholesterol
- Allergies: surgical tape
- Surgery History: Appendicitis – surgery; previous abdominal hysterectomy
Medication at home:
- Panadol Osteo
NUR2447 – Case Study
Complete the case study under the section headings provided.
Section 1: Patient Assessment
- Describe your initial assessment of the patient, Mrs Brinley.
- Identify the physical and psychosocial factors that may have/had impact on Mrs Brinley’s wound, the breakdown and her ability for healing.
Section 2: Wound Assessment
- Discuss the wound, using the elements of T.I.M.E to describe the features/qualities
- Document your assessment findings on the wound management chart
- Identify the type of wound, providing rationales
Section 3: Management plan elements
Discuss the following factors related to the management required for this wound:
- Patient-centred approach: physical and psychosocial elements that need to be addressed
- Equipment, support (do not include wound products) or referrals that may be needed for management of the wound in hospital and later at home
- Wound products: complete the information required for the wound products table
|Wound products table
|1. Type of product2. Mode of action
|3. Rationale for use (or not) in this wound
- Word count: 1500 words
This assignment seeks to identify your understanding of wounds and wound management and does not require essay format: do not include introduction or conclusion. You should use headings, dot points or tables under the relevant sections.
Note that appropriate grammar, spelling and sentence structure remains important to promote clarity of your work. You must provide rationales and references for your responses.
- Submit via Moodle Drop box
- Marking Guide on Moodle
- Word doc only
- Use headings and dot points
- Double-spaced with 2.5cm margins
- File name for submission: (your) student number wound (penalty applies)
- References using current literature should be incorporated into all elements except completion of wound chart
- A minimum of 10 quality references is required
- Wikipedia references are not accepted