NRSG 490 Given that Tina Jones has an open wound on her lower extremity and has diabetes, choose either the Musculoskeletal or Neurological Exam Assessment.

The patient in the case study offered is Ms. Jones, an African American female 28 years old who seeks care for a recent right foot injury. Her right ankle was twisted, and the ball of her foot was scraped, according to Ms. Jones, who claimed that she stumbled on concrete stairs outside a week ago. The purpose of this paper is to identify the possible differential diagnosis for this patient and to provide evidence to support each one.

Unstable glucose levels and severe right foot pain are the two potential nursing diagnoses. Since Tina Jones said that her right foot had an open wound, unstable glucose levels are a possible nursing diagnosis that contributed to the impaired skin integrity. She claims that after taking antibiotics, the wound on her right foot does not seem to be healing. She claims that after taking antibiotics, the wound on her right foot does not seem to be healing. Additionally, she mentions an increase in appetite and an unexpected weight loss of 10 pounds over the previous month, both of which are symptoms of her uncontrolled diabetes (Lutter et al., 2019). She also says she used to take metformin but stopped around three years ago due to side symptoms related to flatulence. She also claims that it has been tiring to take the pills and monitor her blood sugar at the same time.

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Controlling the infection and performing debridement, offloading to ease the pressure, and keeping the wound bed wet are all part of the normal wound care treatment for chronic wounds that are not healing properly (Spampinato et al., 2020). To hasten the healing process of the wound, the underlying disease of diabetes must be treated. As a result, the patient’s blood glucose levels have to be checked, and a suitable antidiabetic treatment ought to be suggested, along with dietary changes and physical activity.

NRSG 490 Given that Tina Jones has an open wound on her lower extremity and has diabetes, choose either the Musculoskeletal or Neurological Exam Assessment.

Right foot acute pain is another potential nursing diagnosis. Lipsky et al. (2020) claim that the discomfort in question often goes away in three to six months or is mostly felt in the soft tissues. It is a tenable diagnosis given the patient’s description of an open cut on their right foot along with excruciating agony. The patient characterized the pain in her leg as radiating and gave it a pain score of 7 out of 10. The female person went on to say that she was unable to continue to put up with the agonizing discomfort. She also claims that the pain has limited her mobility, capacity to attend a job, and ability to take part in academic studies.

The patient allegedly used tramadol to treat their discomfort. Tramadol is a common analgesic used to treat patients’ moderate to severe pain, according to Reina-Bueno et al. (2021). I would advise Tina Jones to continue using her existing Tramadol pain medication regimen since I’m a nurse. I would manually manipulate the afflicted region as a nurse to reduce tissue edema and increase endorphin production. In addition, I’ll use hot and cold compresses. By controlling the transmission of pain signals and reducing the creation of molecules that cause pain, applying ice to the injured region may effectively reduce pain. In post-surgical or acute injury instances, the administration of cold and compression is a widespread technique to hasten functional recovery, relieve pain, and decrease swelling.

References

‌Lipsky, B. A., Senneville, É., Abbas, Z. G., Aragón‐Sánchez, J., Diggle, M., Embil, J. M., Kono, S., Lavery, L. A., Malone, M., Asten, S. A., Urbančič‐Rovan, V., & Peters, E. J. G. (2020). Guidelines on diagnosing and treating foot infection in persons with diabetes (IWGDF 2019 update). Diabetes/Metabolism Research and Reviews, 36(S1). https://doi.org/10.1002/dmrr.3280

‌Lutter, C., Schöffl, V., Hotfiel, T., Simon, M., & Maffulli, N. (2019). Compartment Syndrome of the Foot: An Evidence-Based Review. The Journal of Foot and Ankle Surgery, 58(4), 632–640. https://doi.org/10.1053/j.jfas.2018.12.026

Reina-Bueno, M., Munuera-Martínez, P. V., Pérez-García, S., Vázquez-Bautista, M. del C., Domínguez-Maldonado, G., & Palomo-Toucedo, I. C. (2021). Foot Pain and Morphofunctional Foot Disorders in Patients with Rheumatoid Arthritis: A Multicenter Cross-Sectional Study. International Journal of Environmental Research and Public Health, 18(9), 5042. https://doi.org/10.3390/ijerph18095042

Spampinato, S. F., Caruso, G. I., De Pasquale, R., Sortino, M. A., & Merlo, S. (2020). The Treatment of Impaired Wound Healing in Diabetes: Looking among Old Drugs. Pharmaceuticals, 13(4), 60. https://doi.org/10.3390/ph13040060

NRSG 490 Given that Tina Jones has an open wound on her lower extremity and has diabetes, choose either the Musculoskeletal or Neurological Exam Assessment.