Question Answered H.K. is a 26-year-old man who tried to light a cigarette while… H.K. is a 26-year-old man who tried to light a cigarette while driving and lost control of his truck. Thetruck flipped and landed on the passenger side. H.K. was transported to the emergency department witha deformed, edematous right lower leg and a deep puncture wound approximately 5cm long over thedeformity. Blood continues to ooze from the wound.1. What further assessment will you make of the leg injury, and what precautions will you takein making this assessment?2. What is the most appropriate method for controlling bleeding at this wound site?3. From the above information, it is clear that H.K. is a smoker. List at least three issues related tohis smoking that can complicate his care and recovery. What interventions could be institutedto counter these complications? Would using a nicotine patch eliminate these problems?4. What is the best way to immobilize the leg injury before surgery?H.K. is taken to surgery for open reduction and internal fixation (ORIF) of the tibia and fibula fractures. Hereturns with a full-leg fiberglass cast with windows over the areas of surgery.5. Describe the assessment of a patient with a long leg cast involving trauma and surgery.6. In assessing H.K.’s cast on the third day postoperatively, you notice a strong foul odor.Drainage on the cast is extending, and H.K. is complaining of pain more often and seemsconsiderably more uncomfortable. Vital signs are 123/78, 102, 18, 102.2 ° F (39 º C). What isyour analysis of these findings?H.K. returns to surgery. The wound over H.K.’s fracture site has become necrotic with purulent drainage.The wound is debrided and cultured; then a posterior splint is applied. H.K. returns to his room with ordersfor wet-to-moist dressing changes. The physician suspects osteomyelitis and orders nafcillin (Unipen) andciprofloxacin (Cipro). Contact precautions are implemented.7. Why are two antibiotics ordered? 8. H.K. asks you about the isolation precautions. “Does this mean I have something bad?” What is your best answer? a. “These are precautions that we use for every patient who has surgery.” b. “These precautions prevent the spread of the infection to other patients and to health care personnel.” c. “These are precautions we are taking to help your infection get better.” d. “This is an extremely serious infection; these precautions will keep the infection from getting worse.9. As you continue to assess H.K. over the following days, what evidence will you look for that antibiotics are effectively treating the infection? 10. What will H.K. be taught concerning the care of his cast?11. What nutritional needs will H.K. have, and why?12. To ensure pain management, H.K. is given a fentanyl (Duragesic) 75mcg/hr transdermalpatch. To which therapeutic category does this drug belong? What signs and symptomswould you see if he were to have a toxic or overdose reaction?13. What is the first thing you will need to do if you note a toxic or overdose reaction to thefentanyl transdermal patch?14. What is the antidote to toxic opioid reactions, and how is it administered?15. What issues would the discharge planner need to address with H.K.? Health Science Science Nursing Share QuestionEmailCopy link Comments (0)
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