The requirements to be filled on a patients admission form after an open reduction and internal fixation will include; the patient’s full name, the date of birth, weight, height, and vitals (such as; health status), the M/S on the bone status which will include; fractured right femur and humerus, muscle strength, extensor, abductor muscle strength, normal fixed supinated cavus type foot, the heartbeat rate and rhythm, and the capillary filling.
This information will be vital in determining if K.B. needs to undergo surgery, hence cold pack is preferred as it will ease any pain and swelling. It will also be vital in determining if there are any dislocations in her femur and humerus as well as if there may arise any complications in carrying out a surgery. It will also be important in the assessment of neurovascular and neurological state as well as BM, NPO status, and mobility (Karki, Simonen, Malkia, & Selfe, 2004).
I. Vital signs per routine is a procedure that involves carrying a routine and thorough check- up on a person’s temperature, respiratory rate, and blood pressure. It is a very important procedure for any patient being booked for surgery or being diagnosed health- wise. It is in this regard that it is important in K.B.’s case.
II. Neurological checks every 4 hours: This involves diagnosis of the bodily function of the human being where mostly it checks for circulation of blood and air in the body. This is very vital in K.B.’s case so as to check if there is any head injury, and if the brain was affected.
III. Turn, cough, and deep breathe and incentive spirometer every 2 hours while awake: This involves routine check- up of the lungs and the air system of a human body. In the case of K.B.’s assessment is very relevant as her internal organs may be affected in the accident causing internal injuries that are very dangerous.
IV. Heat pack and elevate right lower extremity and right extremity: This involves checking up of the both the lower and upper appendage of human. This is a very vital procedure in this case as K.B. needs to be checked the extent of her injury.
V. Neurovascular checks every 1 hour: It involves checking of the blood vessels and their normality in distribution of blood in the body. It is an important exercise in this case as K.B.’s injury may have led to other complications such as internal bleeding.
VI. NPO: Also referred as Nil per os, is a procedure in which doctors and medical practitioners withhold fluids and oral food from a patient as a result of various medical reasons. In this case, it is not an important procedure, and therefore should not be carried out on K.B.
VII. IV fluids D₅½ NS at 100 mL/ hr: It is necessary in this procedure as it is used as an aesthetic.
VIII. Morphine sulfate 5 mg IV every 4-6 hours prn: This is used as a pain reliever, hence
Yes, the dose is very safe for my patient.
The correct dosage of my patient 1.5 ml
Since K.B. has indicated vital signs by her color becoming pale and pink with cool and clammy condition, I will reassess the pain so as to figure out what medication I’ll .give to reduce HOB, cough and deep breath. A strong pain reliever will come in handy. I will immediately call the doctor to further analyze her.
The main changes in her neurologic status may range from; respiratory distress, less blood being circulated from the heart to the brain, compartment syndrome, and general pain (Santy, 2000).
I will document that a thorough scan to be carried out on K.B. so as to check if any of her organs were affected by the accident, and if there is presence of internal bleeding.
– Diminished pedal pulse
Edema
Increased Pain
Situation: K.B. has a fractured right femur and humerus
Background: K.B. has undergone an open reduction and internal fixation of the femur fracture and casting of her arm and leg.
Recommendation: I recommend that she gets a thorough checkup and start her on O2 stat. Do you concur with this?
K.B.’s parent’s should be taught on how to clean K.B. now that she has undergone numerous surgical procedures and how she should be sitting, standing, and walking and the entire physical exercise for her to heal faster (Heim, Adunski, Chchick, 2002).
Adolescents are preoccupied with the immediate situation rather than future events.
Discharge planning: Done to ensure that she familiarizes herself with the home and school environment.
Education: She will be taken by her parents or guardian to school until she recovers fully.
Physical and Occupation therapy: Doing vigorous exercises of the limbs and body for faster healing.
Nutrition: Ensure that she eats a lot of vitamins that will assist in building her muscles and bones to be stronger and fully recover from the accident.
References:
Heim, M., Adunski, A., & Chechick, A. (2002). Nonoperative treatment of intracapsular fractures of the proximal femur. Clinical orthopaedics and related research, 399, 35-41.
Kärki, A., Simonen, R., Mälkiä, E., & Selfe, J. (2004). Postoperative education concerning the use of the upper limb, and exercise and treatment of the upper limb: cross-sectional survey of 105 breast cancer patients. Supportive care in cancer, 12(5), 347-354.
Santy, J. (2000). Nursing the patient with an external fixator. Nursing Standard, 14(31), 47.
