Question

The nurse has documented an assessment on a 45-year-old male client on the third postoperative day following an open abdominal appendectomy. Click to highlight the assessment findings that will require follow up. Client has 3 in (7.6 cm) right lower abdominal incision. Proximal 2 in (5 cm) of incision edges are red and well-approximated. Distal portion of incision has separated and has yellow drainage on dressing. Bulb drain has serosanguinous drainage and clumps of yellow pus. Oxygen saturation on room air 97\%. Blood pressure, 112/60 mmHg; heart rate, 102 beats/min; respiratory rate, 22 breaths/min; temperature, 101.2

∘
F(38.4
∘
C) orally. Denies chills. Bowel sounds hypoactive in all 4 quadrants. . Client reports passing flatus, no Abdomen firm and slightly distended bowel movement. Lungs clear to auscultation bilaterally. Client reports incisional pain level of 3/10 red blood cell count 4.2million/mcl (4.2×10
12
/1) thirty (30) minutes following oxycodone 5mg orally. Reports an increased, but tolerable, level of pain while performing cough and deep-breathing exercises while splinting incision. Reports minimal pain on abdominal palpation. White blood count 12.9×103 cells/mm3 (12.9×109/l), , hemoglobin 14 g/dl(140 g/l), blood glucose level 130mg/dl (7.21 mmol/l). The nurse monitors the laboratory data for several clients who are diagnosed with hypoproliferative anemias. For each laboratory data, click to specify if the finding indicates microcytic anemia or megaloblastic anemia. Laboratory Data Megaloblastic Anemia Microcytic Anemia decreased folate decreased mean corpuscular volume (MCV) increased total iron-binding capacity (TIBC) decreased reticulocytes decreased vitamin B12 increased mean corpuscular volume (MCV)

Answer 1

Barbara's infection did not respond to oxacillin therapy because the isolate of Staphylococcus aureus causing the infection was methicillin-resistant (MRSA), a type of bacteria that is resistant to many common antibiotics. Alternative antibiotics, such as vancomycin, are needed to effectively treat MRSA infections.

Step-by-step explanation:

Barbara's infection did not respond to oxacillin therapy because the isolate of Staphylococcus aureus causing the infection was methicillin-resistant (MRSA). MRSA is a type of bacteria that is resistant to many common antibiotics, including oxacillin. Therefore, alternative antibiotics, such as vancomycin, are needed to effectively treat the infection.

MRSA is a major problem in healthcare settings, as it can cause serious and potentially life-threatening infections that are difficult to treat. It is important for healthcare providers to be aware of the presence of MRSA and to use appropriate antibiotics when treating infections caused by this type of bacteria.

In Barbara's case, her doctor changed her antibiotic therapy to vancomycin, which is an effective treatment for MRSA infections. Removal of the port and venous catheter may also have been necessary to fully resolve the infection.