NURN 215 Stage IV Left Hip Ulcer of the Trochanter

NURN 215 Stage IV Left Hip Ulcer of the Trochanter

NURN 215 Stage IV Left Hip Ulcer of the Trochanter

Pathophysiology

Define and concisely explain the pathophysiology of the primary and secondary diagnoses or conditions.  Include 4 major signs and symptoms for

each diagnosis. Do not include extraneous information such as incidence, risk factors, predisposing conditions, treatments, etc.  If the diagnosis is surgical, briefly explain the surgical intervention and the underlying reason for the surgery.  Use a Med-Surg or Pathophysiology textbook.

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Primary Diagnosis(es): Stage IV Left Hip Ulcer of the Trochanter with flap repair.

Mr. G.C was status post left hip replacement about one year ago. The incision site did not heal properly due to a fall and the patient fell into a heater at home. Over time the incision site became a stage IV ulcer. The patient had a wound debridement and flap created to cover the open ulcer by a plastic surgeon Dr. Martin. The purpose of the reconstruction was to; improve hygiene and appearance, reduce fluid and protein loss, and prevent sepsis.

Signs and Symptoms: Change in skin color, Texture, and Temperature. Erythema, Peripheral Edema, and Drainage.

Priority Nursing Diagnosis Using your problem list from your nursing assessment, formulate the 3-part priority nursing diagnosis appropriate to your patient’s condition or needs. Provide rationale for the selection of this nursing diagnosis as the priority nursing diagnosis.	Outcome   Write a patient centered, measurable, realistic outcome that includes a target date.	Interventions	Scientific Rationale  Explain the scientific rationale for each nursing action that you have selected.  (Cite Source)	Evaluation of outcome Describe how the patient is progressing toward meeting the outcome. Use both subjective and objective data to help you evaluate your patient’s progress.
Diagnosis: Risk for impaired skin integrity related to physical immobilization AEB bedfast       Rationale: The patient is S/P left Hip Excision of the trochanter with flap repair. The patient can only reposition on his right side and back. The patient is also bedfast.	Patient will not show evidence of skin breakdown by projected discharge date of 12/14/2015.	1)                                                                   Sparks, S and Taylor, C. (2011) pg 305	1)                       Sparks, S and Taylor, C. (2011) pg 306	The patient is not progressing towards meeting the expected outcome. The patient is refusing to change positions as recommended and lays predominantly on his right side. Patient has developed erythema on right hip.

 

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