Case Study Essay Example

  • Category:
    Nursing
  • Document type:
    Case Study
  • Level:
    Undergraduate
  • Page:
    2
  • Words:
    1328

7Case Study

Case Study

Q1. By which intention would this wound heal and provide two reasons to explain.

Wound healing has been found to be a complex process that involving a highly regulated of cellular events and cascade of biochemical that is designed to restore body tissue following an injury (Lu, Saulis, Liu, Roy, Chao, Ledbetter, et al, 2005). The whole process involves human tissues repair and regeneration in response to tissue loss or damage (Collier, 2004).

The wound should be allowed to heal by secondary intention for the reasons that it has post-operative complications such as excessive drainage and wound dehiscence (Collier, 2004). Due to infections, it has made the wound to have smelly discharge. Therefore, the wound should be cleaned again and allowed to heal with formation of granulation tissues, contraction and eventual spontaneous migration of epithelial cells (Lu, Saulis, Liu, Roy, Chao, Ledbetter, et al, 2005).

Q2. Name three specific cells involved in wound healing. Describe the role each cell plays in wound healing

Three types of cells that are involved in wound healing process are:

  1. Mulder, Haberer & Jeter, 2006).Platelets (thrombocytes) cells, these types of cells help the blood to clot through formation of platelet plug. Also they help in promoting other blood clotting mechanisms. (

  2. surface of the wound, structure of these cells are made up of closely packed cells and ranged in layers (one or more layers). internal and externalEpithelial cells are used to cover or lining of all

  3. .Cohen, 2008)Myofibroblasts cells are used to establish the grip of the wound edges, in other words, they are capable of speeding wound repair by contracting the edges of the wound (

Q3. Explain the rationale for swabbing the wound

(Langemo, Anderson, Hanson, Hunter, Thompson & Posthauer, 2006). A swab is usually taken when the patient wound shows some signs of being infected. It includes; local heat; pain or tenderness; redness/erythema; oedema; inflammation; cellulitis; increased exudates; abscess/pus; purulent discharge; delayed healing or discoloration of wound bed. In the case study, the wound should be swabbed because the patient was experiencing pain, at same time his wound had a smelly discharged (Langemo, Anderson, Hanson, Hunter, Thompson & Posthauer, 2006). The patient wound is usually swab in order to develop a lab culture or specimen, will be used to establish the contributing organism, so that the patient can be given appropriate treatment

The rationale for swabbing should include one or a combination of the following:

Rationale 1: To ensure the tape will not detach

Rationale 2: To ensure all swabs including the x-ray detectable strip are seen by both the physician while a count is undertaken and any discrepancies identified.

Rationale 3: To prevent personnel exposure to potentially infectious material

Rationale 4: To establish a baseline reference for all subsequent counts

Rationale 5: To identify any retained items prior to closing the cavity

Rationale 6: To avoid a swab being retained in the wound inadvertently

. Rationale 7: To identify all items counted at the start of the procedure are present

Benzyl penicillin sodium 1.2 g every 6 hours IVI was prescribed). In our case study, after the swab the patient was prescribed with an appropriate medication to help the wound heal fast (

Q4. Name two possible sources of contamination of the wound and explain the mode of transmission of the microorganism from each source.

The two possible mode of transmission either through the hands of the nurses caring for the patient wound or from contact with inappropriate decontaminated surgical equipments during dressing of the wound. The environment in which the patient is can also be a source of contamination of the wound (Langemo, Anderson, Hanson, Hunter, Thompson & Posthauer, 2006).

In the environment, the mode of transmission can be through bacteria while through clinical procedure the mode of transmission can be through contacts, airborne spread or droplets. In our case study, the wound become infected via the hands of nurses who cleaned the patient, or the nurses used inappropriate decontaminated cleaning equipments (Langemo, Anderson, Hanson, Hunter, Thompson & Posthauer, 2006).

. Q5. Following confirmation that the microorganism infecting the wound was Escherichia coli, the drug was changed to Gentamicin sulfate. Explain why this drug was more appropriate

. Ueno, Hunt & Hopf, 2006)has been found to be resistant to penicillin (E. coli Gentamicin sulfate is active against many different types of bacteria such as Escherichia coli, Staphylococcus and Streptococcus, and Pseudomonas. Penicillin was not used in the treatment because Ueno, Hunt & Hopf, 2006). In other words, ( Gentamicin sulfate was used to treat Escherichia coli infection in the wound because it is easily absorbed by the wound

Discuss the mode of action of GentamicinQ6.

It mode of action is that it inhibits bacterial protein synthesis and this is through binding with the 30S ribosomal subunit, and this is through two different mechanisms (Spindler, Hale, Giddings, Hancock & Gill, 2011). In one mechanism, at low concentrations the amino acid codons will be misread by tRNA and proofreading is impaired. And this will lead to incorrect amino acid sequencing and nonsense proteins. In another mechanism, gentamicin will interfere with the correct amino acid elongation and polymerization, and usually take place at higher concentrations (Spindler, Hale, Giddings, Hancock & Gill, 2011). . is an important antibiotic that are bactericidal in action and have a broad-spectrum of activityaminoglycoside. AminoglycosidesGentamicin is an

. Ueno, Hunt & Hopf, 2006)(, these medicines belong to the same family- they are closely related- and have similar mode of action netilmicin, or kanamycin, amikacin, tobramycinThe adverse effect of Gentamicin medicine can cause serious nerve damage and kidney problem in a patient. While, alternative medications that can be used in the treatment of wound infection

Q7. Name two infection control measures that the nursing staff would have used during the dressing of the wound. Justify how each one breaks the chain of infection and relate it to the case study.

. Cohen, 2008)There are many ways in which micro-organisms can gain access during wound dressing. One such ways is through direct contact; this entails micro-organisms transfer from the hands of nurses. In our case study, the patient might have been infected through dirty hands of the nurses or equipment used during the procedure was dirty. In order to prevent such infections, nurses should make sure their hands and equipment used in dressing procedures is clean (

. Cohen, 2008) Other ways in which micro-organisms can be transfer into the wound is through self-contamination. This will involve physical migration from the patient’s skin into the wound. In our case study, the patient skin might have been infected, thus infecting the wound. To prevent such infections, nurses should make sure areas that are around the wound are cleaned to prevent self-contamination of the wound (

References

. Available at: Recognition and Management of Wound InfectionsCollier M.(2004).

http://www.worldwidewounds.com/2004/january/Collier/Management-of-Wound-

infections.html (accessed 24 May 2010).

Clinical . 1st ed. Yardley, PA: Oxford A Brief History of Wound HealingCohen IK.

Communications Inc; 2008.

Spindler, E. C., Hale, J. D. F., Giddings, T. H. Jr., Hancock, R. E. W., Gill, R. T. (2011).

Deciphering the Mode of Action of the Synthetic Antimicrobial Peptide Bac8c.

55: 1706-1716.Antimicrob. Agents Chemother.

. Nov 2000;54(9):590-3.Int J Clin PractKoveker GB. Growth factors in clinical practice.

. Jul-Aug Med Pregl Komarcevic A. [The modern approach to wound treatment].

2000; 53(7-8):363-8.

Langemo D, Anderson J, Hanson D, Hunter S, Thompson P, Posthauer ME. Nutritional

. Jul-Aug 2006; 19(6):297-8, 300, Adv Skin Wound Care considerations in wound care.

Plast Ueno C, Hunt TK, Hopf HW. Using physiology to improve surgical wound outcomes.

. Jun 2006; 117(7 Suppl):59S-71S. Reconstr Surg

Lu L, Saulis AS, Liu WR, Roy NK, Chao JD, Ledbetter S, et al. The temporal effects of anti-

TGF-beta1, 2, and 3 monoclonal antibody on wound healing and hypertrophic scar

. Sep 2005;201(3):391-7.J Am Coll Surg formation.

. 4th Pocket Guide to Chronic Wound RepairMulder GD, Haberer PA, Jeter KF, eds. Clinicians’

ed. Springhouse, PA: Springhouse Corporation; 2006:85.

Save Your Time for
More Important Things
Let us write or edit the article on your topic