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Medical Surgical Nursing
[A CASE STUDY OF A PATIENT WITH DIABETES RIGHT FOOT ULCER]
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4.6 DAILY NURSING CARE AND PROGRESS OF THE PATIENT
The objective of nursing management is directed towards
 To maining normal weight and strength
 To avoid relapse and encourage recovery
 To prevent complication with intensive management and health education
 Correcting the hyperglyceamia and glycosuria to establish and maintain metabolic control
DAILY NURSING CARE
 DAY ONE/ ADMISSION DAY (28 MARCH 2017)
Admission – patient was admitted into female medical ward (ward 2) via accident and emergency unit 30/3/2017. Patient and relatives where given warm reception in a well ventilated room
Patient data where collected and these include: name, age, sex, address, occupation and religion including particular of next of kin. They where cheerfully received into the ward by welcoming them and concern was shown about the patient condition. A bed was prepared with a neat linen and pillow and patient was assisted on it while patient relative where provided with 2 chairs
Psychological Care – patient and relatives where reassured and encourage to cooperate with the health team. Patient and relative complain was well listen to
Chemotherapy – the drug prescribed include insulin, vitamin B complex, nifedipine and right dosage where given to the patient at the right time
Position – she was positioned on right lateral position to rest the limb with ulcer Diet – patient was adviced on the type of diet she should take i.e low carbohydrate, high protein and low fat, high vitamin to aid quick recovery she was restricted from taking sugar and to minimized excessive intake of whole grain because of the glutein it contain.
Observation –vital sign was observed to know how the patient body is functioning . below are the reading obtain
ï¶ Temperature 37.20c
ï¶ Blood pressure 150/90mmHg
ï¶ Pulse rate 76b/m
ï¶ Respiration 22c/m
Urinary elimination – urinalysis was order for by the physician for laboratory investigation
DAY 2 (29/3/2017)
Observation vital sign were taking and recorded it read thus 36.50c pulse 72b/m respiration 20c/m blood pressure 140/90mmHg
Physical care patient was given assisted bathroom bath to improve personal hygiene and bed linen was properly made to give comfort
Medical Treatment – the prescribe drug was served as prescribed
Wound dressing- this is daily and condition of the wound is improving
DAY 4,5,6,
Patient was met in fair condition
Observation - vital sign were observe and recorded
Physical care, patient was given assisted bathroom bath oral/ mouth wash and bed linen was changed
Exercise- passive and active exercise was done on the patient limbs to present hypo static pneumonia and stiffness of the joint which may result from prolong staying on bed.
Health Education- the patient and the relatives are educated on the causes of the condition(diabetes foot ulcer).It was traced to genetic causes and likelyhood for other member of the family to develop diabetes.Emphasis was laid on the food to avoid.
Chemotherapy- Patient drug was served and chatted.This include tablet glucophage 500mg b.d, Tab captopril 25mg b.d, subcutenous soluble insulin 20i.u 8hourly.
Wound Dressing- Wound was healing fine.
DAY 7-12
There was improvement in the patient condition.
Observation- The observation was carried out from head to toe to detect any abnormality that patient might have developed, the skin colour was checked and was found to be normal,no paleness, the face was checked and does not look dranked,the tongue does not look raw,no oedema.Vital signs is then taken to assess her cardio-pulmonary function,this incude temperature 36Oc,pulse 84b\m,respiration 20c\m,blood pressure 160/100mmHg.
Physical Care- Patient was given assisted bathroom bath and changing of bed linen to provide physical comfort.
Diet- Prescribed diet was given which was prepared by the patient relatives.
PSYCHOLOGICAL CARE- Patient and her relatives are reassured .
MEDICATION- The prescribed drug were given according to physician prescription.
Wound Dressing- The patient wound was dressed with povidon,spirit and biodress and there was progress on the healing.
DAY 13-20
Observation-Patient vital sign was taken and recorded.There was mild progressing blood pressure of 130\90mmHg.
Physical Care- Patient was assisted on bathroom bath,oral hygiene to promote good appetite and to maintain personal hygiene.
Psychological Care-Patient question was well entertained and answered correctly with politeness.Patient and relatives were reassured on her condition.
Diet- Patient and relatives were reminded on the importance of adhering to prescribed diet in order to prevent relapse of the disease.
Wonnd Dressing- The wound was dressed with povidon iodine,spirit and boidress,she was asked to be visiting GOPD department at alternate day.
CHEMOTHERAPY- Patient was seen by the doctor during ward round,who then ordered for her discharge on with fairly good condition,she was placed on medication on discharge.Tablet glucophage 500mg b.d
To come for follow up care in two weeks time.
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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 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 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---
