Chapter 39, Problem 1CS

(1)

Summary Introduction

To determine:

The assessments to be carried out before beginning the vancomycin infusion.

Case summary:

Mr. M, a quadriplegic patient (Age: 45), is currently treated for infected sacral pressure ulcer (stage IV). Wound cultures showed the growth of multidrug-resistant Staphylococcus aureus (MRSA). For every 12 hours, the patient is ordered for an intravenous vancomycin. As a part of treatment, wet-to-dry dressing is applied twice a day. In addition, wound care nurse was referred. Due to the infection with MRSA, the patient is also put on contact precautions.

(2)

Summary Introduction

To predict:

The cause of “hot” sensation in the neck and face, and itching. The patient’s neck and face are flushed.

Case summary:

Mr. M, a quadriplegic patient (Age: 45), is currently treated for infected sacral pressure ulcer (stage IV). Wound cultures showed the growth of multidrug-resistant Staphylococcus aureus (MRSA). For every 12 hours, the patient is ordered for an intravenous vancomycin. As a part of treatment, wet-to-dry dressing is applied twice a day. In addition, wound care nurse was referred. Due to the infection with MRSA, the patient is also put on contact precautions.

(3)

Summary Introduction

To determine:

Ways to minimize complications associated with the infusion of vancomycin.

Case summary:

Mr. M, a quadriplegic patient (Age: 45), is currently treated for infected sacral pressure ulcer (stage IV). Wound cultures showed the growth of multidrug-resistant Staphylococcus aureus (MRSA). For every 12 hours, the patient is ordered for an intravenous vancomycin. As a part of treatment, wet-to-dry dressing is applied twice a day. In addition, wound care nurse was referred. Due to the infection with MRSA, the patient is also put on contact precautions.

(4)

Summary Introduction

To determine:

The therapeutic goal for monitoring the levels of vancomycin in the blood.

Case summary:

Mr. M, a quadriplegic patient (Age: 45), is currently treated for infected sacral pressure ulcer (stage IV). Wound cultures showed the growth of multidrug-resistant Staphylococcus aureus (MRSA). For every 12 hours, the patient is ordered for an intravenous vancomycin. As a part of treatment, wet-to-dry dressing is applied twice a day. In addition, wound care nurse was referred. Due to the infection with MRSA, the patient is also put on contact precautions.

(5)

Summary Introduction

To determine:

The single best way to prevent the spreading of Mr. M.’s (the patient) MRSA infection.

Case summary:

Mr. M, a quadriplegic patient (Age: 45), is currently treated for infected sacral pressure ulcer (stage IV). Wound cultures showed the growth of multidrug-resistant Staphylococcus aureus (MRSA). For every 12 hours, the patient is ordered for an intravenous vancomycin. As a part of treatment, wet-to-dry dressing is applied twice a day. In addition, wound care nurse was referred. Due to the infection with MRSA, the patient is also put on contact precautions.