Am I on the right track?

[Needles McGee, RN]

I posted the discussion question below my thoughts for my response. So, am I off base here? Anything I am missing? Thanks! So far I would say T.Z.'s history of MRSA in a surgical wound would require Tier II contact isolation precautions, with T.Z. being placed in a private room, and and PPE worn by anyone entering the room. (Or does the history of MRSA not factor in here? In which case, would the current wound just require standard precautions?)

As for the second part, I would say due to T.Z.'s DM and history of MRSA, she is at risk for developing a non-healing wound. (Diabetes increases chance for non-healing wounds, and IF T.Z.'s culture comes back positive for MRSA, that adds to the increased risk, correct? SO, am I reading too much into it? Or just base the risk on the DM which causes slow healing wounds?) Case Study: T.Z. is a 67-year-old African-American female who has been admitted to the hospital for a non-healing wound of the lower right leg. She hit her leg on a dresser three weeks ago and the wound now has purulent drainage, an area of erythema that extends four centimeters on all sides and is warm to touch. T. Z. has a history of diabetes mellitus type II, and MRSA of a surgical wound. The nurse has cultured her wound and sent it to the laboratory. What type of isolation will be instituted? Why? What are T.Z.’s risk factors for developing a non-healing wound, and what education needs will you begin to plan for?

[nurseprnRN, BSN, RN]

The CDC is always your friend for these sorts of questions.

CDC - 2007 Isolation Precautions - HICPAC

[HoppaRoundNursie]

I would say you are on the right track if that is the entire case study (but the organization of that post was a little awkward lol). I think you have pretty much answered all of your questions. Don't read too deep into it, they gave you exactly the amount of information they want you to use. Real life information: When in doubt, USE PRECAUTIONS!

You didn't say in your post, but I assume you know what education you would need? Think specifically of checking feet, wound care, infection control, etc.

[MendedHeart]

Most hospitals have different ID policies. My hospital says if the MRSA or whatever infectious disease incident was greater than one year from admission then no Isolation is required. Of course, if it active, contact precautions is needed. Having MRSA In the past does in fact increase the risk for getting it again. I think you are.definitely on the right track.