Wound Management Plan: Scenario 2

Read about the wound management plan for scenario 2 of a patient with malignant wound and venous ulcer. Learn about wound evaluation, management plan, health education, and pain management.

Running head: WOUND MANAGEMENT PLAN: SCENARIO 2
WOUND MANAGEMENT PLAN: SCENARIO 2
Name of the Student
Name of the University
Author Note

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WOUND MANAGEMENT PLAN: SCENARIO 2
Holistic assessment
Mrs. Miriam Gold an 85 year old lady in the palliative care condition with pneumonia
and metastatic cervical cancer. She has a medical history of COPD, GORD and CABG. She lives
with her husband and on the basis of her recent condition that is fluid overload in her body her
family does not want to continue the treatment process. She only can drink mild fluids and her
oral intake is very poor she is unable to move. Her medicinal intake is syringe based which
includes the Fentanyl 200 mcg and Midazolam 10 mg. Mrs. Gold was admitted to the palliative
care as her children and husband could not be able to manage with her condition as she
developed wounds and experiencing severe pain. The wounds of her includes malignant wound
on left groin and also the venous ulcer. Her wounds were developed from the radiotherapy for
the cervical cancer. On this context the nurse should be able to evaluate and manage her pain and
wound. On this context it can be stated that the malignant wounds are caused by the cancerous
cells infiltrating the skin and also affecting the surrounding blood cells and leads to loss of
vascularity and severe pain (Tilley, Lipson & Ramos, 2016). Other than this the venous ulcer is
caused by the dysfunction of the venous valves of the legs and leading to chronic wounds
(Benevides et al., 2016).
Wound evaluation
Regular observation to the condition and the changes in the patient’s condition would be
needed as the basic wound evaluation step. Other than this the factor of the consultation with the
doctor would be required as well on the basis of the bed colour and the odor from the wound
exudates of the patient. However, as the case description the condition of the patient is very
much severe that the wounds cannot be healed. In case of the malignant wound the pus can be
able to develop sepsis in the body. Thus it is needed to be pathological checkups of the wounds

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WOUND MANAGEMENT PLAN: SCENARIO 2
in order to determine any kind of microbial infection is forming or not (Kamoun et al., 2015).
Hence, the record of the colour of the bed which would be yellow to brown in this case and the
odor of the pus should be provided to the doctor. On the other hand the venous ulcer can be able
to stop the blood flow in the body and thus the factor of the blood pressure would be rising in the
body. The evaluation process also depends on the communication of the nurse and the patient.
The discomfort and pain of the patient can be determined by the conversation of the patient and
the nurse. Based on this conversation the nurse should inform the doctor for the proper treatment
of the patient.
Wound management plan
The nurse should be able to treat the wounds on the basis of the doctor prescribed
painkillers and sedating agents as the pain of the patient is high. The wound management plan
would be requiring the conversation with the patient and on the basis of the conversation the
nurse should be able to determine the level of pain and discomfort of the patient. The nurse
should also be able to dry out the wounds depending on the requirement of the moisture of the
tissue (Hommel&Santy-Tomlinson, 2018). The process of the wound management also needs to
be done with the movement of the body in every two hours in order to circulate the blood
properly for proper pain management. The doctor’s opinion and the prescription would be
followed by the nurse in terms of dose and time of the medication and other procedures for the
wound healing. The factor of the wound management would be based on the steps such as
observation, consultation with doctor, moisture control of the wound and the surrounding tissue,
proper medication and pain management by medication or movement of the patient and the
observation would be depending of the changes by the four stages of the wound healing process
by the physiological process which includes hemostasis, inflammatory stage, proliferative phase

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WOUND MANAGEMENT PLAN: SCENARIO 2
and maturation phase (Nasir et al., 2016).The nurse should also try to motivate the patient in
mobility and also wash the wounds for the proper cleaning and controlling the infection as well
by changing the sanitary napkin in regular interval and observing the condition of the wound
which would be requiring the consideration of the moisture of the skin, age of the patient and
also the condition of the patient’s mental condition. The cleansing of the wound would include
the factor of the antimicrobial ointment for the microbial infection control.
Health education
Health education of the patient and the family members would be requiring in this case as
the patient’s condition is severe and the proper observation and treatment is needed. The family
members want to stop the treatment of the patient however, the pain and the infection
management of the patient is required in a priority basis. On the other hand the nurse should be
should be able to motivate the family members and the patient in better self-management and
treatment of wound along with proper medication administration. The cleaning of the wound and
the proper hygiene maintenance by changing sanitation pads in regular basis and also clearing
the perianal portion of the patient in regular interval for the better wound management. All these
steps should be followed in the better treatment of the patient and also taught to the family
members of the patient.
Pain management
Pain management on the other hand should be done with the consideration of the
medication management (Bianchi et al., 2018). The severity of the pain can be determined by the
utilization of the holistic approach of the nurse which helps by utilizing the communication and
positive gestures to the patient. The nurse should be able to support the patient in the period of

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dressing the wound as it would cause severe pain to the patient. Other than this the painkiller and
sedative agent implementation would be recommended for the pain management of the patient.
The mobility cannot be achieved in consideration of the patient’s age and the health condition
(Murphy, 2017). Hence, the pain management would be dependent on the pain killer and the
sedatives.

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References
Benevides, J. L., Coutinho, J. F. V., Pascoal, L. C., Joventino, E. S., Martins, M. C., Gubert, F.
D. A., &Alves, A. M. (2016). Development and validation of educational technology for
venous ulcer care. Revista da Escola de Enfermagem da USP, 50(2), 309-316.
Bianchi, N., Sacchetti, F., Mordà, M., Citarelli, C., Capanna, R., &Giannotti, S. (2018). USE OF
PULSED RADIOFREQUENCY ELECTROMAGNETIC FIELD (PRFE) THERAPY
FOR PAIN MANAGEMENT AND WOUND HEALING IN TOTAL KNEE AND
REVERSE SHOULDER PROSTHESIS: RANDOMIZED AND DOUBLE-BLIND
STUDY. Euromediterranean Biomedical Journal, 13.
Hommel, A., &Santy-Tomlinson, J. (2018). Pressure Injury Prevention and Wound
Management. In Fragility Fracture Nursing (pp. 85-94). Springer, Cham.
Kamoun, E. A., Kenawy, E. R. S., Tamer, T. M., El-Meligy, M. A., &Eldin, M. S. M. (2015).
Poly (vinyl alcohol)-alginate physically crosslinked hydrogel membranes for wound
dressing applications: characterization and bio-evaluation. Arabian Journal of Chemistry,
8(1), 38-47.
Murphy, C. L. (2017). Wound Related Pain Management in a Community Healthcare Setting.
Nasir, N. M., Lee, B. K., Yap, S. S., Thong, K. L., & Yap, S. L. (2016). Cold plasma inactivation
of chronic wound bacteria. Archives of biochemistry and biophysics, 605, 76-85.
Tilley, C., Lipson, J., & Ramos, M. (2016). Palliative wound care for malignant fungating
wounds: holistic considerations at end-of-life. Nursing Clinics, 51(3), 513-531.

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WOUND MANAGEMENT PLAN: SCENARIO 2