Adam Kyle, age 28, fell off a

Adam Kyle, age 28, fell off a ladder and broke his left wrist. He is on call to the OR for an open reduction internal fixation (ORIF). He has no previous health history and lives with his wife and two young children. He is an electrician. The physician’s orders include the following: IV NS @ 100 mL/hr NPO Morphine 5-10 mg sc q4h prn Gravol 25-50 mg IM /sc q4h prn Scopolomine 0.5 mg IM 1 hr pre-op Ancef 1 gm IM 1 hr pre-op 1) Adam is complaining of pain rated 9/10 in his left wrist. Morphine is available in a concentration of 10 mg/mL. How much morphine you would give, and where you would administer the injection? Provide a rationale for your answers. Adam returns from surgery with a plaster of Paris cast. The physician has ordered Adam to be discharged home once his cast is dry. He complains that his cast feels “warm.” 2) Should Adam’s cast feel warm? Why or why not? 3) What is the best method to dry a cast? How long will it take to dry the cast? How you would determine when the cast is dry? 4) What teaching would you need to provide to Adam prior to his discharge? Provide a rationale for your answers. 5) What signs and symptoms would you expect to assess if Adam was experiencing compartment syndrome? 6) Who would you notify if Adam experienced compartment syndrome? Why?

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