Case Studies, Chapter 32, Skin Integrity and Wound Care

1. As nurse in a medicalsurgical unit in a hospital, you are caring for a 27-year-old

professional football player who underwent surgery to repair a compound fracture of his
femur. The surgery went smoothly and you are responsible for his postoperative care after he
returns from PACU.
a. What is his skins role in preventing infection before surgery?
b. Describe how you would expect his wound to heal.
c. Indicate factors that could affect the healing of his surgical wound.
d. For which complications would you monitor his wound?
e. Outline signs and symptoms that might indicate his wound is infected. In what
timeframe might they appear?
2. As a visiting nurse, you are caring for a 32-year-old writer who became paraplegic as a result
of a motorcycle accident 1 year ago. He is recovering from a subsequent depression, and
your visits are to monitor not only his emotional outlook but also to encourage his hygienic
self-care and offer strategies for his success. He wears a leg bag and is incontinent of stool,
and you are monitoring a red spot on his left buttock, which has progressed to a pressure
ulcer in which subcutaneous fat is visible.
a. In this case, outline the mechanisms that contributed to the development of the
pressure ulcer.
b. What specific assessments should be performed to prevent formation of pressure
ulcers?
c. How would you stage his pressure ulcer?
d. Indicate the information that would be included in an assessment of his wound.
e. Identify appropriate outcomes for this patients plan of care.