Assessment and Treatment

Discuss the significance of understanding the following items in relation to clinical practice as an advanced practice nurse. Consider the following two situations in addressing your assigned roles:

A 32-year-old Asian American construction worker visits his primary care physician with a 2-inch cut on the anterior aspect of his right hand. He lacerated his hand while fixing a barbed-wire fence 5 days ago. He told his wife that he did not have time to go to his primary care provider for such a small cut. The primary care provider noted the wound bed to be erythemic, swollen, and with a small amount of purulent greenish drainage on the Band-Aid, the wife had placed on cut. The patient had an oral temperature of 100°F. The primary care provider cleaned the wound, applied a clean dressing, administered Tdap, and called in a prescription for 10 day-courses of an antibiotic.

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A 5-year old was playing on his family’s farm when he accidentally tripped over a fallen fence suffering a similar injury as the first patient. This child suffered a 2-inch cut to the anterior aspect of his right hand. His father cleaned the wound, covered the site, and made an appointment for the following week (about 3 days later) to see the pediatrician. The pediatrician examined the wound and noted the wound bed to be erythemic, swollen, and with a small amount of purulent drainage on the Band-Aid, the father had placed on the cut. The patient had an oral temperature of 100°F. The primary care provider cleaned the wound, applied a clean dressing, administered DTaP, and called in a prescription for 10 day-course of an antibiotic.
In your initial post:

1. Identify some potential concerns based on the findings of the wounds and provide a rationale for the healthcare provider’s treatment choices. Include the mechanism of wounds healing in your discussion. In addition, briefly discuss this individual’s risk for shock and what type of shock he is at most risk for based on the information presented.
Explain your rationale for your choices, citing resources from the literature.

2. What are the key data and assessment information needed if you are caring for this patient? List your plan of care for this individual. Describe modifications (if any) to the plan of care that you would use when caring for a 32-year-old, married Asian American male versus a 5-year-old male child who is very active outdoors.

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