Norma James, a 65-year-old widow who lives alone, presents at the geriatric nursing clinic at the local senior center with a wound on her ankle about the size of a quarter. The wound is sore, with yellowish drainage. The skin around the wound is red and inflamed. Ms. James says that she has had the sore about 3 weeks and that she treated it with butter for a while but that that seemed to make it worse. Ms. James says that her foot hurts when she walks on it. The nurse at the clinic smells cigarette smoke on Mrs. James clothing. When asked, Ms. James reports that she smokes about a pack a day. In response to a question from the nurse, Ms. James says that she has diabetes and high blood pressure. Ms. James is not able to say what medicines she takes but estimates that she takes “about four different ones.”
Question 1
What metabolic factors will increase the risk of delayed wound healing?
Question 2
What teaching can the nurse provide Ms. James to promote wound healing in relation to metabolic concerns?
Linking the exemplar of wound healing with the concept of perfusion:
Question 3
What factors related to perfusion will increase the risk of delayed wound healing for Ms. James?
Question 4
What teaching will you provide Ms. James to reduce these risks related to perfusion?