Case Scenario: Mr George McFarlane is a 53-year-old Caucasian Male,...

Question Answered step-by-step Case Scenario: Mr George McFarlane is a 53-year-old Caucasian Male,… Case Scenario:Mr George McFarlane is a 53-year-old Caucasian Male, admitted to hospital after seeing his General Practitioner (GP) for an infected left (L) toe, caused by a blister/ lesion, possibly from ill-fitting shoes. When he realised there was a lesion present, he initially did not consider it serious and did not seek medical treatment straight away. After a week, the smell disturbed him, and he sought advice from his GP who prescribed oral antibiotics and stressed the importance of cleansing and changing the dressing on his wound regularly. Due to Mr McFarlane’s job which required being on the road for long hours at a time, these regular dressing changes did not occur. Subsequently, due to irregular dressing changes and Mr McFarlane’s Methicillin-resistant Staphylococcus Aureus (MRSA) status and Type II diabetes, the lesion failed to heal and became larger and deeper. Mr McFarlane returned to his GP five (5) weeks later. The GP immediately referred him to a specialist wound clinic. Investigations included a full blood count (FBC). The white blood cell (WBC) count was 17x 10?/L, predominantly neutrophils. The erythrocyte sedimentation rate (ESR) was 75mm/hr. An x-ray showed changes consistent with osteomyelitis. Mr George McFarlane was admitted to hospital for surgical debridement of his wound. A large amount of tissue was excised from his left foot, which resulted in amputation of all 5 toes. The wound was packed and placed on a suction wound dressing (negative-pressure wound therapy), to minimise the exudate at the wound surface and promote healing by granulation. Post-operatively, initially he did well. However, on the seventh day after surgery he became febrile and his diabetic control deteriorated. His left foot had swollen above the bandaging. The dressing was removed, there was tissue engorgement and cellulitis surrounding the wound and evidence of necrosis (as shown in the photograph below). Mr McFarlane has a Past Medical History (PMHx):· Type ll Diabetes needing close management· Osteoarthritis in L) Knee· Peripheral Vascular Disease (PVD)· Chronic Obstructive Pulmonary Disease (COPD)· Methicillin-resistant Staphylococcus Aureus (MRSA) positive· Peripheral neuropathy Social History (SHx):· Second marriage· Occupation- Long Haul truck driver· ETOH (Alcohol) usage on a regular basis· Smoker, averages 15/20 cigarettes per day· Often consumes take away/ fast food diet as away from home regularly Mr McFarlane’s current assessment consists of the following: · BP 135/85· RR 18 · SpO2 92% Room Air (RA) · HR 89 · Temp 38.2oC · BGL 13.8mmol, · U/A (Glucose ++, ketones+, protein +, SG 1010, PH 5) · Pain score 7 at rest · GCS 15 · Water low score of 15 (High Risk)Discuss what further education and preventative strategies would be required to reduce the risk of this scenario re-occurring to Mr. McFarlane. In your answer you should discuss members of the Multidisciplinary Team that you could engage with in order to access information for Mr McFarlane. Also discuss appropriate community referrals after discharge for Mr. McFarlane. Discuss, in your answer, areas including the following: a. prevention b. use of various treatments c. principles of and practices for person-focused nursing practice d. maintenance of positive life rolese. enabling change of a person’s behaviour over time to improve health outcomesf. establishing readiness for attitudinal and behavioural change Please also discuss which members of the Multidisciplinary team that you could engage with in order to access information for Mr McFarlane. Also discuss appropriate community referrals after discharge for Mr McFarlane. Health Science Science Nursing E.SCIENCE NUR211 Share QuestionEmailCopy link Comments (0)