1400: Client reports swelling, erythema, and painful lesion to the left upper extremity. The client reports that he noticed a pimple-like lesion three days ago that grew in size and became painful over the course of three days. The client has a medical history of diabetes mellitus (type one) and has noticed higher-than-normal blood glucose levels. The client reports that pain has increased to a level where he cannot go to the gym daily. On assessment, the client has a large, reddened pustule in the left upper extremity. Pain rated 7/10 on the Numerical Rating Scale. Vital signs: T 98.7° F (37.1° C) P 88 RR 16 BP 138/84 Pulse oximetry reading 99% on room air.

1519: Bedside I&D performed by physician. Applied 4x4 gauze sponge to the wound and wrapped with rolled sterile gauze. Culture and sensitivity were obtained and sent to the lab.

1610: Discharged client home. Discharge teaching provided. Vital signs: T 98.7° F (37.1° C) P 82 RR 17 BP 133/81 Pulse oximetry reading 98% on room air.

1400:

• obtain supplies for incision and drainage (I&D)
• culture and sensitivity of the wound drainage

1509:

• discharge client home
• follow-up with primary healthcare provider (PHCP) in three days
• discharge prescription: trimethoprim/sulfamethoxazole 160mg/800mg one tablet PO every twelve hours for 7 days
• discharge client with wound care supplies

1514: Bedside I&D was performed on a left upper extremity abscess. Area was prepped and cleaned with povidone iodine. 1% lidocaine infiltrated for anesthesia. A large amount of purulent, foul-smelling drainage was removed from the abscess. Minimal blood loss. Client tolerated the procedure with no reports of discomfort. Area was dressed by nursing. Strong suspicion of MRSA abscess.