Nursing care plan for a patient with Fournier's gangrene: Clinical case.

INTRODUCTION: Fournier's gangrene, a relatively rare form of necrotizing fasciitis, is a rapidly progressive disease affecting the deep and superficial tissues of the perineal, anal, scrotal, and genital regions. Despite the significant evolution in medical knowledge, there is still scarce evidence regarding the nursing care plan in patients affected by this pathology, which hinders its correct management. For this reason, we present the following clinical case of a 53-year-old male patient with Fournier's gangrene who was admitted to the emergency department for 3 days of pain in the perineal area and fever. OBJECTIVE: The objective was to establish an individualized care plan for the patient detailing the diagnoses, expected outcomes and interventions through nursing taxonomies. CASE DEVELOPMENT: A systematic assessment was performed using Marjory Gordon's model of functional health patterns as a reference. After drawing inferences, three collaborative problems and two nursing diagnoses were established with their outcome criteria and interventions. Once the plan was executed, the results obtained highlighted that the interventions were consistent in achieving the objectives set out in the problems present in the case patient. CONCLUSIONS: The development of an individualized plan made it possible to detect problems, establish realistic objectives and define interventions that optimized nursing care in this patient with Fournier's gangrene.

Abordaje y manejo de colostomía como tratamiento de Gangrena de Fournier / No disponible

Se presenta un caso de un paciente con Gangrena de Fournier. Como consecuencia de la dificultad de aislar la cura de las heces y la imposibilidad de poner una sonda rectal para canalizar su salida, se decide hacer colostomía. No terminan ahí las complicaciones: presenta una rotura del estoma con salida de material fecal al abdomen, que precisa de nueva cirugía para repararlo. Infección de herida quirúrgica precisando drenado y curas; dehiscencia del estoma. Sin cuidador principal es primordial la educación sanitaria para que, en el momento del alta, el propio paciente realice un buen manejo del cuidado del estoma. Gracias al plan de cuidados, y mediante una valoración según patrones funcionales de Marjory Gordon, se evitan complicaciones y, las que surgen, se detectan precozmente. De los patrones alterados se realiza el plan de cuidados con la taxonomía NANDA, NOC, NIC

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The care of a patient with Fournier's gangrene.

Fournier's gangrene is a rare, necrotizing fasciitis of the genitals and perineum caused by a mixture of aerobic and anaerobic microorganisms. This infection leads to complications including multiple organ failure and death. Due to the aggressive nature of this condition, early diagnosis is crucial. Treatment involves extensive soft tissue debridement and broad-spectrum antibiotics. Despite appropriate therapy, mortality is high. This case report aimed to present nursing approaches towards an elderly male patient referred to the urology service with a diagnosis of Fournier's gangrene.

[Negative pressure therapy in the loss of perineal substance]. / La thérapie par pression négative dans les pertes de substance périnéale.

Over the last ten years, negative pressure therapy has played a major role in the treatment of complex perineum wounds resulting from infection, trauma or cancer.The use of instillation has enabled its use to be extended to certain particularly difficult situations. It is also used routinely in support of dressing techniques for less complex wounds.

A demonstration of clinical reasoning through a case of scrotal infection.

Clinical reasoning has been defined as collecting clues, processing information, and coming to an understanding of a patient problem, then planning and implementing interventions, evaluating outcomes, and reflecting on and learning from the process. Clinicians with effective reasoning skills positively impact patient outcomes.

«Cuidados enfermeros en la gangrenade Fournier, todo un reto» / No disponible

Se presenta un caso clínico de gangrena de Fournier, una patología infecciosa de alta morbimortalidad, atendido en el Servicio de Urologíade los HH. UU.Virgen del Rocío (Sevilla). Se muestran los patrones funcionales alterados, siguiendo el modelo de M. Gordon, asícomo los cuidados enfermeros prestados. Se destaca la necesidad de una buena coordinación entre los equipos de enfermería de hospitalización,hospitalización domiciliaria y atención primaria de salud, pues de ello va a depender en gran medida la buena resoluciónde la herida quirúrgica y el estado de salud del paciente (AU)

We report a case of Fournier's gangrene, an infectious disease of high morbidity and mortality, treated at the Urology Department ofthe HH. UU. Virgen del Rocío (Sevilla). Altered functional patterns are showed, following the model of M. Gordon and nursing careprovided. It highlights the need for good coordination between the nursing teams of hospitalization, hospital care and primary healthcare, since this will depend largely on the good resolution of the surgical wound and the patient's health status (AU)