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Published by Linda Kuglarz

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Published by: Linda Kuglarz on Oct 12, 2008
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05/09/2014

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DIAGNOSIS: Cellulitis of the labia, diabetes mellitus PATHOPHYSIOLOGY: Cellulitis (sel-u-LI-tis) is a common, potentially serious bacterial skin infection. Cellulitis appears as a swollen, red area of skin that feels hot and tender, and it may spread rapidly. Skin on lower legs is most commonly affected, though cellulitis can occur anywhere on your body or face. Infections on the face are more common in children and older adults. Cellulitis may affect only your skin's surface — or, cellulitis may also affect tissues underlying your skin and can spread to your lymph nodes and bloodstream. Left untreated, the spreading infection may rapidly turn lifethreatening. That's why it's important to seek immediate medical attention if cellulitis symptoms occur. ALLERGIES: NKA

VII.

FOR CELLULITIS: Diabetes- can slow down your body's ability to fight infection. High blood glucose leads to high levels of sugar in your body's tissues. When this happens, bacteria grow and infections can develop more quickly in people with diabetes. Common sites of infection are your bladder, kidneys, vagina, gums, feet, and skin. Early treatment of infections can prevent more serious complications. FOR DIABETES MELLITUS: Age greater than 45 years Diabetes during a previous pregnancy Excess body weight (especially around the waist) Family history of diabetes Given birth to a baby weighing more than 9 pounds HDL cholesterol under 35 High blood pressure (greater than or equal to 140/90 mmHg) Impaired glucose tolerance Low activity level Poor diet

RISK FACTORS:

VI.

PAST MEDICAL HX: DM,HTN.

V. DISCHARGE PLANS: • D/C FOR HOME • CALL FOR APPOINTMENT IN 2 WEEKS • KEEP A LIST OF ALL MEDICATIONS

• JOT DOWN SPECIFIC QUESTIONS FOR YOUR NEXT VISIT WITH YOUR MD • OBTAIN RESULTS OF YOUR TESTS • FOLLOW A LOW FAT DIET 3 MG/DAILY • REST ADEQUATELY

II. SIGNS&SYMPTOMS 1. Red, swollen, tender and warm left lower abdomen. 2. Fever of 102.0 F 3. Severe pain in left lower abdomen and perineal area 4. Chest pain/ dyspnea.

IV. MEDICATIONS: • ASPIRIN EC 81MG TAB - ANTICOAGULANT, ANTIPLATELET • PANTOPAZOLE UD TAB 40MG/PROTONIX - PPI, DECREASES GI SIDE EFFECTS CAUSED BY OTHER MEDICATIONS • ACETAMINOPHEN UD CPL1000MG/TYLENOL ES- FOR PAIN, PRN • CLINDAMYCIN - LINCOSAMIDE ANTIBIOTIC, FOR ANAEROBIC STREPTOCCOCCI AND AEROBIC GRAM POSITIVE COCCI FOR BACTERIAL INFECTION THAT THIS PT HAS DEVELOPED IN LEFT LOWER PERINEAL AREA • CLOTRIMAZOLE LOTION - ANTIFUNGAL , CREAM FOR PT INFECTION ON THE POSTERIOR NECK BETWEEN THE FOLDS • FERROUS SULFATE- BLOOD FORMER, IRON PREPARATION, PT NEEDS TO TAKE IT WITH FOOD, IT MAY CAUSE GI UPSET, PT HAS A WOUND THAT NEEDS IRON TO HEAL. • LANTUS INSULIN - LONG ACTING INSULIN , PT HAS DM

III. DIAGNOSTIC TESTS: 7/29/08 LABS HEMATOCRIT 11.1 L- pt has lost blood due to infected wound and its debriedement, recent bleeding and inflammation HEMOGLOBIN 32.7 L - it is low becauswe rbc are low and hemoglobin carries the O2 in the blood and has low iron levels, low because Rbc’s are low and Hgb is carried on Rbc’s, recent bleeding RBC 3.70 L - pt had wound debriedement, acute inflammation in left lower labia LYMPH 14 L BAND 15 H Glucose Serum 147 H- pt’s body is under stress and stress increases glucose, 07/28/08 CT WITH CONTRAST OF PELVIS CLINICAL INDICATION: FEVER & PAIN IN THE PERINEAL AREA -the uterus is normal in size, the urinary bladder and rectum are normal in appearance, no enlarge pelvic lymph nodes or abnormal collection of fluid in the pelvis seen. - there are multiple gas pockets within subcutaneous layer of the left inguinal region extending medially and inferiorly to the subcutaneous layer of the left perineum and the medial aspect of the left thigh. IMPRESSION: findings are indicative of cellulitis with gas producing infection extending from left inguinal region to the left side of the perineum and the medial aspect of the left upper thigh.

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