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RNSG 2331 Fractured Femur ORIF (complete)
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RNSG 2331 Fractured Femur ORIF (complete) RNSG 2331 Fractured Femur ORIF (complete) RNSG 2331 Fractured Femur ORIF (complete)
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RNSG 2331 Fractured Femur ORIF (complete)Scenario
K.B. is a 16-year-old girl who fell while skiing. She briefly lost consciousness but is now alert
and oriented. 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 will be admitted to
your unit after an open reduction and internal fixation (ORIF) of the femur fracture and casting
of her leg and arm.
1. You are taking the report from the postanesthesia care unit (PACU) nurse. K.B. is awake and
taking ice chips. What information will you document on the admission form? check for gag
reflex, Monitor vitals q5-15 minutes, examine surgical site and monitor interventions being
performed such as IV fluids.
2. How will you use this information in planning your immediate assessment and care of K.B. on
admission? you must assess for pain, pulses to the extremity, and check bandage and dressing for
integrity.
Chart View
Physician’s Orders
Vital signs per routine for postop patient
Continuous pulse oximetry
Neurologic checks every 4 hours
Turn, cough, and deep breathe and incentive spirometer every 2 hours while awake
Heat pack and elevate right lower extremity and right upper extremity
Neurovascular checks every 1 hour
NPO
IV fluids NS at 100 mL/hr
Morphine sulfate 5 mg IV every 4 to 6 hours prn
3. For each order listed in the chart, state whether the order is appropriate or not and state why. 1.
order is correct but could specify at what time intervals. 2. pulse oximetry is appropriate to
monitor airway and breathing status. 3. correct, neurologic function assessment is highest
priority to observe for adverse effects of surgery 4. turning is not recommended for patients who
received ORIF. other interventions are correct. 5. Cold pack is the recommended therapy for first
48 hours. 6. this is cruicial in assessing the outcome of limb from surgery and to monitor for
adverse effects. 7. NPO status only until gag reflex returns. 8. IV fluids is a correct intervention
post op to promote hydration with NPO status. 9. this is appropriate for pain management
CASE STUDY PROGRESS
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