It is now hospital day (HD) 7 and Sean’s infection is clearing and he is feeling better. His dietary intake remains good and he is meeting his calorie and protein goals with commercial supplements and high-protein snacks. The medical resident wants to initiate zinc, vitamin C, and vitamin A to aid in wound healing.
Anthropometric Data:
Weight: 100 kg (218 lbs)
Biochemical Data:
Glucose 105 (70-139 mg/dL) White blood cells 9.1 (4-11 K/uL) Clinical Data: Medications: Ciprofloxacin, Lovenox, Seroquel, Baclofen, multivitamin, Colace, senna Vital Signs: Temperature: 98.6oF
Description Documented By Wound Care Nurse On HD 7:
Sacral wound—stage II: Partial-thickness wound on sacrum, shallow open ulcer measuring 2.5 cm × 2.1 cm with pink wound bed; remains free of slough or exudate. Coccyx wound—stage III: Full-thickness wound on coccyx, open ulcer measuring 3.3 cm × 3.9 cm with red tissue with light serosanguinous wound exudate; granulation tissue is present. Mild redness and swelling around wound noted. No odor or tenderness observed.
Dietary Data:
Diet Prescription: Regular, high-protein diet with commercial supplement twice daily
1. Do you agree with the initiation of zinc, vitamin C, and/or vitamin A? Why or why not?
2. How would you describe Sean’s wound healing progress?
3. What dietary recommendations would you make to improve Sean’s intake of micronutrients that aid in wound healing?
4. Are any adjustments to his nutrition prescription or energy and protein goals warranted? Why or why not?