K>B is a 16 year old who fell while skiing. She was transported down the hill by
ID: 240990 • Letter: K
Question
K>B is a 16 year old who fell while skiing. She was transported down the hill by the ski patrol after being stabilized and then was flown to the hospital. She has a fractured right femur and humerus. She is admitted to yourunit after an open reduction and internal fixation (ORIF) of the femur fracture and casting of her leg and arm.
1. What information should you receive from the postanesthesia care unit (PACU) nurse?
2. How will you use this information in planning your immediate assessment and care of K.B.?
CASE STUDY PROGRESS
K>B has been on the unit for approximately 6 hours. You identify the following changes in your assessment data: K.B. is difficult to arouse, but when is able to identify who and where she s: PERRLA is +1 with slower reaction time than eariler: color is pale, pink: skin is cool and clammy; heart rate is 126 beats/min, repiratory rate is 28 nreaths/min, teperature (oral) is 39C; Sao2 is 90%. You find that neurovascular checks of teh affected extremities are unchaged.
4. What should your immediate nursing intervention include?
5. What information should you report to the orthopedic surgeon, and what is your rationale for doung so?
6. K.B.'s Glasgow Coma Scale begins to decline. What are posible reasons for changes in her neurologic status?
CASE STUDY PROGRESS
K.B. spent 12 hours in the pediatric ICU being monitored for changes in her neurologic status. Her primary heakth care provider (PCP) determinated she was stable and had her transferred to the pediatric unit. It is now 24 hours postop. K.B suddenly begins to complain of extrem e pain in her lower right leg. Your assessment findings right foot cool, pale, with an absent pedal pulse and decreased mobility.
7. What is the most likely cause of these changes, and what should your immediate response be?
8. K.B.'s cast is split and her foot pulses are restored. K.B. and her parents are extremly anxious. What education and support should be provided to K.B. and her parents?
Explanation / Answer
1). Regarding the patient, the following information must be obtained from the postanesthesia care unit (PACU) nurse:
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