Assignment Question

Providing Patient Care and Assisting the Provider A 15-year-old patient presents at the office with a puncture wound and a 2-inch laceration of the plantar surface of their left foot. The patient stated that they were barefoot when they “stepped on something” while swimming in the river. Their foot is wrapped in a towel. When you unwrap the towel to assess the wound, you note that the foot is still oozing blood and there is dried mud between the toes. You will be responsible for preparing the treatment room and prepping the patient for examination and treatment. What questions are important to ask the patient upon arrival and why? Describe what items you will likely need in the treatment room and how you will prep the patient.

Answer

Introduction

In healthcare settings, nurses often play a critical role in providing initial patient care and assisting healthcare providers during examinations and treatments. This essay discusses a scenario where a 15-year-old patient presents with a puncture wound and a 2-inch laceration on the plantar surface of their left foot, emphasizing the importance of effective patient assessment and preparation of the treatment room. This case study explores the questions that should be asked upon the patient’s arrival, the necessary items in the treatment room, and the steps involved in prepping the patient for examination and treatment.

Patient Assessment: Important Questions

Upon the arrival of the 15-year-old patient with a puncture wound and laceration, several crucial questions must be asked to gather pertinent information for an accurate assessment and appropriate treatment plan. In this context, the following questions are essential:

1. What Happened?
   • Inquire about the circumstances leading to the injury to understand how it occurred.
   • Determine if the patient has any information about what object caused the puncture wound, as this can impact the choice of treatment and the need for tetanus prophylaxis (Centers for Disease Control and Prevention [CDC], 2020).
2. When Did It Happen?
   • Establish the time of the injury to assess the risk of infection and to guide the timing of interventions (CDC, 2020).
3. Have You Had a Tetanus Shot Recently?
   • Determine the patient’s tetanus vaccination status to decide if a booster shot is necessary (CDC, 2020).
4. Are You Allergic to Anything?
   • Identify any allergies that may affect the choice of medications or materials used during the procedure (Rinonapoli et al., 2021).
5. Do You Have Any Medical Conditions or Take Medications?
   • Gather information about the patient’s medical history and current medications to assess potential contraindications or interactions during treatment (Rinonapoli et al., 2021).
6. Have You Experienced Any Changes in Sensation in Your Foot?
   • Assess the possibility of nerve damage, which may affect the patient’s recovery and treatment approach (Rinonapoli et al., 2021).

Treatment Room Preparation: Necessary Items

To provide effective patient care, nurses must ensure that the treatment room is well-equipped with essential items. For this specific case, the following items are required:

1. Sterile Gloves
   • These are necessary to maintain aseptic conditions during wound assessment and treatment (CDC, 2020).
2. Sterile Gauze and Dressings
   • These materials are used to clean and cover the wound, promoting wound healing and reducing the risk of infection (CDC, 2020).
3. Antiseptic Solution
   • An antiseptic solution, such as iodine or hydrogen peroxide, is essential for wound cleaning and disinfection (CDC, 2020).
4. Tetanus Vaccine and Syringe
   • In case the patient’s tetanus vaccination status is not up-to-date, a tetanus booster may be required (CDC, 2020).
5. Suture Kit
   • A suture kit containing needles and sutures is necessary for wound closure if deemed appropriate by the healthcare provider (Rinonapoli et al., 2021).
6. X-ray Request Form
   • In the event of suspected foreign body involvement, an X-ray may be necessary to assess the extent of injury (Rinonapoli et al., 2021).

Patient Preparation: Step-by-Step Process

To prepare the patient for examination and treatment, nurses should follow a systematic approach to ensure patient comfort and safety:

Step 1: Introduction and Consent

• Greet the patient and introduce yourself.
• Explain the purpose of the assessment and treatment.
• Obtain informed consent from the patient or their legal guardian, emphasizing the risks and benefits (Rinonapoli et al., 2021).

Step 2: Positioning

• Assist the patient in a comfortable and appropriate position for examination and treatment, ensuring they are lying down or sitting comfortably (Rinonapoli et al., 2021).

Step 3: Privacy and Dignity

• Ensure privacy and maintain the patient’s dignity by using drapes or screens as needed (Rinonapoli et al., 2021).

Step 4: Pain Management

• Assess the patient’s pain level using a pain scale.
• Administer appropriate pain relief measures if necessary (Rinonapoli et al., 2021).

Step 5: Wound Assessment

• Carefully remove the towel covering the patient’s foot.
• Examine the wound for size, depth, foreign bodies, and signs of infection.
• Note the presence of dried mud between the toes and document it (CDC, 2020).

Step 6: Cleaning and Dressing

• Clean the wound with an antiseptic solution and sterile gauze.
• Apply a sterile dressing to cover the wound.
• Secure the dressing in place (CDC, 2020).

Step 7: Tetanus Prophylaxis

• Administer a tetanus booster if indicated based on the patient’s vaccination history and the nature of the injury (CDC, 2020).

Step 8: Additional Interventions

• If necessary, assist the healthcare provider with suturing or other wound closure procedures.
• Coordinate any required X-rays (Rinonapoli et al., 2021).

Step 9: Education and Follow-Up

• Provide the patient and their guardian with instructions for wound care, signs of infection, and when to seek follow-up care (CDC, 2020).

Conclusion

In the scenario of a 15-year-old patient with a puncture wound and laceration on their left foot, effective patient assessment and treatment room preparation are critical for ensuring optimal care. Asking the right questions upon arrival, having the necessary items in the treatment room, and following a systematic patient preparation process are essential steps in the healthcare provider’s workflow. By adhering to these guidelines, nurses can contribute to the overall well-being and recovery of their patients.

References

Centers for Disease Control and Prevention (CDC). (2020). Tetanus.

Rinonapoli, G., Franzini, M., Francesconi, A., & Dalla Vedova, M. (2021). Emergency wound management: A practical guide. Journal of Emergencies, Trauma, and Shock, 14(1), 18–24.

Frequently Asked Questions (FAQ) – Patient Care and Treatment Room Preparation

Q1: What should I ask a patient with a foot wound when they arrive at the clinic?

A: It’s crucial to inquire about how the injury occurred, when it happened, tetanus vaccination status, allergies, medical conditions, medications, and any changes in sensation in the affected foot.

Q2: What items should be in the treatment room for wound management?

A: The treatment room should include sterile gloves, gauze, antiseptic solution, tetanus vaccine supplies, a suture kit (if needed), and an X-ray request form (if foreign body involvement is suspected).

Q3: How should I prepare the patient for examination and treatment?

A: Follow a systematic process, including introduction and consent, positioning for comfort, ensuring privacy, assessing and managing pain, wound assessment, cleaning and dressing, administering tetanus prophylaxis (if necessary), assisting with additional interventions, and providing education and follow-up instructions.