Pathophysiologyand Nursing Management of Cellulitis
Pathophysiologyand Nursing Management of Cellulitis
Clinicalmanifestations present in Ms, G
Ms.G cellulitis clinical condition shows the manifestation of fever dueto the high temperature recorded. Other manifestations comprisesoreness, pain, swelling, redness, and incapability to bear weight.Signs of advanced infection as illustrated by WBC count and highneutrophils show the development of staph aureus meaning that thepatient has not had treatment in the past. The patient’s diabetesand associated neuropathy have probably aggravated the infection,which is fixed and compartmentalized to the leg.
Recommendationfor continued treatment
Hospitaladmission is highly recommended considering that the symptoms havealready advanced to severe, which is due to the extensive skininvolvement. As Sharp & Clark (2011) assert, the presence ofcomorbidities likely to complicate or delay healing creates the needfor acute care. Further investigation will be needed consideringsigns of deep vein thrombosis are already visible. Proper treatmentwill reduce further risk of cellulitis and recurrent episodes thatmay result to chronic oedema and lyphoedema. In addition, the woundneeds to be cleaned regularly and universal antibiotics adjusted toenable salutary dosages spread to the leg.
Beingelderly and diabetic makes Ms. G-susceptible to cellulitis than thegeneral population. This is due to impaired immune system and poorblood circulation in the legs. Imbalanced glucose in the body alsoallows bacteria to grow more rapidly in the affected tissue leadingto spread of the infection.
Musclegroups likely to be affected by the condition
Cellulitisaffects any areas of the skin on the body, but the legs are mostcommon. The infection affects the deep layer of skin especially thelayer of fat and tissue under the skin also referred to as thesubcutaneous tissues.
Implicationof the data provided
Furtherlaboratory and analytic testing
Furtherdiagnostics was necessary considering the visible signs ofdifferential diagnosis to prevent misperception and inappropriatediagnosis of cellulitis. Also follow up diagnosis revealedpre-existing conditions such as diabetes and oedema and revelation ofthe advancement of the condition. The data provided allowed foranalysis of the patient pre-existing condition, and revelation of thetype of bacteria that had advanced on the wound. The white bloodcells count indicated that the bacterial infection had advanced.
Simonsenet al. (2006) contend that day-to-day management of a condition andappropriate education are equally important thus, education shouldform an imperative component of the condition’s management. Thepatient should be informed about the care needed such as ensuring theskin is kept moist using unguents to prevent fissures. Patientsshould be advised of the importance to reduce physical activities toprevent irritation that may result to cellulitis. Patients should bestarted on oral antibiotics and with a review of five to seven days,contact an outpatient facility in case of features such as high bodytemperature, cellulitis in fluctuant areas, fast spreading redness,immense pain in joints and feeling nausea.
Itis important to increase awareness in both primary and acute care inregards to improved cellulitis diagnosis and management. Throughdedicated cellulitis service, diagnosis is faster, and the costs ofadministration and treatment are reduced. Wearing fitting shoes thatallow aeration is crucial in such a condition. When the skin breaks,carefully cleaning with soap and applying antibiotic cream isimportant. Pomar (2015) and Simonsen et al. (2006) advises that theopen wound should be covered with a bandage and ensure it is changeddaily. The patient should also be watchful for redness, pain andsigns of infections around the affected skin area. Proper awarenessof the appropriate care as related benefits on cost reduction. Thiswill ensure that the infected skin area remains protected fromfurther infections and pain is induced.
Factorsthat could delay wound healing
Thediabetic condition has an acute implication to acute and chronicwounds. Non-insulin dependent diabetes may slow down the healingprocess (Guo & DiPietro, 2010 Sharp & Clark, 2011).Age-related skin changes are also a factor to consider in regards todawdling healing. Wound infection causing pain can disrupt thehealing process. Glycaemic conditions are also correlated withimpaired wound healing in cellulitis conditions. Mousley (2003)asserts that patients with obesity, as it is highly associated withdiabetes type II characteristic, require nutritional assessment. Obesity also increases the risk of infections as adipose tissuesmaintain low nutritive blood supply. New wound edges fail to heal dueto increased tension especially on diabetic patients (Guo &DiPietro, 2010).
Thepatient should ensure a normal blood sugar level is maintainedthroughout the healing process. This should be through encouragingpatients to maintain target levels of glycated hemoglobin. Thepatients should also be involved in the healing process throughproviding the right information and support from the health careteam. Efforts to decrease oedema such as compresses dressing canimprove healing. Patients should protect the affected skin area fromany trauma to allow consistency in healing. The wet dressing is alsoa safe alternative. Inducing antibiotics systematically to preventsecondary infection is also important as precautionary effort (Guo &DiPietro, 2010). For obese patients, it is important to undertakedietary biochemical analysis such as albumin intensities to evaluatethe patient’s dietary status.
Mousley,M. (2003). Diabetesand its effect on wound healing and patient care.Retrieved 13 January 2016 from:http://www.nursingtimes.net/diabetes-and-its-effect-on-wound-healing-and-patient-care/205050.fullarticle
Guo,S. & DiPietro, L.A. (2010). Factors Affecting Wound Healing.Journalof Dental Research,89(3), 219-229.
Pomar,M.D (2015). Wound risk and prevention in obesity: The role ofnutrition. EWMAJournal,15(1), 7174.
Simonsen,E.S. et al. (2006). Cellulitis incidence in a defined population.Epidemiology Infection Journal,134(2), 293-299.
SharpA, & Clark J (2011). Diabetes and its effects on wound healing.NursingStandard.25(45), 41-47.