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Wound Care Sim
2
Wound Care
Simulation
Annie Cox
Carly Cummer
Sarah Mattison
Jamie Markel
Grace Sloan
Patient Profile
- Name: Jessica Brown DOB: 09/25/84 Age: 37 Ht: 5' 4" Wt: 140lbs Diagnosis: Abdominal Wound, Type 1 Diabetes
- Meds: Sliding scale insulin, prophylactic cephalosporin, Morphine, PRN acetaminophen, blood transfusion
- Allergies: Bee stings
- Socioeconomic Status: Middle Class
- Health Insurance: Blue Cross Blue Shield
- Occupation: Elementary School Teacher
- Nutrition: Normal with no deficiencies; appetite decreased since the wound occurred
- Support System: Married, supportive Friends, Involved and supportive family (Both Parents, Older Brother)
Patient
Profile
Story
Jessica was taking her 2 kids (3 and 4) trick or treating and Michael Myers came out of the woods and stabbed her. Due to this she now has an open abdominal wound that is being kept open for monitoring.
Vitals: Temp: 98.0 Pulse: 90 Resp.: 16 BP: 108/67 Blood Glucose: 130
Labs: WBCs elevated in response to trauma, RBCs/Hgb lower due to blood loss but now stable, continue to monitor WBCs for infection, awaiting results on blood borne pathogen tests
Story/Wound Type
Treatment Plan
Evidence Based
Practice
To begin this patient was given a tetanus shot and is being tested for blood borne pathogens. The surgeon is planning on leaving the wound open for the first 24 hours to ensure that there is no further damage. The dressing orders are to lightly pack the wound with steri-strips that are wet with normal saline and an ABD pad over top (Choron, 2017). After the first 24 hours we would do a TAC according to Fitzpatrick a TAC should allow the everything in the abdomen to expand as well as protect from external bacteria and allow for proper drainage from the wound. A TAC would also allow for quick access to the abdominal opening if needed.
References
Fitzpatrick, E. R. (2017). Open Abdomen in Trauma and Critical Care. Critical Care Nurse, 37(5), 22–45. https://doi.org/10.4037/ccn2017294
https://0-search.ebscohost.com.library.svsu.edu/login.aspx?direct=true&db=ccm&AN=125112054&site=ehost-live
References
Choron, R. L., Hazelton, J. P., Hunter, K., Capano-Wehrle, L., Gaughan, J., Chovanes, J., & Seamon, M. J. (2017). Intra-abdominal packing with laparotomy pads and QuikClot™ during damage control laparotomy: A safety analysis. Injury, 48(1), 158–164. https://doi.org/10.1016/j.injury.2016.07.033