Leg Ulcer Case Study
Chapter One *A Brief Overview of a Venous Leg Ulcer *and the Assessment Process The nurse must have the skills and knowledge to identify a venous leg ulcer. Dowsett (2005) believes that it is important that nurses and other health care professionals look for the underlying cause of an ulcer. Whereas, the Royal College of Nursing (1998) has different views, and argues that, professionals who are fully trained in leg ulcer management should only be able to identify an underlying cause as it is easily mistaken that diagnosis of an arterial leg ulcer is made rather than venous which could cause serious treatment complications for the wound as well as the patient. There are major problems associated with a venous leg ulcer such as, pain, loss
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There are essential details that the patient can tell the nurse about their ulcer and the factors that may contribute to this. Such factors are their full medical history these details should include varicose veins, diabetes, Deep Vein Thrombosis (DVT), previous leg surgery and any family history of leg ulceration (Dougherty and Lister 2004). The importance of this is that if a leg ulcer is diagnosed incorrectly, such as a venous ulcer being mistakenly diagnosed as an arterial one can have serious complications for the patient and causing further delays in the healing of the wound. Also the nurse must undertake baseline observations this includes, the patient’s weight, height, blood pressure (BP), oxygen saturations levels, temperature and respiratory rate, and also the patient’s nutritional intake, urine samples and routine blood tests such as glucose and haemoglobin levels must be gained, as diabetes is present in approximately 5% of patients with leg ulcer (SIGN 1998). Murray (2004) also agrees with Dougherty & Lister (2004) & Bolton et al (2004) stating that that hyperglycaemia can have an effect in the wound healing process, as this can be linked with infection and decreased oxygen levels in the haemoglobin will slow down the healing process and go onto starve tissue. These factors are important to know as it plays a big part in the wound healing process. In clinical practice thesebasic observations are a vital part of information gained to ensure safer patient care and early recognition of
There are essential details that the patient can tell the nurse about their ulcer and the factors that may contribute to this. Such factors are their full medical history these details should include varicose veins, diabetes, Deep Vein Thrombosis (DVT), previous leg surgery and any family history of leg ulceration (Dougherty and Lister 2004). The importance of this is that if a leg ulcer is diagnosed incorrectly, such as a venous ulcer being mistakenly diagnosed as an arterial one can have serious complications for the patient and causing further delays in the healing of the wound. Also the nurse must undertake baseline observations this includes, the patient’s weight, height, blood pressure (BP), oxygen saturations levels, temperature and respiratory rate, and also the patient’s nutritional intake, urine samples and routine blood tests such as glucose and haemoglobin levels must be gained, as diabetes is present in approximately 5% of patients with leg ulcer (SIGN 1998). Murray (2004) also agrees with Dougherty & Lister (2004) & Bolton et al (2004) stating that that hyperglycaemia can have an effect in the wound healing process, as this can be linked with infection and decreased oxygen levels in the haemoglobin will slow down the healing process and go onto starve tissue. These factors are important to know as it plays a big part in the wound healing process. In clinical practice thesebasic observations are a vital part of information gained to ensure safer patient care and early recognition of