Holistic Assessment and Wound Healing Management for Congestive Cardiac Failure and Venus Leg Ulcer

Holistic assessment and wound healing management
of an individual presenting with Congestive Cardiac
Failure and Venus Leg Ulcer following hospital
Discharged: Case Study
SID: 1511896
Word Count: 4800

Table of Contents
INTRODUCTION.........................................................................................................4
Patients Presentation..................................................................................................5
PATHO-PHYSIOLOGY LEG ULCER..........................................................................7
OVERVIEW OF NURSING THEORIES AND MODELS.............................................8
THE NURSING PROCESS.......................................................................................14
ASSESSMENT..........................................................................................................14
PAIN ......................................................................................................................... 16
Eating and Drinking...................................................................................................17
Mobility...................................................................................................................... 17
Planning.................................................................................................................... 18
Implementation..........................................................................................................20
Evaluation..................................................................................................................21
Conclusion.................................................................................................................22
Recommendation...................................................................................................... 23
REFERENCES..........................................................................................................24
APPENDIX 1............................................................................................................. 26
APPENDIX 2............................................................................................................. 26
APPENDIX 3............................................................................................................. 27

INTRODUCTION
The venous leg ulcer is complicated and chronic disease which affects
most of the patient of 65 years old. The sensitive body of old people will easily
get in contact with these viruses that attached with their lives for long time. This
disease is prevalent in the UK among the people above the age of 60- 80 years
of old. The reason behind occurrence of the diseases in these peoples is weaker
immunity of old people and lack of white blood cells and the platelets in order
to fight against the dangerous diseases. According to posnett el at (2009),
CVLU affects 1- out of 2% of the UK population with over half having an
active ulcer.
The cost incurred in the treatment of this dangerous diseases estimated by
the National Health Service accounts for 5.3 billion each years as per the recent
study conducted in 2013-2014 in the UK. The study also reveals that the
patients suffering from this dangerous diseases will be counted all above the age
of 18 years as there is record of patients having this disease below 18 years.
The study reveals that the practised nurses are involved in treating patients in
order to avoid social isolation. The practice of the hospital starts that 18.6
million practices nurses and doctors are form part of this event, 1.09 million
doctors and paramedical staffs also visits communities and 3.4 million hospital
also gathers and treats outpatient visits through organising camps.
NHS Choices defines venous ulcers as wound which occur on skin of human
being due to improper functioning of venous valves. Moreover, the patients past
medical history (PMH) are also incorporated in the report which further helps in
as well as reason for planning, implementation and evaluation of patient care
with the use of appropriate model has also been explained.
The current essay will cover critical evaluation on report of care for patient. In this
regard, practical and theoretical elements regarding care planning as well as examination of
patient ailment has been explored under the report. Though, case study assignment related to
leg ulcers has been taken into account by taking specific situation of patient. In this manner,

report is completed in four steps such as nursing process as per the NMC (2010) along with
models of nursing as well as theories. It would be effective to provide holistic and and system
demonstration of care provided to patients and accordingly conclusion and evaluation have
been done. Furthermore, verbal consent has been taken for promotion of concordance,
respect difference in context of autonomy and maintaining dignity of patient.
Patients Presentation
Under the current study anonymity of patients has been maintained by complying
Data Protection Act 1998 and NMC 2015. At this juncture, pseudonym will be applied in
overall presentation.
The medical history of the patient will help the doctor in order to design
the best treatment for their patient. The history is essential in order to know the
allergies of the patient in order to prescribe accurate medicines to heal the
patients.
The current study is about Robert who is a 78year- old man who lives
alone in a one-bedroom flat. Mr Robert is active person who are educated and
are settled in their life as he is married and have two children. This person
belongs to the rich family who have status in the society and who speaks
English and all other languages. He worked in good company and enjoys higher
position in the business. The background of Mr Robert will not help him as they
are suffering from social isolation as different society members discriminate
them among different individuals.
He was admitted in the social home care with venous leg ulcer patients to
facilitate the patients. They feel more comfortable with all the individuals
suffering from the same disease and get motivated in terms of taking treatment.
Social isolation is the basic problem faced by these people which will be
reduced to relieve their pain. Robert will meet and greet all the individuals
suffering from identical diseases which reduces their mental distress level. The
mental stress will get reduced by focusing on other activities.

The loneliness of Robert will be minimized by breaking the social
isolated boundaries of their room. The consent of Robert has taken in verbal
form by talking face to face with the patient by asking various questions related
their problem and mental status by living in the society. The information
obtained regarding their prescribed medicines, allergy, reactions, blood and
sugar level will be very helpful in analyzing their nursing needs.
The medical findings of the doctor diagnosis suggest that Mr Robert has
past medical record of congestive cardiac failure. This current discovery of
evidences related to their diseases will help in planning perfect prescription for
providing perfect treatment to the patients.
Robert had a patient who has controlled analgesia which is also known as
PCA, a urinary catheter, which allows them to monitor the pain which is
worked as pain relief machine. The programmable machine and functioning has
intended that will not deliver overdose of the medication. It allows patient to
take a complete set of vital signs to monitor their own temperature, pulse,
respiration, blood pressure and oxygen saturation level.
The results related to their blood pressure and the medicines taken by them
reveals that the 140/80 blood pressure level which is under the control of the
doctors. The medicine taken by Robert for Blood pressure is LOSAR-50 mg
tablets to control their current blood pressure levels.

PATHO-PHYSIOLOGY LEG ULCER
The Venous ulcer is described by The Wound, Ostomy and Continence
Nurse Society (WOCN) as an open wound on the lower leg of venous origin or
ankle of person. The most common causes of VLS are chronic condition and
venous hypertension. The higher pressure of venous tends to become reason of
vales in the lower leg veins. However, vales perform the work to prevent back
flow of venous blood at the time of calf muscle congresses the veins to pump
the blood return to the heart (Viv as, Lev-Tov and Kirsner, 2016). Owing to
this, in case vales are incompetent then form of ulceration can be found in skin
as venous pooling and congestion leads to leak the blood into the tissue as
edema.
The venous ulcers is that disease which occurs due to lack of venous
valves in the body of an individual. This valves usually found in or around the
areas of leg near the muscles. The insufficient amount of venous valves will
affect the soft tissues of the legs that easily contracted with the attack of viruses.
The clotting of blood will raise the effect of this disease on the body of a
person.
The normal time taken by these diseases in the normal body of an
individual is around 6 weeks to get rid of this disease.
 Swollen ankles
 Darkening of skin
 Skin around the ulcer gets hard
 Feeling heaviness in the legs
The diagnosis of this disease as discovered that the assurance
will not be provided on the certainty of the ulcer. The existence of the
ulcer is due to disturbances created in the venous valves. The slow