Question

A. Chronic Pressure Ulcer – Stage 4

Your patient is a 47-year-old woman who has had a history of diabetes for the past 25 years, is a stroke survivor, and has congestive heart failure. She developed a stage 4 pressure ulcer following an above the knee amputation six months ago during her hospital stay. She lives at home with her daughter, who is a nurse, and also has home health care three days a week for dressing changes. Home health care is planned to last for only three weeks.

Wound etiology: Pressure ulcer, stage 4
Wound location: Coccyx
Thickness: Full
Size: 6×4×1.4cm
Undermining: 2–10 o’clock, 0.7cm
Wound tissue: 80% red granulation, 20% yellow fibrinous slough
Exudate: Heavy
Bioburden: Yes

What dressing order would you choose to benefit your patient most?

a. Cleanse wound with normal saline. Pat dry. Pack wound and undermining with calcium alginate. Cover with bordered foam three times a week.
b. Cleanse wound with normal saline. Pat dry. Pack wound with wet-to-dry dressing twice daily. Cover with abdominal pads. Secure with paper tape.
c. Cleanse wound with normal saline. Pat dry. Pack wound and undermining with silver alginate. Cover with bordered foam daily.

A. Chronic Pressure Ulcer – Stage 4

Your patient is a 47-year-old woman who has had a history of diabetes for the past 25 years, is a stroke survivor, and has congestive heart failure. She developed a stage 4 pressure ulcer following an above the knee amputation six months ago during her hospital stay. She lives at home with her daughter, who is a nurse, and also has home health care three days a week for dressing changes. Home health care is planned to last for only three weeks.

Wound etiology: Pressure ulcer, stage 4
Wound location: Coccyx
Thickness: Full
Size: 6×4×1.4cm
Undermining: 2–10 o’clock, 0.7cm
Wound tissue: 80% red granulation, 20% yellow fibrinous slough
Exudate: Heavy
Bioburden: Yes

What dressing order would you choose to benefit your patient most?

a. Cleanse wound with normal saline. Pat dry. Pack wound and undermining with calcium alginate. Cover with bordered foam three times a week.
b. Cleanse wound with normal saline. Pat dry. Pack wound with wet-to-dry dressing twice daily. Cover with abdominal pads. Secure with paper tape.
c. Cleanse wound with normal saline. Pat dry. Pack wound and undermining with silver alginate. Cover with bordered foam daily.

B. Chronic Diabetic Neuropathic Foot Ulcer

A. Chronic Pressure Ulcer – Stage 4

Your patient is a 47-year-old woman who has had a history of diabetes for the past 25 years, is a stroke survivor, and has congestive heart failure. She developed a stage 4 pressure ulcer following an above the knee amputation six months ago during her hospital stay. She lives at home with her daughter, who is a nurse, and also has home health care three days a week for dressing changes. Home health care is planned to last for only three weeks.

Wound etiology: Pressure ulcer, stage 4
Wound location: Coccyx
Thickness: Full
Size: 6×4×1.4cm
Undermining: 2–10 o’clock, 0.7cm
Wound tissue: 80% red granulation, 20% yellow fibrinous slough
Exudate: Heavy
Bioburden: Yes

What dressing order would you choose to benefit your patient most?

a. Cleanse wound with normal saline. Pat dry. Pack wound and undermining with calcium alginate. Cover with bordered foam three times a week.
b. Cleanse wound with normal saline. Pat dry. Pack wound with wet-to-dry dressing twice daily. Cover with abdominal pads. Secure with paper tape.
c. Cleanse wound with normal saline. Pat dry. Pack wound and undermining with silver alginate. Cover with bordered foam daily.

A. Chronic Pressure Ulcer – Stage 4

Your patient is a 47-year-old woman who has had a history of diabetes for the past 25 years, is a stroke survivor, and has congestive heart failure. She developed a stage 4 pressure ulcer following an above the knee amputation six months ago during her hospital stay. She lives at home with her daughter, who is a nurse, and also has home health care three days a week for dressing changes. Home health care is planned to last for only three weeks.

Wound etiology: Pressure ulcer, stage 4
Wound location: Coccyx
Thickness: Full
Size: 6×4×1.4cm
Undermining: 2–10 o’clock, 0.7cm
Wound tissue: 80% red granulation, 20% yellow fibrinous slough
Exudate: Heavy
Bioburden: Yes

What dressing order would you choose to benefit your patient most?

a. Cleanse wound with normal saline. Pat dry. Pack wound and undermining with calcium alginate. Cover with bordered foam three times a week.
b. Cleanse wound with normal saline. Pat dry. Pack wound with wet-to-dry dressing twice daily. Cover with abdominal pads. Secure with paper tape.
c. Cleanse wound with normal saline. Pat dry. Pack wound and undermining with silver alginate. Cover with bordered foam daily.

B. Chronic Diabetic Neuropathic Foot Ulcer

A. Chronic Pressure Ulcer – Stage 4

Your patient is a 47-year-old woman who has had a history of diabetes for the past 25 years, is a stroke survivor, and has congestive heart failure. She developed a stage 4 pressure ulcer following an above the knee amputation six months ago during her hospital stay. She lives at home with her daughter, who is a nurse, and also has home health care three days a week for dressing changes. Home health care is planned to last for only three weeks.

Wound etiology: Pressure ulcer, stage 4
Wound location: Coccyx
Thickness: Full
Size: 6×4×1.4cm
Undermining: 2–10 o’clock, 0.7cm
Wound tissue: 80% red granulation, 20% yellow fibrinous slough
Exudate: Heavy
Bioburden: Yes

What dressing order would you choose to benefit your patient most?

a. Cleanse wound with normal saline. Pat dry. Pack wound and undermining with calcium alginate. Cover with bordered foam three times a week.
b. Cleanse wound with normal saline. Pat dry. Pack wound with wet-to-dry dressing twice daily. Cover with abdominal pads. Secure with paper tape.
c. Cleanse wound with normal saline. Pat dry. Pack wound and undermining with silver alginate. Cover with bordered foam daily.

A. Chronic Pressure Ulcer – Stage 4

Your patient is a 47-year-old woman who has had a history of diabetes for the past 25 years, is a stroke survivor, and has congestive heart failure. She developed a stage 4 pressure ulcer following an above the knee amputation six months ago during her hospital stay. She lives at home with her daughter, who is a nurse, and also has home health care three days a week for dressing changes. Home health care is planned to last for only three weeks.

Wound etiology: Pressure ulcer, stage 4
Wound location: Coccyx
Thickness: Full
Size: 6×4×1.4cm
Undermining: 2–10 o’clock, 0.7cm
Wound tissue: 80% red granulation, 20% yellow fibrinous slough
Exudate: Heavy
Bioburden: Yes

What dressing order would you choose to benefit your patient most?

a. Cleanse wound with normal saline. Pat dry. Pack wound and undermining with calcium alginate. Cover with bordered foam three times a week.
b. Cleanse wound with normal saline. Pat dry. Pack wound with wet-to-dry dressing twice daily. Cover with abdominal pads. Secure with paper tape.
c. Cleanse wound with normal saline. Pat dry. Pack wound and undermining with silver alginate. Cover with bordered foam daily.

A. Chronic Pressure Ulcer – Stage 4

Your patient is a 47-year-old woman who has had a history of diabetes for the past 25 years, is a stroke survivor, and has congestive heart failure. She developed a stage 4 pressure ulcer following an above the knee amputation six months ago during her hospital stay. She lives at home with her daughter, who is a nurse, and also has home health care three days a week for dressing changes. Home health care is planned to last for only three weeks.

Wound etiology: Pressure ulcer, stage 4
Wound location: Coccyx
Thickness: Full
Size: 6×4×1.4cm
Undermining: 2–10 o’clock, 0.7cm
Wound tissue: 80% red granulation, 20% yellow fibrinous slough
Exudate: Heavy
Bioburden: Yes

What dressing order would you choose to benefit your patient most?

a. Cleanse wound with normal saline. Pat dry. Pack wound and undermining with calcium alginate. Cover with bordered foam three times a week.
b. Cleanse wound with normal saline. Pat dry. Pack wound with wet-to-dry dressing twice daily. Cover with abdominal pads. Secure with paper tape.
c. Cleanse wound with normal saline. Pat dry. Pack wound and undermining with silver alginate. Cover with bordered foam daily.

our patient is a 47-year-old woman who has had a history of diabetes for the past 25 years, is a stroke survivor, and has congestive heart failure. She developed a stage 4 pressure ulcer following an above the knee amputation six months ago during her hospital stay. She lives at home with her daughter, who is a nurse, and also has home health care three days a week for dressing changes. Home health care is planned to last for only three weeks.

Wound etiology: Pressure ulcer, stage 4
Wound location: Coccyx
Thickness: Full
Size: 6×4×1.4cm
Undermining: 2–10 o’clock, 0.7cm
Wound tissue: 80% red granulation, 20% yellow fibrinous slough
Exudate: Heavy
Bioburden: Yes

What dressing order would you choose to benefit your patient most?

a. Cleanse wound with normal saline. Pat dry. Pack wound and undermining with calcium alginate. Cover with bordered foam three times a week.
b. Cleanse wound with normal saline. Pat dry. Pack wound with wet-to-dry dressing twice daily. Cover with abdominal pads. Secure with paper tape.
c. Cleanse wound with normal saline. Pat dry. Pack wound and undermining with silver alginate. Cover with bordered foam daily.

B. Chronic Diabetic Neuropathic Foot Ulcer

B. Chronic Diabetic Neuropathic Foot Ulcer

Answer 1

Option ( C ) is correct. ( Cleanse wound with normal saline. Pat dry. Pack wound and undermining with silver alginate. Cover with bordered foam daily )

Explaination :-

Due to date of onset, wound depth, exudate amount and bioburden, an antimicrobial absorptive dressing is the best choice. The frequency is based on the exudate amount and the knowledge that the daughter can change the dressings on the days home health care is not available.