Question

Case 3 (I need answers typed please)

Patient: Err, Wanda

DOB: 10/27/1940

Medical Record Number: 01201631

Allergies: Morphine

Precautions: MRSA

Height: 5” 1

Weight: 40 kg

You are the nurse caring for Mrs. Err, a pt who is 4 days post-op from a knee replacement. While performing her dressing change, you note her incision is reddened and swollen, with a small open area. She is in continuous pain. You notify the provider who orders that the wound be cultured.

Two days later, the wound culture results return. The culture reveals bacterial growth; additionally, Mrs. Err’s morning labs indicate her WBCs are elevated. In the past 24 hours, her temperature has been as high as 39°C and her pain has worsened. The physician orders a CVC to be placed so Mrs. Err can receive long-term antibiotics.

Using the nursing process, plan care for Mrs. Err. Embellish your evaluative statements as needed.

PRIORITY PROBLEM #1 (Actual)                                PRIORITY PROBLEM #2 (Risk)

Diagnosis:                                                                   Diagnosis:

Outcome:                                                                    Outcome:

Interventions:                                                             Interventions:

Evaluation:                                                                  Evaluation:

Answer 1

Answer 1:

Diagnosis: Elevated WBCs indicate that their is serious infection in the body.

Outcome: The infection caused the wound to increase and lead to the bacterial growth.

Interventions: Antibiotic should be given and also emulgel for the relief.

Answer 2: Priority problem;

• Invasive procedures
• Pharmaceutical agents, like immunosuppressants
• Increased exposure to pathogens
• Compromised circulation
• Break in the integrity of the skin
• Chronic disease
• Rupture of amniotic membrane

Interventions: Patients with poor nutritional status may be anergic or unable to muster a cellular immune response to pathogens making them susceptible to infection.