Consist of three (3) paragraphs using at least two (2) sources, written in APA 7th edition .
Discussion Board
The nurse is caring for a 78-year-old client admitted from home who sustained a significant laceration to the scalp when he tripped and fell while trying to light his cigarette. During the head-to-toe assessment, the nurse notes that he has a large stage 3 decubitus ulcer over the sacral area. His past medical history includes diabetes, hypertension, COPD, and kidney transplant 15 years ago. He weighs 110 pounds and is 5′7″. The nurse notices that he has generalized edema. (Learning Objectives: 7–10)
1. Differentiate between primary and secondary intention, and give an example of each from the scenario above.
2. What factors in the scenario above may impair the healing process and why?
3. Summarize the three phases of healing.
4. What are some of the effects of aging on the immune system that might affect this client’s ability to heal.
Expert Solution Preview
Introduction:
The care of wounds is an important aspect of the nursing profession. Understanding the different types of wound healing, factors that can impact the healing process, and the effects of aging on the immune system are all crucial in providing effective care. In this discussion, we will address four questions related to the care of a 78-year-old patient who sustained a significant laceration to the scalp and has a stage 3 sacral decubitus ulcer.
1. Differentiate between primary and secondary intention, and give an example of each from the scenario above.
Primary intention healing occurs when the wound edges are approximated and secured, allowing for minimal tissue loss and an accelerated healing process. It involves a quick and timely closure of the wound with minimal healing complications and scarring. In the scenario provided, the scalp laceration may be closed using sutures or staples, allowing for primary intention healing.
Secondary intention healing occurs when a wound is left open to heal naturally by granulation, contraction, and epithelialization. In this case, the stage 3 sacral decubitus ulcer would need to be treated using secondary intention healing as it is an open wound. The wound would be dressed appropriately and allowed to heal naturally over a longer period of time.
2. What factors in the scenario above may impair the healing process and why?
Several factors can potentially impair the healing process, including age, diabetes, hypertension, COPD, kidney transplant, and generalized edema in the patient. These factors can impact the formation of new blood vessels and the ability of the immune system to combat infection. Diabetes and hypertension can both cause delayed wound healing as they can weaken the body’s immune system and the ability to receive oxygen and nutrients from the blood vessels. COPD and kidney transplant surgeries can impair the healing process due to decreased oxygen delivery to tissues. Generalized edema can also impair wound healing, as the swelling can compress blood vessels, further limiting blood flow to the area.
3. Summarize the three phases of healing.
The process of wound healing is typically divided into three phases:
a) The inflammatory phase is the initial phase of healing and is characterized by redness, heat, and swelling. This phase stimulates the immune system and removes debris and bacteria from the wound to prepare for healing.
b) The proliferative phase is the second phase, which begins after 3 days and is characterized by the formation of new blood vessels and granulation tissue. This phase helps to fill the wound with new tissue.
c) The remodeling phase is the final phase of healing, in which the wound matures and strengthens. The new tissue is remodeled to resemble the surrounding tissue, and closure is complete.
4. What are some of the effects of aging on the immune system that might affect this client’s ability to heal?
Aging can lead to immune system changes that may impact the ability to heal in older adults. These changes include a decline in the number of immune cells, decreased immune cell function, and alterations in cytokine signaling that play a role in inflammation and tissue repair. These changes can lead to susceptibility to infections and slower wound healing. Therefore, the age of the patient in the scenario could put him at risk of impaired immune function, making it harder for him to combat infection and aid in wound healing.
