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Medical Surgical Nursing
[A CASE STUDY OF A PATIENT WITH DIABETES RIGHT FOOT ULCER] -
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CHAPTER ONE
1.0 INTRODUCTION
1.1 BACKGROUND OF THE STUDY
This case study was carried on Alhaja A.H, a 60years old trader who has right foot ulcer, patient was brought to accident and emergency unit on 30th march, 2017 with clinical diagnosis of right foot ulcer and later transfer to ward 2.
Approximately 15 to 20 percent of estimated 16million persons in the united state with diabetes mellitus will be hospitalized with a foot complication and also estimated in Nigeria (Harrison, 2012).
Mustapha (2010) define diabetes mellitus as an endocrine disorder in which there is deficiency or lack of insulin production leading to metabolic disorder of carbohydrate, fat and protein and characterized by hyperglycemia, dehydrative vascular changes and neuropathy.
Foot ulcers are significant complication of diabetes mellitus and after precede lower- extremity amputation. The most frequent underlying etiologies are neuropathy, trauma, deformity, higher planter pressure and peripheral arterial disease. Thorough systemic evaluation and categorization of foot ulcer help guild appropriate treatment (Fryberg, 2011)
Foot disorder such as ulceration, infection and gangrene are the leading causes of hospitalization in patient with diabetes mellitus. Unfortunately many of those patients will require amputation with the foot or above the ankle as a consequence of severe infection or peripheral ischemia (Mustapha, 2011).
Approximately 85 percent of the diabetes – related lower extremity amputation are preceded by foot ulcer. Sharp debridement, management of underlying infection, and ischemia as well as relief of pressure using total contact cast, removable cast walker or half shoe are mainstay of initial treatment of diabetic foot ulcer. The aim of therapy should be early intervention to allow prompt healing of the lesion and prevent recurrence once it is healed. Multidisciplinary management programs that focus on prevention, education, regular foot examination, aggressive intervention and optimal use of significant reductions in the incidence of lower extremity amputation. (Fryberg,2011)
PURPOSE OF THE STUDY
 To critically look at concept of diabetes complication i.e. diabetes mellitus foot ulcer, causes, sign and symptoms, predisposing factor, prevention and management of the condition
 To provide adequate care for diabetic mellitus foot ulcer patient and prevent further complication that can arise from diabetes foot ulcer such as amputation and even death
 To increase knowledge in medical field from latest discovery and management of diabetes foot ulcer. Hence preventing or minimize the rate at which other complication arise
 To create awareness about the disease and health educate the people on how it can be detected and prevented
 To serves as an award of certificate in general nursing as required by the nursing and midwifery council of Nigeria
SIGNIFICANCE OF THE STUDY
The importance of this study cannot be overemphasized based on the following point
i. This care study provide patient the opportunity to have close access to health practitioner and hence benefitting from therapeutic health education
ii. It increase nurse-patient relationship by improving an individualized care for the patient
iii. It will serve as base line for further studies about diabetes mellitus foot ulcer and it will help in the reduction of mortality rate in patient with diabetes mellitus foot ulcer, thereby improving economic standard of the patient
iv. It provide information necessary to carryout research for junior nurse who might be faced with the challenge of care study in the course of his/her study
v. It enhances the nurse ability to give an appropriate health education to the people as the nurse is better equip with updated knowledge.
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TABLE OF CONTENTS - [ Total Page(s): 1 ]TABLE OF CONTENTTitle page Certification Dedication Acknowledgement Table of content CHAPTER ONE INTRODUCTION Background of the study Purpose of the study Significant of the study CHAPTER TWOLITERATURE REVIEW OF DIABETES MELLITUS FOOT ULCER Definition of diabetic foot ulcer Causes of diabetes foot ulcer Risk factor for diabetes foot ulcer Foot ulcer assessment and classification Pathophysiology of diabetes foot ulcer Clinical manifestation of diabetes foot ulcer Complication ... Continue reading---
CHAPTER TWO - [ Total Page(s): 7 ]CHAPTER TWOLITERATURE REVIEW OF DIABETES MELLITUS FOOT ULCER2.0 INTRODUCTIONThis chapter reviewed related literatures of diabetic foot ulcer based on the following sub-heading Definition of diabetic foot ulcer  Causes of diabetes foot ulcer  Risk factor of diabetic foot ulcer  Assessment and classification of Diabetic foot ulcer  Pathophysiology of Diabetic foot ulcer Clinical manifestation of diabetic foot ... Continue reading---
CHAPTER THREE - [ Total Page(s): 2 ]CHAPTER THREE3.1 DEMOGRAPHIC DATA AND HISTORY OF THE PATIENT Particular of a patient with diabetes mellitus foot ulcer  Name Alhaja A.H  Age 60years  Sex female Ethnicity Yoruba State of origin Kwara state  Folder number 01-31- ... Continue reading---
CHAPTER FOUR - [ Total Page(s): 4 ]CHAPTER FOURMANAGEMENT OF THE PATIENT WITH DIABETES MELLITUS4.0 PHYSICIAN SYSTEMIC REVIEW The findings made on the patient based on systemic review are as follows  PHYSICAL EXAMINATIONPhysical examination of the extremity having a diabetic ulcer can be divided into 3broad categories  Examination of the ulcer and the general condition of the extremity  Assessment of the possibility of vascular insufficiency  Assessment for the possib ... Continue reading---
CHAPTER FIVE - [ Total Page(s): 1 ]CHAPTER FIVESUMMARY, CONCLUSION AND RECOMMENDATION5.1 SUMMARY This care study was carried out on a 65years old woman Alhaja A.H who was admitted on 28th march 2017 in to the female medical ward (ward2) of the Kwara state general hospital Ilorin, with diagnosis of right foot ulcer secondary to diabetes mellitus Different literature was reviewed based on the patient condition under the following headings:- definition of the diabetes mellitus, causes, incidence, anatomy and physiology ... Continue reading---
REFRENCES - [ Total Page(s): 1 ]REFERENCEMustapha, R.O (2010) Pharmacology for all health profession. 3rd Edition, Ilorin, Gorge Bullet LTDRoss, J.S & Wilson, K.W.J (2010). Anatomy and Physiology in Health and Illness. 9th edition, London, Harrison, R.O (2011) Textbook for Medicine with Relevant Anatomy and Physiology. 2nd Edition, Bougary Suffolk, Chaucer press ... Continue reading---
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