Case Scenario
Mrs Gina Bacci is a 49year old Italian lady (with poor English) who was admitted to hospital 2 weeks
ago for surgery following complications from a right foot ulcer. She underwent surgery under general
anaesthetic, for partial amputation of forefoot and the great and first toes. She has a history of; Type
II diabetes (diagnosed 6years ago); Peripheral vascular Disease (PVD); and Obesity (BMI 40.4m2;
Height 165cm weight 110kgs). Due to her worsening diabetes she has been commenced on insulin
during her admission to hospital.
Gina was discharged from hospital 7days ago and has presented to the outpatient department for
further wound assessment and management. She is not due to see the surgeon for her follow up
post-operative appointment for another 2 weeks.
Current Medications on discharge one week ago are as follows:
• Novorapid TDS 12units
• Lantus 30units nocte.
• Pregabalin 75mg mane
• Paracetamol 1g QID
Mrs Bacci admits she sometimes forgets and doesn’t think she needs to take all her medications.
She is mobilising with an offloading boot and walking stick. On examination her blood pressure is
120/70mmHg; Pulse 88 bpm regular; RR 18 bpm and SpO2 at 97% on RA, temp 37.8ºC Her feet and
toes on her right foot are cool to touch with a capillary refill of 2-3 seconds. Mrs Bacci states that she
normally has cold feet and wears bed socks. Her BGL is 12.6mmol/L.
When you examine her wound you note that there is an Island film dressing along the incisional
wound which is wet from serous exudate output. The wound has some dehiscence along the suture
line and there is some sloughy tissue. The surrounding skin is warm, and dark pink and painful to
touch.

Assignment: A Right Foot Ulcer

Assignment: A Right Foot Ulcer
Assessment 1: Essay (1800 words) +/- 10%
Considering the case study above and using the clinical reason cycle write an essay that addresses
the following 3 questions.
Question 1: Based on the case study, critically analyse and discuss the underlying pathophysiology
and causes of the patient’s post-operative wound status. (650 words)
Question 2: Identify 2 main nursing priorities of care for this patient and provide a justification and
rationale for each. (350 words)
Question 3: From your identified priorities, outline and justify the appropriate and safe nursing
management of the patient during this time. (600 Words)
[Hints:] The word limits for each question are a guide and gives you an idea of the weighting of
discussion required, plus allows for approximately 100words for an introduction and 100words for a
conclusion.
In order to justify and rationalise your nursing priorities and nursing management strategies, you
need to link your discussion specifically to both the case study, and academic literature in
answering each question.
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.