cellulitis right foot

Reflective Journal : Cellulitis , Right Foot

This is a reflective journal about my patient , whose name is not used here due to ethical reasons . He is a 39-year-old Hispanic gentleman admitted with cellulitis , right foot . When I encountered him in the hospital , he was otherwise clinically stable with a heart rate of 70 per minute , blood pressure 124 /82 , temperature 36 .1 , and he was maintaining an oxygen saturation of 97 . However , a normal saline drip was running at the rate of 125 mL per hour . He was completely independent and was moving

to the bathroom dangling due to the cellulitis right foot . He was on antibiotics , and his infection seems to have been controlled . His blood sugars were ed , and the report is not yet available . On questioning , I came to know that this happened after 2 days of incurring an injury at work , and to start with it was just a simple graze . Since it is in the foot , it was important to know whether the patient had suffered from any such cellulitic event earlier . Smoking has an important role in such incidents , and he revealed that he is a smoker of 6 cigarettes per day . On examination , his pedal pulses , particularly in the dorsalis pedis artery seemed to be full volume , and there appeared to be no compromise in the circulation . While my attempt was to keep his dressings intact with no bleeding or inflammation , it was also important to monitor his vascular status by repeated palpation of the dorsalis pedis pulse . The wound appeared to be clean , and the base of the lesion appeared healthy and granulating . The antibiotic he was placed on is dependent on his wound base culture and sensitivities . The dressing needed to be changed everyday , and I demonstrated ideal dressing to the student nurses , and they performed dressing of the wound daily . With hydrogen peroxide and povidone iodine cleansing of the wound followed by normal saline wash , the wound happened to improve very fast . When the wound was improving , the granulation tissues started to bleed , and it was initially worrisome , but this also indicated that healing is happening very fast , and fresh bleeding is a sign of recovery in cellulitis . Since the infection is controlled , the priority would be dressing the wound , and educating him about the importance of quitting smoking . At the end , the patient was discharged with advice to continue home dressing that was taught to the family members until it healed completely . It was an opportunity to refresh the knowledge of management of cellulitis from the nursing perspective , and I feel this has helped the patient to a great extent

References

Twibell , Ryan Hermiz (2005 . Faculty Perceptions of Critical Thinking in Student Clinical Experiences . Journal of Nursing Education , 44 (2 71-79

McNamara , D . R . et al (2007 . A Predictive Model of Recurrent Lower Extremity Cellulitis in a Population-Based Cohort . Archives of Internal Medicine 167 : 709 - 715 ...