ACADEMIC
H.K. is a 26-year-old man who tried to light a cigarette while driving and lost control of his truck. The truck flipped and
landed on the passenger side. H.K. was transported to the emergency department with a deformed, edematous right
lower leg and a deep puncture wound approximately 5 cm long over the deformity. Blood continues to ooze from the
wound.
1. What further assessment will you make of the leg injury, and what precautions will you take in making
this assessment?
Selected Answer:
H.K. should have a neurovascular assessment done at least every two hours, assessing the 5 P's: pain, pulse,
pallor, paresthesia and paralysis. Pain should be evaluated using OLDCARTS and his LE pulses should be
closely monitored to determine perfusion to the LE.
The patient's leg needs to be stabilized
The nurse should immediately assess the patient’s vital signs in order to determine his exact condition.
Capillary refill could also be evaluated in order to additionally determine the oxygen saturation of the
patient. Also, the nurse should evaluate the patient’s blood levels because he is continuing to lose blood. He
is at risk for going into hypovolemic shock. It is important that the nurse supply the patient with both blood
and oxygen to allow the body to begin the healing process as soon as possible, which requires a great deal
of oxygen carried by the blood.
2. What is the most appropriate method for controlling bleeding at this wound
site? Selected Answer:
Immobilize the leg and apply pressure with a sterile bandage.
A tourniquet could be placed above the knee and used as a short-term solution to stop the bleeding.
However, the patient will most likely undergo emergency surgery as soon as he reaches the hospital;
therefore, the tourniquet would need to be removed before the surgery, and an alternative form of bleeding
control must be utilized during the surgery itself.
3. From the above information, it is clear that H.K. is a smoker. List at least three issues related to his smoking
that can complicate his care and recovery. What interventions could be instituted to counter these
complications? Would using a nicotine patch eliminate these problems?
Selected Answer:
Smoking slows healing, increases the risk of infection and increases the level of pain. Interventions would
be to have the patient stop smoking. The nicotine patch might be helpful but it is unclear if nicotine
through the patch causes the same level of blood vessel constriction.
4. What is the best way to immobilize the leg injury before
surgery? Selected Answer:
Splint the tib/fib to prevent movement
The best way to immobilize the leg before surgery is to use a splint. This kind of device is easy apply and
remove when the surgery is about to begin. Also, it will hold the limb still before surgery adequately in
order to prevent further injury.
This study source was downloaded by 100000839604613 from CourseHero.com on 01-18-2022 05:45:35 GMT -06:00
https://www.coursehero.com/file/44759372/Tibia-CSdocx/
H.K. is a 26-year-old man who tried to light a cigarette while driving and lost control of his truck. The truck flipped and
landed on the passenger side. H.K. was transported to the emergency department with a deformed, edematous right
lower leg and a deep puncture wound approximately 5 cm long over the deformity. Blood continues to ooze from the
wound.
1. What further assessment will you make of the leg injury, and what precautions will you take in making
this assessment?
Selected Answer:
H.K. should have a neurovascular assessment done at least every two hours, assessing the 5 P's: pain, pulse,
pallor, paresthesia and paralysis. Pain should be evaluated using OLDCARTS and his LE pulses should be
closely monitored to determine perfusion to the LE.
The patient's leg needs to be stabilized
The nurse should immediately assess the patient’s vital signs in order to determine his exact condition.
Capillary refill could also be evaluated in order to additionally determine the oxygen saturation of the
patient. Also, the nurse should evaluate the patient’s blood levels because he is continuing to lose blood. He
is at risk for going into hypovolemic shock. It is important that the nurse supply the patient with both blood
and oxygen to allow the body to begin the healing process as soon as possible, which requires a great deal
of oxygen carried by the blood.
2. What is the most appropriate method for controlling bleeding at this wound
site? Selected Answer:
Immobilize the leg and apply pressure with a sterile bandage.
A tourniquet could be placed above the knee and used as a short-term solution to stop the bleeding.
However, the patient will most likely undergo emergency surgery as soon as he reaches the hospital;
therefore, the tourniquet would need to be removed before the surgery, and an alternative form of bleeding
control must be utilized during the surgery itself.
3. From the above information, it is clear that H.K. is a smoker. List at least three issues related to his smoking
that can complicate his care and recovery. What interventions could be instituted to counter these
complications? Would using a nicotine patch eliminate these problems?
Selected Answer:
Smoking slows healing, increases the risk of infection and increases the level of pain. Interventions would
be to have the patient stop smoking. The nicotine patch might be helpful but it is unclear if nicotine
through the patch causes the same level of blood vessel constriction.
4. What is the best way to immobilize the leg injury before
surgery? Selected Answer:
Splint the tib/fib to prevent movement
The best way to immobilize the leg before surgery is to use a splint. This kind of device is easy apply and
remove when the surgery is about to begin. Also, it will hold the limb still before surgery adequately in
order to prevent further injury.
This study source was downloaded by 100000839604613 from CourseHero.com on 01-18-2022 05:45:35 GMT -06:00
https://www.coursehero.com/file/44759372/Tibia-CSdocx/
