Assessment and Diagnosis of Venous Leg Ulcer - Essay Example

 Assessment and diagnosis of venous leg ulcer While analyzing the patients advanced age one should be aware of the health problems associated with the old. This is due to their weak immune system thus hard to overcome disease. As a result of illness some could are likely to be confined on their beds with little attention from the society owing to their engagement in other obligations. Homes for the elderly are now. Despite it being the case it’s hard to provide the required attention sometimes. This however doesn’t guarantee all the necessary attention. At such an advanced age some could circum to disease as well as hopelessness. It is thus important to adopt a good follow up plan to facilitate such an obligation. In order to attain this all stakeholders ought to cooperate at length to facilitate a turn around. The report is based on a scenario where an 80 year old is infected with a leg ulcer disease at her lower limp; it comes to our attention that this wasn’t the fast time she was exposed to such a disease but had on previous occasions had some success stories which spanned within a period of about three year in counting. While addressing her current condition a number of considerations had to be made while aiming at providing accurate treatment. This is as highlighted bellow; This level contains the following sections: Assessment phase Clinical features Interpretation of findings (Doppler) studies Investigations phase Differential diagnosis full scenario findings prescriptions phase Assessment phase In the event of being infected with a leg ulcer disease one ought to go to a qualified medical physician for help. This is due to its ability to affect ones health and could as well go out of hand. While carrying out the diagnosis not all physicians qualify; such assessment can only be carried out by those trained in ulcer management. As a result of regular encounter with similar cases some are likely to prescribe the best treatment for this disease. The report however tends to look at the necessary procedures to be followed while treating a patient with such a disease. Assessment phase helps while checking on how bad the disease could have gone out of hand thus prescribing the best kind of treatment. While the patient could be portraying certain symptoms such features ought to be compared to those already captured pertain the same disease. This is due to it likely to be related thus could as well help in ensuring a good approach is put to task other than employing trial and error method (Sussman & Bates-Jensen, 2007). It is at the Doppler stage that the findings are analyzed at length while checking on how critical the condition could have gone. Several questions are likely to be asked as highlighted; Does the patient feel pain? How severe is the condition Does it produce odour Is any discharge This is then followed up with a physical examination to check on its criticality. Its during this stage that one is able to identify the signs such as Enlarging ulcer. pain Pyrexia. odour Cellulites (one could have a red skin at the affected area with hot sensation) The medical professional does the inspection while at the same time recording the info with the view of coming up with a good medication. The info is then compared to those already captured in the medical database and could as well be crucial while checking on how one could be responding to treatment. Some of the considerations made while analyzing this condition are as follows; one ought to consider the size as well as depth of the wound. This is achievable through a variety of ways and could be achievable through photographical means. Another critical look ought to be done on the wound bed. How is the granulation? In case the tissues are badly affected it’s wise to remove it for quick healing. An appropriate dressing should as well be considered. One is likely to gauge how the wound is healing by simply looking at the ulcer edge. In some instance it could be shallow but could as well be punched out at times. Thus is wise to document how the ulcer is responding to treatment. While under this disease ones social life could have been affected to a great extend. It is thus important to know whether they still go about their daily routine as they used to. In case they don’t they too are likely to be under the risk of being under the danger of suffering from obesity as well a diabetes and can only hamper their quick recovery thus in case they are exposed to such disease they should as well seek medical attention to facilitate quick recovery. This level contains the following sections: Investigations Differential diagnosis View full scenario View full scenario no prescriptions How to manage pain associated with leg ulcer One out to check on the duration within which the pain takes place as well as how sever it could be. This is because it’s likely to worsen over time. When such a condition occurs it only indicates poor healing. Associated venous diseases as well as leg ulcers are painful. The pain however varies. It could at times be constant or could as well be intermittent. In case of severe pain this only indicates the likelihood of a complication. Thus one could be advised to avoid walking without elevating the affected leg. This however is depended on how severe the wound is thus one ought to stick to a certain treatment without opting for another before actualizing some progress. It’s also important to avoid using some drugs likely to lead to inflammation on the wound such as those containing sulfur (Baranoski & Ayello, 2008). Clinical features of venous leg ulcer disease While going about the diagnosis process one ought to consider a number of issues such as the patients history and could as well be critical while carrying out the physical examination, thus assisting in ensuring a right remedy is considered. Some of the symptoms likely to be encountered could be portrayed through leg pain, itchiness, heaviness in the leg as well as swelling. The risk related to such a disease ought to also be considered with some portraying thrombosis which could as well lead to immobility among some patients. As a result of such tendencies one ought to differentiate the various causes leading to such a disease. Some patients could have as well aggravated such conditions through their personal habits such as smocking as well as the consumption of other drugs which only work at worsening their personal health. In the event of one suffering from diabetes as well as related sickness the condition could at times be amplified thus it’s wise to identify such issues before recommending medication (Cheung, 2009). There are times when some may have been regularly encountered such sickness thus the medication offered at the time should be used to go about facilitating a new treatment. Owing to its ability to be inappropriately done no wonder the reoccurrence. In some case surgeries may have been done on the patient thus submitting them to same condition may at times fail to work as anticipated. This shows how critical a patient’s history is key to bringing about the required turn around in their health. How to examine a person with venous leg ulcer Most people lack the ability to identify people with such diseases. The report however highlights a number of features demonstrated by this sickness. This is as follows; One is likely to demonstrate chronic insufficiency People are thus asked to examine the patients varicose veins while both in a standing as well as sitting position. The patient could as well portray hair loss as well as coldness in his affected leg. It’s also important to check on his pulse in case he suffering from the disease it could be abnormal. How to interpret Doppler disease In the event of it being below 0.5, this is an indication of severe condition. It is thus important to refer one to a medical specialist for further treatment. At times such a condition could be above 0.5 but below 0.8 thus indicating an arterial disease. There are times when it could as well be above 0.8 thus the need to consider compression bandages as a safe means. These ratios are likely to vary though especially with age (Bluth, 1999). Doppler assessment Doppler assessment on ankle brachial pressure index (ABPI) ought to be carried on all patients portraying such conditions at the time when it initially the presentation stage. At the passage of a period of about twelve weeks in case a delay occurs before it heals, then one could consider her another three months while gauging how it responds. This should as well be followed up with another six month interval to avoid its reoccurrence. One is likely to identify how it may be responding and in case of deterioration its likely to reoccur thus could as well portray an increase in the ulcer size which is then followed up by forgetting to mention the change in the affected foots color as well as temperature (Gabka & Bohmert, 2008). Further findings Apart from the disclosed characteristics other conditions are likely to delay the process of regaining health such as anemia, owing to the low blood cont among individuals. At times the body could as well contain some cells causing ulceration condition; this could as well worsen the condition. This implies that one may need constant medication to contain such a situation. In the event of the body containing high urea it could as well affect ones healing process. Such a condition is likely to come about when one’s body lacks enough protein not forgetting to mention diabetic conditions. Other patients do portray same sentiments owing to them being infected with HIV which puts their health at high risk of infection (Zuther, 2009). Other likely causes Systemic vasculitis: This is likely to cause leg ulcers which could be deep Diabetic ulcer: Takes place on ones foot. It may have other components such as neuropathic, as well arterial components Hypertensive ulcer: This is likely to cause one to experience pain at the edge of the affected leg Malignant ulcer: Does not respond to known treatment Traumatic conditions could as well cause it Table. Physical characteristics portrayed by the existing ulcers types of disease Type of ulcer Typical site Wound edge characteristics Venous ulcer Medial malleolus (gaiter area) Sloping Arterial ulcer Dorsum of the foot Punched out Diabetic ulcer Plantar or lateral aspect of foot or toes — Pressure ulcer Sacrum, greater trochanter, or heel — Basal cell carcinoma Sun exposed area Rolled Squamous cell carcinoma Sun exposed area Everted Vasculitic ulcer Dorsum of the foot or calf Punched out, deep, well demarcated Tuberculosis or syphilitic ulcer — Undermining Data from: Grey et al, 2006a Conclusion It has come to our conclusion that a lot needs to be done while going about the decision making process regarding Leg ulcer management. When concrete measures are put in place people ought to be well placed while identifying odious symptoms associated with this disease. By so doing they could as well refer those identified with such disease to qualified physicians who could in the long run consider appropriate actions to be adopted while treating sick patients. As a result sick patients are better placed to benefit from treatment which could also help in ensuring the disease doesn’t go beyond treatment levels. This is due to special treatment from well trained specialist. Such sickness is likely to reoccur but with specialized attention its likelihood is at a minimized level as compared to those rarely taking such treatment. In the event of such sickness re occurring it’s likely to be put within containable limits through appropriate medication. This among others plays an important role in containing such disease (Jones, 2005). Reference Zuther, J.E. 2009. Lymphedema Management: The Comprehensive Guide for Practitioners. New York. Press Pvt Ltd. Jones, R. 2005. Oxford Textbook of Primary Medical Care.New York. Oxford University Press. Goro, A.H., & Mulley, A.G. 2009. Sussman, C. & Bates-Jensen, B.M. 2007. Wound Care: A Collaborative Practice Manual. Baltimore. Healthside Publishing Service. Pg 307 Baranoski, S. & Ayello, E.A. 2008. Wound Care Essentials: Practice Principles. Library of Congress. Pg 11. Cheung, S.T. 2009. Crash Course: Ophthalmological Dermatology. Library of Congress. Pg 188. Bluth, E.I. 1999. Ultrasound: A Practical Approach to Clinical Problems. New York. Library of Congress. Pg 111. Gabka, C. & Bohmert, H. 2008. Plastic and Reconstructive Surgery of the Breast. Library of Congress. Pg. 144.   Top of Form Bottom of Form Read More