Answer To: NRSG 258 Assessment Task 1Case ScenarioMrs Gina Bacci is a 49year old Italian lady (with poor...
Soumi answered on Apr 07 2021
Running Head: POST-OPERATIVE COMPLICATION IN WOUND HEALING 1
POST-OPERATIVE COMPLICATION IN WOUND HEALING 10
FACULTY OF HEALTH SCIENCES
School of Nursing Midwifery and Paramedicine
SEMESTER ONE, 2019
NRSG258: Principles of Nursing: Surgical
POST-OPERATIVE COMPLICATION IN WOUND HEALING
Table of Contents
Introduction 3
Q1. Pathophysiology and Causes of Patient’s Post-Operative Wound Status 3
Q2. Justifying and Rationalising Two Main Nursing Priorities of Care 5
Q3. Suitable Safe Nursing Management for Mrs Bacci 6
Conclusion 8
References 9
Introduction
Human body has a specific mechanism for the wound healing. This process is being divided into 3 stages, inflammatory, the proliferative and remodelings of wound. Regardless of the type ad cause of wound, these three stages are always constant in any kind of wound healing. Even during the post-operative wound healing the wound first undergo inflammation and then the further healing occurs staring from the edges of wound and reaching the centre. During later stages, collagen deposition and wound remodelling takes place, which covers the wound however, there are certain medical conditions, under which wound healing is impaired such as diabetes and peripheral vascular disease.
Q1. Pathophysiology and Causes of Patient’s Post-Operative Wound Status
Post-operative wounds require special care as the wound is open skin tissue, which can be easily attacked by bacteria, and they can cause infection, which does not allow the wound to heal. Further, after the first two stages of wound healing it is suggested that water or any other liquid application should be avoided in order to maintain the collagen fibril network. However, it has been found that surgical wounds often lead to secretion of some exudate from the corners. Secretion of this exudate presents complications in wound healing because it does not allow the wound to get dry and, thus, remodelling is inhibited (Mishriki, Law & Jeffery, 1990)
By examining the type of exudate secreted, reason and cause behind its secretion can be determined. Foertsch, Hoffmann, Ren, Stolar and Tuite (2016) explained several types of exudates that have been observed during wound healing and especially during the post-operative wound healing. Based on the character and type of exudate the reason behind its secretion can be easily identified.
In the presented case of Mrs. Bacci, there is secretion of serous exudate from the wound and that is further forming an island film along the incisional wound. Foertsch, Hoffmann, Ren, Stolar and Tuite (2016) mentioned that the release of serous exudate from the wound occurs due bacterial infection. As supported by Dhivya, Padma and Santhini (2015), serous exudate is clear, thin and watery fluid released from the wound. Further, release of serous exudate is necessary as it contains sugars, white blood cells and proteins that are required for wound healing.
However, normal or minimal secretion is acceptable but since, the current case presents that the dressing was completely wet. Therefore, this proves that the secretion rate of serous exudate is very high and also has high bio-burden that is high amount of harmful bacteria that causes infection. Mrs. Bacci also presents high blood glucose level as normal blood glucose level is 6-7mmol/L but in her case, it was 12.6mmol/L, which directly links to severe case of diabetes.
High blood glucose level is linked with impaired wound healing, as presented by Dreifke, Jayasuriya and Jayasuriya (2015), due to high blood glucose level the cell walls become rigid and tough and therefore do not allow proper blood and nutrient supply to the wound, due to this wound do not receive nascent oxygen also and this ultimately delays wound healing. This delay makes wound vulnerable to bacterial attack. Due to bacterial attack, there is secretion of serous exudate from the wound.
Another major complication that Mrs. Bacci presents is in the form of peripheral vascular disease or PVD. PVD is condition, in which blood supply to body parts other than brain and heart is affected. Wilcox,...