Principles of Nursing: Wound Care and Patient Health Literacy

This document discusses the principles of nursing related to wound care and patient health literacy. It explores the pathophysiology of wound complications, the importance of medication adherence, and the role of wound cleanliness in promoting healing. The document also highlights the significance of patient health literacy in managing wounds and provides recommendations for proper diet and nutrition for diabetic patients.

PRINCIPLES OF NURSING
1
Nursing Care
Student’s Name
Professors Name
Institution of affiliation
Date

PRINCIPLES OF NURSING
2
Question one
The pathophysiology of Mrs. Bacci’s condition involves the formation of an Island film
covering along the incisional wound which is wet from serous exudate output. Also, the wound
bears some dehiscence along the suture line, and there is some sloughy tissue. The surrounding
skin is warm, and dark and painful to touch (Bullock, & Hales, 2019). The cause bad condition
after surgery may be as a result of low immunity of Mrs. Bacci’s body who type II diabetes,
making her immunocompromised (Su, Chang, Peng, & Chen, 2018). Type two diabetes is known
to cause a delay in healing of any wound of the body and patient with it are advised to avoid
injuries at any cost.
Mrs. Bacci reveals that sometimes she forgets to take her medication while at times she thinks
that she is not supposed to take all the medication. Her failure to adhere to doctor’s prescription
is one of the causes of the worsening state of the wound. Among the medications, she received
during discharge is paracetamol 1g QID, a drug used to relieve or kill pain in the body. In case
one of the medications she has not been taking is paracetamol, then that is why the wound is so
painful to touch (Rwegerera et al, 2018).
Mrs. Bacci has poor English which affects the understanding of the label or rather instructions
written in the drug’s packet for medication. Her forgetting and failure to take all the medication
is due to lack of understanding as well as ignorance of the consequences of failing to adhere to
doctor’s medication protocols.
The tests show that her feet and toes on her right foot are cool to touch with a capillary refill of
2-3 seconds and she states that she normally has cold feet. The coldness is due to her previous
peripheral vascular disease and obesity which interferes with blood circulation. Blood circulation

PRINCIPLES OF NURSING
3
matters are the most common causes of cold feet. The warm blood gets difficulties in reaching
extremities whereby the high cholesterol in the body of obese person forms plaques inside the
blood arteries that decreases the amount of blood reaching the feet or legs, resulting to cold.
The dehiscence of the wound leads to the production of a large amount of serous fluid which
makes the healing process of the wound more complicated. Generally, a healing wound is
supposed to have a medium amount of wetness, but an excess of it interferes with healing (Craft,
& Gordon, 2019). The cause of dehiscence is systemic because Mrs. Bacci has several health
complications apart from the surgery state.
Question two
Keeping wound clean
Ensuring that the wound is clean to prevent emergence infections is the best nursing
priority of care to Mrs. Bacci “nurses are unique kind. They have this insatiable need to care for
others, which is both their greatest strength and fatal flaw” by Dr. Jean Watson. Intermittently,
wound cleansing is needed to assist in eliminating wound debris like excess exudate, that mostly
delays healing of the wound. Mrs. Bacci has Island of film from serous exudate output, and this
is causing complication in wound healing (Brown, Edwards, Seaton, & Buckley, 2015).
Patient health literacy
The patient has wound dehiscence which is painful to touch. Her wound dehiscence is due to a
weakened immune system because she has diabetes and her skin integrity compromised. The
nurse should educate her properly concerning eating a healthy diet that helps to prevent wound

PRINCIPLES OF NURSING
4
dehiscence. Also, health education on the importance of taking medication as per doctor’s
prescription, so that wound can heal as expected with less pain (Levett-Jones, 2018).
Question three
Wound dehiscence and infection are the most common surgical wound complications.
Thus, nursing priorities of care target on dealing the two main areas. The wound cleaning assists
sterilizing the wound to prevent pathogen infections that cause diseases at the wound site. Mrs.
Bacci’s wound is dark pink and warm which may indicate the presence of infection. Wound
swabs can be taken for culture to determine the pathogen so that antibiotic therapy can be
commenced immediately (Sveen et al, 2018).
Health studies reveal that patient with peripheral vascular disease, oxygen distribution to the
tissue meet halfway — the tissues failure to acquire enough oxygen result in slower healing of
the wound. Mrs. Bacci suffers PVD disease; this explains the importance of health literacy to her
form the nurse (Lin, Xie, Yao, Dai, & Wu, 2018). She needs to be aware of the root cause of
complication so that she can be able to take it easy “Just like there’s always time for pain, there’s
always time for healing”-Jennifer Brown. Health literacy the best safe wound management
principles (Thorp, 2019).
Dietary health literacy this patient is vital to expose her on the best diet to follow to enhance
wound healing (Chakravartty et al, 2018). Research reveals that poor nutrition makes metabolic
process slow thus minimizing collagen synthesis. Low collagen synthesis leads to delayed
wound healing, resulting in complications (Forbes, & Watt, 2016). Additionally, a special diet
needed for a diabetic patient, and she requires guidance on how to feed because diabetes leads to
weak immunity thus poor wound healing. Patient health literacy is the best wound management

PRINCIPLES OF NURSING
5
care because Mrs. Bacci have many immunosuppressive disorders and if she is not aware of her
health condition well, the process will not be easy to her.

PRINCIPLES OF NURSING
6
References
Brown, D., Edwards, H., Seaton, L. & Buckley, T. (Eds.) (2015). Lewis's medical-surgical
nursing.Assessment and management of clinical problems. Australian and New Zealand
Edition.(4th.ed.). Chatswood, NSW: Elsevier Australia.
Bullock, S., & Hales, M. (2019). Principles of pathophysiology. (2nd ed.) Australia: Pearson.
Chakravartty, S., Vivian, G., Mullholland, N., Shaikh, H., McGrath, J., Sidhu, P. S., ... & Patel,
A. G. (2018). Preoperative liver shrinking diet for bariatric surgery may impact wound
healing: a randomized controlled trial. Surgery for Obesity and Related Diseases.
Craft, J.A., & Gordon, C.J. (Eds.). (2019). Understanding pathophysiology (3rd ed.). Australia:
Elsevier.
Forbes, H. & Watt, E. (Eds). (2016). Jarvis’s Physical examination and health assessment (2nd
Aust. & NZ ed.). Chatswood: Elsevier.
Levett-Jones, T. (Ed.) (2018) Clinical Reasoning: Learning to think like a nurse. (2nd ed.)
Frenchs Forest, N.S.W.: Pearson.
Lin, S., Xie, J., Yao, X., Dai, Z., & Wu, W. (2018). the Use of Cryotherapy for the Prevention of
Wound Complications in the Treatment of Calcaneal Fractures. The Journal of Foot and
Ankle Surgery, 57(3), 436-439.
Rwegerera, G. M., Moshomo, T., Gaenamong, M., Oyewo, T. A., Gollakota, S., Mhimbira, F.
A., ... & Rivera, Y. P. (2018). Antidiabetic medication adherence and associated factors

PRINCIPLES OF NURSING
7
among patients in Botswana; implications for the future. Alexandria journal of medicine,
54(2), 103-109.
Su, C. L., Chang, C. C., Peng, Y. S., & Chen, M. Y. (2018). The Predictive Factors Associated
With Comorbidities for Treatment Response in Outpatients With King Classification III
Diabetes Foot Ulcers. Annals of plastic surgery, 81(6S), S39-S43.
Sveen, L. R., Timmerhaus, G., Krasnov, A., Takle, H., Stefansson, S. O., Handeland, S. O., &
Ytteborg, E. (2018). High fish density delays wound healing in Atlantic salmon (Salmo
salar). Scientific reports, 8(1), 16907.
Thorp, S. L. (2019). Pathophysiology of Cancer Pain. In Essentials of Interventional Cancer
Pain Management (pp. 13-17). Springer, Cham.