Reference no: EM133442029

Case Study Wound Infection.

Part II - The ARNP

Th e next day, Margo went to another urgent care facility where she hoped she would find some relief. John, an Advanced Registered Nurse Practitioner (ARNP), took her history and performed his clinical assessment, noting a normal body temperature and normal-size lymph nodes. While examining the injured finger, he observed significant swelling, mild erythemia, and a small wound with minimal clear exudate. Other than the index finger, the rest of Margo's hand appeared normal. Upon completing his examination, John cleaned the wound, numbed the area, and injected a medication called Depo-Medrol into Margo's finger. Afterwards, he talked to Margo about wound infections, including the redness and swelling she had been dealing with. John told Margo to clean her wound three times a day with soap and water and then to dry it thoroughly. He gave her a prescription for the antibiotic Keflex to be taken two times a day for 10 days. He also gave her a visit summary/discharge instruction paper that identified the clinical impression/diagnosis as "cellulitis/foreign body/fungi." John further instructed Margo to return in 72 hours if her symptoms did not improve.

Once home, Margo closely read the written information she had been given and noted that the document mentioned she had been taking the drug Septra since May 3rd without improvement. Also, her medical services/charge sheet noted "foreign body removal" as a procedure carried out, yet she had no memory of such a procedure. Although at the end of her clinical visit Margo had signed the paper acknowledging her treatment, she was now more confused than ever regarding the cause of her wound and the course of her treatment.

Questions

1. What is the function of Depo-Medrol? Speculate on the reasoning/consequences of its use in this particular case.

2. What pathogens are targeted by Keflex (the newest prescription)?

3. What types (genus/species) of fungal pathogens typically cause wound infections?

4. If a fungal pathogen was implicated, would Keflex eliminate that particular infectious agent?

5. Why did Margo's recent documents mention she was taking Septra rather than Bactrim as her earliest (May 3rd) documents listed?