Question

Gina Dickerson is a 34-year-old woman who is being admitted to the orthopedic unit following a motor vehicle accident. She was driving her car through an intersection when someone ran a stop sign and hit her vehicle.

Ms. Dickerson was diagnosed in the emergency room with a compound fracture of the left femur and a comminuted fracture of the left ankle.

When this patient arrived in the orthopedic unit at 1600, her left leg was immobilized with an air cast and ice bags were applied. She was medicated in the emergency room with morphine sulfate, 2 mg intravenously at 1200. The nursing admission assessment data revealed that Ms. Dickerson had no significant medical problems. Her vital signs on admission to the unit were as follows: temperature, 99.2°F; pulse, 90 beats per minute; respirations, 24 breaths per minute; oxygen saturation, 95% on room air; and blood pressure, 140/80 mm Hg. She was scheduled for surgery in the morning to repair both fractures.

1.Explain the type of fractures this patient has incurred.

2.List the top three priority nursing interventions for this patient upon admission.

3.What are some complications that this patient is at high risk for developing?

4.What is the significance of the patient’s vital signs?

Answer 1

Ans :-1)

Ms. Dickerson was diagnosed in the emergency room with a compound fracture of the left femur and a comminuted fracture of the left ankle.

An open fracture, also called a compound fracture , is a fracture in which there is an open wound or break in the skin near the site of the broken bone. A compound fracture is one that also causes injury to the overlying skin.

The most common causes of compound fractures are falls, accidents, overuse, and osteoporosis.

Comminuted - The break is in three or more pieces and fragments are present at the fracture site.

2) Nursing interventions :-

- The nurse should instruct the patient regarding proper methods to control edema and pain.Administer prescribed medications, which may include opioid or nonopioid analgesics and prophylactic antibiotics for an open fracture.

Rationale - To make patient comfortable

-Assess sign and symptoms of patients.Rationale : patient has an open wound which increases risks of infection.

- It is important to teach exercises to maintain the health of the unaffected muscles and to increase the strength of muscles needed for transferring and for using assistive devices.

- Wound management. Wound irrigation and debridement are initiated as soon as possible.

3) Open tibial fractures result in high rates of complications.

- organisms grown in post-operative infections

-loss of bone growth

- loss of nobility

- Necrosis

- Thromboembolic disease

4)   significance of the patient’s Vital signs are :-- Pulse - pain and increase anxiety may raise heart rate.

-Temperature :-patient should assess rise of temperature

- strong radial pulses;

- Respirations :- respiratory rate should normal if low respiratory rate should look for respiratory complications.

- blood pressure Examination : Swelling may increases blood pressure.

- Palpation