[Solved]: Louis Greenwell is a 68-year-old man, who complains…

Louis Greenwell is a 68-year-old man, who complains of left foot pain. States he stepped on “something” in the yard a few days ago. He is unable to bear weight on the left foot and he is nauseated. Mr. Louis has type 2 diabetes that is controlled with metformin (Glucophage) 500 mg orally twice daily. Physical exam is as follows: BP 160/90, P 110, R 24, T 100.8° F, left foot swollen, red, and warm to touch, open area on ball of left foot near first metatarsal, with tissue loss and irregular wound margins measures 2 cm in diameter, with moderate amount of thick yellow drainage, bilateral paresthesia in lower legs, enlarged, mobile and tender lymph node to left groin, blood glucose 350, WBC 19, neurtrophils 80, bands 12, lymphocytes 5, monocytes 15. The physician ordered wound cultures x 1, Bactrim DS i po BID x 10 days, Tylenol 1gm po q 4 hours prn for temp > 100.2, Norco i po q 6 hours prn for pain. 1. Interpret the CBC. What are the overall conclusions? 2. a. What manifestations occur with local inflammatory responses? b. What manifestations occur with systemic inflammatory responses? c. Does Mr. Louis have a local or systemic response? 3. Which other diagnostic test is needed to help establish a diagnosis in Mr. Louis? 4. By what method will his wound heal? Give basic elements that the body needs to heal 5. Include at least 6 factors that may interfere with or delay the healing of wounds? Include not only factors affecting Mr. Louis but also other factors that could negatively impact wound healing. Briefly state how these factors impair would healing.