Clinical Manifestation and Recommendation for Continued Treatment
The clinical manifestations in Ms. G include the presence of skin and soft tissue infection which indicates a likely occurrence of cellulitis. The manifestations in the skin suggest erythema, edema and skin warmth. The sign is as a result of a breach in the surface as a barrier which develops due to the entry of bacteria through the skin (Stevens et al…, 2014). The presence of fever at 38.9 degrees is also a clinical manifestation. Cellulitis manifests by affecting the deeper dermis and the subcutaneous fat layers of the skin. The presence of the yellow drainage indicates cellulitis with purulence subjected to slow development and manifestation of symptoms after a few days (Raff & Kroshinsky, 2016). Critical symptoms include the fever chills, severe illness, headaches and inflammation.
Recommendations
• Examination of the interdigital toe spaces for fissuring or maceration. Assessment of the condition helps in the reduction of the likelihood of recurrent infections (Raff & Kroshinsky, 2016).
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• Perform a radiographic exam to determine the presence of skin swelling.it is advisable to perform differential diagnosis as cellulitis can be confused with other diseases and non-infectious sicknesses.
• Discovery of recurrent cellulitis warrants for serological testing to ensure the use of beta-hemolytic streptococci as a diagnostic tool. The in-depth test helps to prevent reinfection through the use of the anti-hyaluronidase test (AHT), or the Streptozyme antibody test which are more reliable (Stevens et al…, 2014).
According to ARC, the muscle groups affected during a cellulitis infection comprise the posterior compartment of the leg made up of the large muscle at the back of the leg (Wingfield, 2012). The muscles are commonly referred to as the calf of the leg. The calf is made up of two distinct muscles groups namely the tibialis anterior, flexor digitorum longus, and hallucis longus flexor (Wingfield, 2012). The muscles wrap around the medial malleolus as a small group of four muscles is also affected if the popliteal muscle located behind the knee joint.
The Significance of Subjective and Objective Provided Data Regarding Diagnosis, Laboratory Testing Education and Future Preventive Care
The subjective data refers to the symptoms as described by the patient. Subjective data reflects the feelings, concerns and personal interpretation of the patient condition (Stevens et al…, 2014). Subjective data provides a medical background for diagnosis outlining the reasons for the patient’s presence in the hospital or health care center. Ms. G complains of pain and heaviness in the leg which alerts the nurses of the vital signs to be included in her diagnosis. The inability to measure pain makes it an important fact when collecting subjective data as one of the critical signs which call for immediate attention and assessment.
Information on pain followed by observable behavior on the extent of the pain helps in determining medication as they vary depending on the degree of pain. She states that she is unable to bear the weight of the leg which translates to swelling and the nature of the affected muscles which marks the first point of assessment and observation (Stevens et al…, 2014). Her statement of being in bed for three days and living alone with no one to help with meals gives the nutritional background of the patient which is essential before medication.
Objective data refers to the observable and measurable data obtained through the assessment of the vital signs, through physical examination laboratory tests and diagnosis. It offers complete information on the patient conditions with no room for doubts and arguments. The presence of observable drainage and redness in the left leg red knee to ankle leads to narrowing down of the disease to a skin condition, the presence of the calf and the results of its measurement represents the presence of swelling and a palpable mass (Wingfield, 2012). The high temperature as an indication of fever and measuring the height and weight of the patient completes the diagnosis process that is informative of the cellulitis conditions and the necessary medical steps to be undertaken (Raff & Kroshinsky, 2016).
Factors Present to Delay Wound Healing
In cellulitis, conditions wound infection is indicated by factors such as erythema, edema, increased pain, fever and a change in drainage to a swelling nature. The presence of the common infection-causing bacteria is Staphylococcus aureus in Ms. G laboratory tests is likely to cause a delay in the healing of the wound. Also, cellulitis which is a bacterial infection of the subcutaneous layer of the skins and the dermal leads to systematic complications in the body (Stevens et al…, 2014). The immobility in Ms. G’s case where she has been in bed for three days increases the risk of delayed healing in her wound. Living alone and lack of proper nutrition and hydration combined with poor hygiene and poor circulation are factors that will contribute to the non-healing wound (Wingfield, 2012).
Precautions for Delayed Wound Healing
Non-healing wounds result in significant pain and discomfort to the patient, and it also has a psychological effect on the health of the patient due to their painful and physical appearance. Precaution must be taken when addressing delayed healing of wounds. The wound must be subjected to proper and immediate cleansing to reduce the high concentration of the bacteria which can result in expansion. The patient must maintain appropriate and balanced diet nutritional habits and stay hydrated (Raff & Kroshinsky, 2016). For cellulitis infections, oral antibiotics will be administered for healing and control of possible reinfection of the wound. Also, an appropriate dressing should be chosen, and it should allow a moist wound environment and keep the patient comfortable (Wingfield, 2012). The choice of proper care and a weight reduction plan for the wound should be initiated. The patient should be informed of appropriate care and management system to prevent further infection.
References
Raff A.B. & Kroshinsky D. (2016). Cellulitis: A Review . Journal of American Medical Association. Pp.316-325.
Stevens D.L., Bisno A.L., Chambers H.F. et al (2014). Practice guidelines for the diagnosis and management of skin and soft tissue infections. Infectious Diseases Society of America. Clinical Infections Disorders. Vol.59, Episode 10.
Wingfield C. (2012). Diagnosing and managing lower limb cellulitis . Nursing Times; Vol.108: chapter 27, pp.18-21.
