Pathophysiological Assessment and Nursing Care Priorities on Case Study Review

Pathophysiological assessment and nursing care priorities on
Case study review
Patient Bacci state, and the path physiology assessment has discussed relating to the patient
situation, cues of action and information processing based on the indications presented.
Priority nursing interventions has been assessed using the identification of patient problems
and establishing goals of care (Hunter & Arthur, 2016). Identified priorities entail an
examination of diabetic foot ulcer and wound care management. Finally, justification of
nursing priorities reviews action taking and evaluation of outcome stage of clinical reasoning
cycle.
Patient Mrs Gina Bacci depicts a state of diabetic foot ulcer with the previous history of type
II diabetes, peripheral vascular disease and obesity. The evaluation of the patient foot ulcers
is critical. The pathophysiology arises from various complications occurring from multiple
causes. The damage of the weak foot muscles has to lead to an imbalance of flexion-
extension of the foot causing the skin to break down and forming the ulceration (Formosa,
Gatt & Chockalingam, 2016).
Infection is a serious medical condition, which threatens the state of Patient Bacci due to
these consequences of deep infection. In the foot ulcers, the complications tend to increase.
The difficulties arise from intercommunication and the spread of the infection; with low pain
detection, leads to the continuation of the ambulation further expand the range. Thus, the
combination of various factors such the obesity, glucose level intolerance, and peripheral
disease worsens the state of the disease (Zhang et al., 2017).
Patient Bacci body mass status indicates that the presence of obesity is imminent. This
facilitates insulin resistance. The development of insulin resistance develops to type II

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diabetes leading to metabolic syndrome. This has led to patient development of type II
diabetes, leading to elevated levels of sugar levels in the blood. During the diabetic state of
the patient, there is an increased risk of worsening state of diabetic foot ulcers (Jaiswal et al.,
2016). The wound healing disorder affects the treatment process which further exacerbates
the patient state of infection. Skin damage on the foot ulcer is imminent which result from
shift change of pressure points (Brennan et al., 2013). This will proceed to form skin damage
developing into ulcers. The underlying neuropathy lowers the state of oil glands and sweater
making the foot moisture to reduce and hence increasing susceptibility to injury, while
sensory neuropathy decreases the sensation of wound pain. Status of the immunopathy
reflects the underlying causes (Jupiter et al., 2016).
With Patient Bacci diabetic mellitus state, there is decreased healing of the soft tissue leading
to ulcers. During the advanced stage of diabetes, skin structure tissue, nerves, and blood
vessels are damaged hence there is no control of blood, this slow progress of wound healing
in the wound lower risk of wound complication (Barshes et al., 2016).
The patient state of neuropathy remains to be primarily an underlying condition for type II
diabetes. The occurrence of tingling, pain, and numbness are clear symptoms of peripheral
neuropathy, leading to vulnerable infections thus exacerbating the contamination of the
patient. The weakened immunopathy of the patient is further worsening the healing process
of the patient also declining the state of foot ulcers causing more infection (Tokuda et al.,
2018).
The diabetic foot ulcer increases the condition associated with peripheral arterial disease of
Patient Bacci, coupled with neuropathy, ischemia, and infection. Compromised metabolic
mechanism elevates the risks of infection and wound healing for the patient. This is
exacerbated by peripheral vascular disease, ulceration, and gangrene formation. Further, the
declined state of the immunopathy of the patient leads to more susceptibility of infections.

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The associated metabolism syndrome impairs the synthesis of portions, fibrinogen, and
collagen. Research has shown that immune system impairment occurs among patients with
lower blood glucose level tolerating infection worsening wound state (Clerici & Faglia,
2016).
The autonomic neuropathy complications lead to diminished sweating, with underlying skin
becoming dry and susceptible to developing an infection. The occurrence of the external
conditions of Patient Bacci worsens the state of the patients. Peripheral disease occurrences
are the significant manifestation of type II diabetes presented the patient. Often peripheral
vascular disease occurs at all levels of the arterial tree and bifurcation sand bends of the
artery, located in the hemodynamic shear stress is low. In the diabetic state, the distal vessels
such as the anterior, posterior tibias and perinea are inclined (Jupiter et al., 2016).
Identification of nursing priorities of care for this patient, justification and rationale
Nursing priorities in the nursing process of Patient Bacci are critical for wound management.
The following nursing priorities are essential for the patient are the periodic examination and
patient screening and Wound management care. Rationales wound management care is the
improvement of nursing care is a crucial aspect of managing the state of the patients.
According to the WHO, nurses play a critical role in reviewing patient status as they are the
most significant component of health care. The nurse’s role includes prevention of the disease
and health promotion on Patient Bacci state (Clerici & Faglia, 2016). The nurses offer a
combination of these care services and seek to eliminate and provide health services, which
aim to reduce physical, emotional and mental needs of the patient.
Regular wound screening and examination
These diabetic foot ulcers management can often result in various risks factors which need
urgent attention. Thus causes detachment from the skin and impair the wound healing for the
patient. The state of the peripheral neuropathy can lead to excessive pressure, and further