Musculoskeletal Trauma A 25-year-old male client riding his motorcycle was struck by a speeding truc

Musculoskeletal Trauma A 25-year-old male client riding his motorcycle was struck by a speeding truck while passing him on a narrow rural road. As a result of the accident, the client was thrown into a ditch with the motorcycle landing on his right leg. His riding helmet remained intact during the accident. After lifting the motorcycle from the client’s entrapped right leg, first responders at the scene found him to be alert and oriented × 3, and able to move both arms and his left leg. The only visible injury was severe bone and soft-tissue damage of his right leg. The client states that his pain was a 10/10 on a 0 to 10 pain intensity scale. Vital signs: pulse = 90 beats/min, respirations = 24 breaths/min, and blood pressure = 130/78 mm Hg. The client was immobilized and transported to the emergency department (ED). Upon admission to the ED, the nurse reviews the prehospital documentation. 1. Which client assessment requires immediate follow-up by the ED nurse at this time? A 25-year-old male client riding his motorcycle was struck by a speeding truck while passing him on a narrow rural road. As a result of the accident, the client’s right leg was severely damaged by the motorcycle and he was transported to the hospital by ambulance. After evaluation by the interprofessional health care team in the ED and multiple x-ray examinations, the client was found to have several closed fractures of the femur, tibia, and fibula. Large portions of skin and soft tissues were damaged, but most of the skeletal muscle on the right leg remained intact. The client was sedated for fracture reduction and immobilization with a fiberglass splint. After this procedure, he was admitted to the acute care orthopedic unit with an IV infusion and client-controlled analgesia. 2. What are some of the complications that the patient is at risk of during while in the hospital? A 25-year-old male client experienced severe right leg trauma due to a motorcycle accident. After reduction and immobilization of several right leg fractures, the client was admitted to the acute care orthopedic unit with an IV infusion and client-controlled analgesia. The surgeon told the client that he would have an open reduction internal fixation after swelling in the right leg decreases. 3. Based on the client’s condition, the client’s priority need will be to prevent ___________1___________. In addition, he will need interventions to prevent potentially life-threatening complications of immobility, especially ______________2______________ and ______________2_______________. A 25-year-old male client experienced severe right leg trauma due to a motorcycle accident. After reduction and immobilization of several right leg fractures, the client was admitted yesterday to the acute care orthopedic unit with an IV infusion and client-controlled analgesia. This morning, the client’s IV was converted to a saline lock because the client was eating and drinking adequate fluids. His pain level this morning was a 3/10 with PCA morphine, but the PCA is scheduled to be discontinued by 8 p.m. this evening. The night nurse discontinued the PCA per surgeon’s order and assured the client that he could still have morphine when needed. At 4 a.m., the nurse gave the client the prescribed dose of morphine for his report of 9/10 pain. At 5 a.m., the client reported that the pain was now “more like a 12 out of 10” and he feels painful tingling in his right foot. He states that the morphine he received an hour ago “did not touch” his pain. 4. What are the most appropriate interventions/actions for the client care at this time? A 25-year-old male client experienced severe right leg trauma due to a motorcycle accident 5 days ago and was admitted to the acute care orthopedic unit. Since that time, he has had two surgeries, including a fasciotomy due to compartment syndrome, and open reduction internal fixation (ORIF) of the tibia. His fasciotomy wound is open but healing well with new granular tissue at the base of the wound. The ORIF incision is well-approximated and beginning to heal. The client has a new leg splint that begins above his knee and ends under his foot for support during the healing process. What nursing actions are appropriate for the client at this time? Select all that apply. A. Manage the client’s pain to achieve a 2/10 to 3/10 on a 0 to10 pain intensity scale. B. Perform frequent lower extremity neurovascular assessments (“circ checks”). C. Collaborate with the case manager to plan for hospital discharge planning. D. Reinforce teaching about crutch-walking using a three-point gait. E. Remind assistive personnel to assist the client in changing positions every 1-2 hours. F. Encourage client to select high-fiber foods to help prevent constipation. G. Reinforce leg exercises and ankle “pumps” to prevent deep vein thrombosis. H. Remind the client to use his incentive spirometer at least every 2 hours. I. Ask the client to report any burning or pressure sensation of the right heel

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