Question

The nurse is completing the admission assessment for an 87-year-old patient admitted for treatment of arterial ulcers in the lower extremities. Upon examination, the patient has areas of ulceration on both legs. The ulcers are small, circular, and deep with yellow drainage. The patient reports increased pain when ambulating, which usually decreases with rest. The following admission prescriptions were written for this patient: Vital signs every 4 hours Bed rest with bathroom privileges Consult to wound ostomy RN for wound management Amoxicillin 500 mg PO every 6 hours Correlate the patient’s clinical manifestations with the pathophysiology of arterial ulcers.

a.The wound ostomy RN consults the patient, and orders hydrocolloid dressings.

b. What is the rationale for this type of dressing?

c. What dietary teaching is indicated in this patient?

Answer 1

a. Arterial ulcers are the ulcere due to inadequate blood supply to the affected area.

Most commonlynoccur on lower legs and feet

It is also known as ischemic ulcer.

Pathophysiology: These are due to arterial insufficiency that is due to inadequate deliver of oxygen and nutrient to tissues. It occurs due to high blood pressure and atherosclerosis..

b Hydrocolloid dressings:These dressings provide moist and insulating healing environment which protects uninfected wounds.

It helps bodies own enzymes to heal wounds.

There is no need to change this dressing as often as other dressings..

These dressings contain gel forming agents inside a wafer of dressing. And have waterproof backing which is made of polyurethane.

These are useful for ulcers which are clean, uninfected.

c. Diet teaching: Ulcer healing requires proper nutrition Adequate balance of macro and micronutrients is important to support cellular activities that are necessary for repairing tissue.

Protein: adequate proteibis needed for platlet function, fibroblast proliferation, wound remodelling.

Carbohydrate: it is needed fir energy for tissue repair.

Lipid:for cell membranes stabilization.

Micronutrienta:

Vitamin A: For formation of granulation tissue, collagen synthesis, epithelialisation.

Vitamin C: for collagen synthesis.

Iron: for oxygen transport and antibody function

Adequate amount of fruits, vegetables, dietry fibres are required.