Question

2. A nurse is caring for a client who has a traumatic injury to the right ankle. The client has an unstable fracture with only a temporary splint in place. The client is having increased pain that is unresolved with IV narcotics and has 4+ edema, pallor, and pulselessness of the right foot. What should the nurse suspect, and what interventions should be taken?

Answer 1

The patient may have a fractured or broken ankle. It happens when one or more bones in the ankle joint break. The broken ankle is very painful . The symptoms include severe pain, tenderness ,swelling, bruising, difficulty in walking or movint the foot, and bleeding ( if bone pierces the skin ).

The interventions should be taken include :

1) Leave protruding bone alone

If a bone has broken through the skin, dont push it back into  place . Cover the area with a clean bandage.

2) stop bleeding

Apply steady,direct pressure with a cloth for 15 minutes and elevate the wound.

3) control swelling

* remove ankle bracelets,or toe rings.

* apply RICE therapy

Rest ankle by having the person stay off of it. Use cretches if necessary

Ice area , use an ice pack or wrap the ice in a clean cloth. Donot place the ice directly against the skin.

Compress by wrapping ankle lightly ( not tightly) with an "ace" bandage or elastic ankle brace. Donot try to align the bones.

Elevate ankle above heart level.

4) manage pain and inflammation

Administer over the counter pain medications such as ibuprofen or aspirin. Avoid ibuprofen or other NSAIDs if the person has heart failure or kidney failure.

5) Take x- ray of the ankle , leg, and foot. Take CT or CAT scan or an MRI to determine if surgery is needed.

If needed, the docter will set the broken bone back in place and immobilize the ankle with a splint, cast or other device.Surgery may be necessary to repair the break.ORIF( open reduction and internal fixation) can be the proposed surgery to treat the broken ankle.

Note: please do like the answer.