Ella Year Female Explained for Students (Easy Guide)

This type of question evaluates analytical and critical thinking skills.

What This Question Is About

This question relates to ella year female and requires a structured academic response.

How to Approach This Question

Use appropriate theories and support your answer with clear reasoning.

Key Explanation

This topic involves ella year female. A strong answer should include explanation, application, and examples.

Original Question

Ella is an 84 year old female who still lives at home, alone. She presented to emergency with complaints of ongoing cellulitis in her right foot. She has a history of diabetes and has had a sore on her great toe that she “just can’t get healed up”. She also stated she didn’t come to hospital before now because she “can’t feel it anyways” and “it doesn’t smell that bad”. Ella is pleasantly confused and also has a history of mild dementia according to previous charts. She required IV antibiotics and was admitted for further work-up/assessment and monitoring. Admitting Dx.: Cellulitis. Med. Hx.: Cellulitis, acute kidney injury, vertebral compression fracture, COPD, mechanical aortic valve, CHF, mild dementia, DMII. Admit: Jan. 21, 2022. Allergic: Macrobid, Oxycodone, Pregabalin. Regular Diet. AAT. Code Status: DNR. Routine precautions. Medications: Furosemide, Budesonide/Formoterol, Betahistamine, Apixaban, Salbutamol, Spironolactone, Calcium carbonate, Olanzapine, Metformin. She has BID VS and physical assessments. She has a double lumen PICC in her basilic vein, right arm. Requires daily weights. Foley catheter in situ, incontinent of stool. Great toe wound dressing changes every Mon/Thurs and PRN – as per MD orders. Thinking of aseptic technique and wound care what type of care would the doctor likely prescribe for this patient given it was necrotic when assessed? What type of dressing would you be likely to use? If it is indeed necrotic, what diagnostic testing could we expect to be ordered? What interventions would be likely if necrosis confirmed? Surgical debridement? Removal of toes? What do you think would determine this? What complications do you think Ella could have from this necrotic wound? What medical history diagnosis’ increases her likelihood of morbidity/mortality? Why? When checking Ella’s CMAR (computer medication administration record) you notice something extremely important is missing. What could it be? Ella has a PICC line in situ, many patients have these. A PICC line is considered a central venous access device (CVAD). Why do you think Ella has one? What are some nursing considerations for a patient with this device? What are some complications of having one at insertion time and afterwards? Look up PICC line insertions under fluoroscopy, you may accompany patients for this type of procedure and it is important to know the A&P. If you were assessing a patients PICC line of IV sites what are some things that would be considered within defined limits of your assessment and what would be significant findings? Why would you be concerned about your significant findings? As you complete your assessment you notice that Ella is becoming more and more agitated and restless in the bed. She seems less pleasantly confused and more just confused now. You check vital signs and notice that she has a fever again and that her blood pressure is much lower than your initial assessment. 79/40 down from 150/84 to be exact! What do you think is happening with Ella? What may be some other significant assessment findings? Her pedal pulses may become diminished or her capillary refill could be sluggish or mottling could be present on her skin – why would any of these things happen to Ella as she is deteriorating? Can we expect Ella to get worse quickly? What are our plans should she have a cardiac arrest? She is deteriorating right in front of our eyes! Do you think Ella requires a higher level of care? Ie. ICU? She is a DNR after all? How do you think we would decide as Ella clearly can’t make this decision on her own? Ella has mild dementia and lives alone. This is not her first time having cellulitis. The emergency triage notes also stated that Ella was “dishevelled and unkempt on arrival”. When asked by the triage nurse how she arrived at the ER, Ella could not remember. Later she remembered she had driven her car. Ella has no close relatives in the area and only a few church friends that check in on her on occasion. She has one adult son who lives in Europe and hasn’t returned any phone calls since admission. What are some obvious concerns that you have for Ella as a health care professional? What are some barriers to healthcare for Ella? What are some socioeconomic factors that may have contributed to her hospital admission? Who would we want involved in Ella’s circle of care in addition to nurses and doctors? Why? In general, what are some medications and activities that can benefit patients with dementia and why are they beneficial? What are some things you want to avoid with the dementia population? Certain phrases, body language, etc?

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