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Medical Surgical Nursing
[A CASE STUDY OF A PATIENT WITH DIABETES RIGHT FOOT ULCER]
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By the end of 2-4days there is proliferation of epiderma cell and tissue forming cells called fibroblast approaching the wound to fill the gap formerly filled by demolished blood clot. this fibroblast can not multiply if the plasma protein is low, hence the importance of adequate intake of protein for efficient wound healing. The epiderma cell at this edge of the wound continue to proliferate and start to close up the wound under the scab. The protective scab start to slough off around the second day after epiderma cell might have sealed off the surface of the wound completely.
3. SCAR TISSUE FORMATION STAGE.
Tis occure between 5-14days.This is a stage of healing the injured tissue with fibrous connective tissue.As the phygocyte continues their function,the fibroblast i.e the precollagen fibres become converted to collagen fibres with the help of vitamin c.The collagen fibre help to reconstruct and strengthen the epidermal and dermal tissue.Tis finally lead to the formation of scar tissue.Maximum strengthen of scar tissue continue to form in the absence of tension that can reduce the scar tissue formation
The healing process continue over weeks until the damaged and repaired tissue has regained its former anatomical and function state.All wound heal rapidly where there is a good blood supply.
2.90 FACTORS INFLUECING WOUND HEALING IN A DIABETIC PATIENT.
Wound healing can be slow when the patient is diabetic .An important point to remember about a diabetic patient wound is that it heals slowly and can worsen rapidly,so requires close monitoring .The following are several factors that influence wound healing in a diabetic patient.
BLOOD GLUCOSE LEVEL
It all start here,an elevated blood sugar level stiffens the arteries and causes narrowing of the blood vessels .The effect of this are far reachen and including the origin of wound as well as risk factors to proper wound healing.
POOR CIRCULATION
Narrow blood vessel lead to decreased blood flow and oxygen to a wound. An elevated blood sugar level decrease the function of red blood cell that carry nutrient to the tissue.This lower the efficiency of white blood cell that fight infection.Without sufficient nutrient and oxygen,a wound heals slowly.
DIABETIC NEUROPATHY
When blood glucose level are uncontrolled,nerves in the body are affected and patient can develop a loss of sensation,this is called diabetic neuropathy.When there is a loss of sensation,patient can not feel a developing blister,infection or surgical wound problem.Because a diabetic pation may not be able to feel a change in the status of wound or the actual wound,The severity can progress and there may be complication.
IMMUNE SYSTEM DEFICIENCY
Diabetes lowers the efficiency of the immune system, the body defence system against infection. A high glucose level causes the immune cells to function ineffectively, which raises the risk of infectionfor the patient.
Studies indicate that a particular enzyme and hormone that the body produce in response to an elevated blood sugar are responsible for negatively impacting this immune system.
INFECTION
With a poorly functioning immune system, vdiabetes are a higher risk for developing an Infection. infection raises many health concern and also shows the overall healing process. Left untreated, infection can heighten the risk of developing gangrene, sepsis, or abone infection like osteomyelitis. According to statistics, diabetes is the number one reason for limb amputation in the world. (Harrison)
2.10 HOW TO IMPROVE DIABETES FOOT ULCER HEALING
There are several things a patient can do to improve wound healing .The most important thing is to control the blood sugar level. healing can be improved by taking these measures.
• Eating a healthy diet and maintaining good nutrition will help to regulate blood glucose level and also provide the essential vitamins and nutrient to enhance the healing process.
Adequate protein, carbohydrate and vitamin c intake are important factors to aid healing.
• Keep pressure off the wound to aid healing.
• Chronic inflammation is a common in many chronic disease, including diabetes. Engaging in regular aerobic exercise, chronic inflammation can be reduced. Exercise lower the blood sugar and also help with weight management, another factor in blood glucose level control.
• Avoidance of smoking to improve circulation and overall health.
• Cardiovascular heath is important to maintaining good circulation for both the healing existing wound and prevention of future wound development.
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ABSRACT - [ Total Page(s): 1 ]ABSTRACT IS COMING SOON ... Continue reading---
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 ONE - [ Total Page(s): 1 ]CHAPTER ONE1.0 INTRODUCTION1.1 BACKGROUND OF THE STUDYThis 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 (Har ... 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---
