Question

John Davis, is a 54 y/o male admitted for surgical resection and biopsy of multiple lesions on his back and shoulders. The patient is fair skinned with multiple moles on his shoulders and anterior and posterior torso. The patient is high risk for basal cell carcinoma and has had mole - mapping. Mr. Davis is very thin and reports an 8 lbs. weight loss over the last four months. He owns a land scape business, works outside, he also enjoys being out on his boat. He had a basil cell carcinoma removed from his forehead four years ago (Mohs micrographic surgery) which has left a large scar. Mr. Davis is concerned about potential scars from these lesions. He denies any other health issues. The patient does not smoke, but drinks 2 beers after work daily and more on the weekends. VS BP 150/89, P 62, R 14, T 98.2.

Select Concerns: A)Postoperative pain management
B)Potential for skin graft
C)Poor prognosis discussion
D)Alcohol consumption

Answer 1

John Davis's case concerns include postoperative pain management following surgery for basal cell carcinoma, the possibility of requiring a skin graft due to multiple lesions, and the implications of his regular alcohol consumption on healing and recovery.

Step-by-step explanation:

John Davis, a 54-year-old male with a history of basal cell carcinoma, is at high risk for additional skin cancer and has been admitted for surgical resection and biopsy of multiple lesions. Given the patient's fair skin, outdoor occupation, and history of skin cancer, several concerns stand out that require attention.

• Postoperative pain management - Mr. Davis will likely experience pain following his surgical procedures, and thus will require effective pain management strategies.
• Potential for skin graft - Considering the multiple lesions and prior large scar from Mohs surgery, Mr. Davis may require skin grafting to repair tissue post-surgery, similar to cases of other skin-related surgeries.
• Alcohol consumption - Although Mr. Davis denies other health issues, his regular alcohol intake could affect his healing process and overall recovery, and should be discussed as part of his care plan.

Addressing the potential for visible scarring is also important for Mr. Davis's quality of life. A thorough discussion of prognosis and treatment options tailored to his individual situation is recommended, balancing the need for cancer control with cosmetic outcomes.