Pressure Sore on an Elderly Patient’s Heel
The patient has a stage 1 decubitus ulcer on her left heel. Both feet are cool but are the same temperature. Distal pulses are palpable but weak on the good foot; they are not palpable on the left and can only be heard faintly with a handheld Doppler. You note unilateral petechiae on the dorsum of the left foot.
You see an elderly woman who resides in a nursing home for a pressure sore on her left heel that has been present for the past few days. She has advanced dementia and cannot provide any useful history herself. The nursing home reports a history of hypertension and coronary arterial disease.
The patient’s vital signs are normal. Results of the head and neck examination are unremarkable; the lungs are clear and the heart beat is regular, with a 3/6 systolic ejection murmur. The abdominal exam is benign. The extremities show no cyanosis, clubbing, or edema.
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