Question

Discuss 5 complications of fractures. Discussion should include description and nursing. one point for name of complication, two points for discription and two points for nursing implication. Total point for this section is 20

The patient is taking these drugs s/p orthopedic surgery: heparin, Motrin and morphine. What are drugs for. What are important nursing implication for the patient taking these drugs. nursing implication must include lab test and antidote when applicable

Heparin is an anticoagulant blood thinner that prevents the formation of blood clots. Motrin is a nonsteroidal anti-inflammatory drug (NSAID). works by reducing fever, inflammation and pain in the body. Morphine is an opioid medication or narcotic is used to treat moderate to severe pain.

Answer 1

Complications of fractures:

A.Fat embolism:

a.It is orginates in the bone marrow and occurs after a fracture when a fat globule is released into the bkood stream.

b.Fat embolism can occur within the first 48 to 72 hours following the injury.

Nursing implications:

a.Administer oxygen

b. Monitor vital signs and respiratory status.

B.Compartment syndrome:

a.Tough fasica surrounds muscle groups ,forming compartments from which arteries, veins,and nerves enter and exit at opposite ends.

b.Within 4 to 6 hours after the onset of compartment syndrome,neurological damage is irreversible if not treated.

Nursing implications:

a. Notify the health care provider immediately and prepare to assist the health care provider.

b.If severe ,assist the HCP with fasciotomy to relieve pressure and restore tissue perfusion.

C.Infection and osteomyelitis:

a.It can be caused by the introduction of organisms into bones leading to localized bone infection.

b.Inflammatory response to bone tissue.

Nursing implications:

a.Prepare ti initiate aggressive ,long term intravenous antibiotic therapy.

b .Administer hyperbaric oxygen therapy to promote healing.

D.Avascular necrosis:

a.Avascular necrosis occurs when a fracture interrupts the blood supply to a section of bone.

b It leads to bone death.

Nursing implications:

a.Notify the HCP if pain or numbness occurs.

b.Prepare the client for removal of necrotic tissue because it serves as a focus for infection.

E.Pulmonary embolism:

a.It is complication of facture,

b.It is caused by the movement of foreign particles into the pulmonary circulation.

2) A.Heparin:

a.It prevents thrombin from converting fibrnogen to fibrin and it prevents thromboembolism.

Nursing implications:

a.Monitor for bleeding gums hematuria and so on

bThe antidote is protamine sulphate

Nursing implication for lab test:

aTo maintain a therapeutic level of anticoagulants when the client is recieving a continous infusion of heparin ,the aPTT should be 1.5 to 2.5 times the normal value.

b. Monitor platelet count

B.Motrin:

a.It is used to relieve inflammation and pain

b.Hypoglycemia can occur if it taken with insulin.

Nursing implications:

a.Monitor the signs of bleeding

b.Assess the client for allergies

Implication for lab test:

a.Monitor renal and liver function test

b.Monitor complete blood test.

C.Morphine:

a.It can suppress the pain impulses.

b.The antidote is naloxone

Nursing implications:

a. Monitor vital signs and urine out put

b.Monitor blevel of consciousness.

Implication for Lab test:

a.Monitor complete blood count.

b.Monitor arterial blood gas