Final answer:
Ms. Fischer should conduct a thorough assessment of Marisa's sacral ulcer, potentially involving wound cultures, a tissue biopsy, and imaging tests. Wound care management is crucial, including cleaning, debridement, antibiotics, and pressure-relieving measures. A multidisciplinary team should be involved in managing the ulcer and its underlying causes.
Step-by-step explanation:
The question pertains to the management of a sacral ulcer as part of a simulated clinical exercise using the Shadow Health platform, where students engage in virtual clinical experiences. For Marisa, a 52-year-old woman with a history of abdominal pain, swollen lymph nodes, fatigue, and a fever after receiving medical care abroad, Ms. Fischer should ensure that a comprehensive assessment is performed. This assessment may include a detailed physical examination of the sacral ulcer, considering the risk factors such as immobility, malnutrition, and incontinence that might contribute to its development and severity.
Additional tests can include wound cultures or tissue biopsy to determine infection, blood tests for nutritional deficiencies or systemic infection. Imaging studies such as an MRI might be needed to assess any underlying bone involvement. In terms of treatment, wound care management principles apply, which includes regular cleaning, debridement of necrotic tissue, addressing any infections with appropriate antibiotics, and utilizing pressure-relieving devices to avoid further tissue damage. Moreover, a multidisciplinary approach may be required, involving consultations with wound care specialists, dietitians for nutritional support, and physical therapists for mobility assistance.
The clinical observations, outcomes, and the next steps should be closely monitored, documenting the wound's healing progress and adjusting the management plan accordingly.