1. Mr Smith is an 80-year-old gentleman with an arterial ulcer on his right ankle. Mr Smith has a medical history of Peripheral Arterial Vascular Disease; he is immunocompromised due to chemotherapy for cancer treatment. Mr Smith is a heavy smoker and has a poor nutritional status. Mr Smith explains that this ulcer started out as a break in his skin after knocking his ankle on a piece of furniture three months ago.

Mr. Smith is finding his wound very painful with a pain score of 4 at rest and 6 with dressing changes, especially at dressing change times and when he is lying in bed.

a. Explain the appropriate pain management for Mr. Smith in relation to his painful ulcer?

b. Identify the appropriate medication administration timeframes appropriate to his wound dressing change schedule.

2. Mr Smith is an 80-year-old gentleman with an arterial ulcer on his right ankle. Mr Smith has a medical history of Peripheral Arterial Vascular Disease; he is immunocompromised due to chemotherapy for cancer treatment. Mr Smith is a heavy smoker and has a poor nutritional status. Mr Smith explains that this ulcer started out as a break in his skin after knocking his ankle on a piece of furniture three months ago.

On assessment of Mr. Smith`s wound, you observe that it is malodorous, erythematous, has a purulent discharge and is inflamed. Mr. Smith explains that he is feeling generally unwell. After discussion with the RN and Doctor it is decided to take a wound swab.

Using dot points, outline the procedure for the collection of a wound swab specimen for microbiology (refer to Tabbner`s chapter x).

3. Mr Smith is an 80-year-old gentleman with an arterial ulcer on his right ankle. Mr Smith has a medical history of Peripheral Arterial Vascular Disease; he is immunocompromised due to chemotherapy for cancer treatment. Mr Smith is a heavy smoker and has a poor nutritional status. Mr Smith explains that this ulcer started out as a break in his skin after knocking his ankle on a piece of furniture three months ago.

The RN asks you to update Mr. Smith`s wound care plan to include:

Weekly measurements of the wound

Weekly clinical photography of the wound

Weekly wound tracing

Explain why wounds should be measured and how you would take measurements of Mr. Smith`s wound.

Explain how the use of digital photography can assist with assessing wound healing.

Explain the process of wound tracing.