Cellulitis occurs when bacteria, most commonly streptococcus and staphylococcus, enter through a crack or break in your skin. Cellulitis can occur anywhere on your body; the most common location is the lower leg. Bacteria is most likely to enter in a break of skin.

1.    What clinical manifestations are present in Ms. G and what recommendations would you make for continued treatment? Provide rationale for your recommendations.

  Clinical manifestations are redness, swelling, fever, high WBC, unable to bear weight on leg, larger calf size by 3 inches, and positive Staph culture of wound with thick yellow drainage. The pain you can see in the patient’s face would be clinical as well.  

Instead of heat I would apply cool, damp cloth over the affected area for relief. I would get an order of antibiotics. Cellulitis treatment usually includes an oral antibiotic. Within three days of starting an antibiotic, the infection usually responds. You may need to take the antibiotic for as long as 14 days but typically 5-10 days. The bacteria can spread rapidly, and get to the lymph nodes and the bloodstream. Rarely the infection can spread to the deep layer of tissue called the fascial lining and this would require quick response because it represents an emergency.  I would offer Tylenol for the fever and the pain.

2.    Identify the muscle groups likely to be affected by Ms. G’s condition by referring to “ARC: Anatomy Resource Center.”  

The muscle groups that could be affected would be these but not limited to these: tibialis anterior, extensor hallucis longus, popliteus, flexor hallucis longus, extensor digitorum longus, peronaeus tertius, flexor digitorum longus and the tibialis posterior

3.    What is the significance of the subjective and objective data provided with regard to follow-up diagnostic/laboratory testing, education, and future preventative care? Provide rationale for your answer.

The follow up for the lab would be to do another culture and blood test after antibiotics are stopped. Measure the leg daily to see that the swelling is improving. Watch for redness, as it should be decreasing, watch for the fever to be eliminated.

Future care includes: Wash your wound daily with soap and water. Inspect your feet daily. Moisturize your skin regularly this will help to avoid drying and cracking. Trim fingernails and toenails carefully.  Wear proper footwear and gloves and treat infections as soon a s you see them. You need to educate the patient about diabetics having a weakened immune system as well as maybe a nutrition evaluation to assist with the patient being considered obese. Both obese and diabetic are susceptible to circulatory complications, associated neuropathy as well as weakened immune systems.

4.      What factors are present in this situation that could delay wound healing, and what precautions are required to prevent delayed wound healing? Explain

Protein is said to assist in wound healing. (Advanced Tissues, 2015) This patient lives alone and may need help with meals. Perhaps get her part of a meal program after meeting with the dietitian. Having education about diet can help with promoting wound healing and controlling her weight.

Advanced Tissues (2015) The Role of Protein in Wound Healing.  Retrieved August 01, 2017, from

Copstead, L. E., & Banasik, J. L. (2013). Pathophysiology. St. Louis, MO: Elsevier.

Grand Canyon University (2017) The Anatomy Resource Center. Retrieved August 1, 2017 from

Norm, B., & I. (2016, January 27). Cellulitis. Retrieved August 01, 2017, from

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