ANP8010 Advanced Practice In Nursing

Question:

15 year old Diana Prince met with an accident while riding her bicycle yesterday. The paramedic reported blunt trauma to the pelvis. Her Blood pressure was falling and hence she was shifted to the ICU and transfused 3 units of Packed RBS. Her BP is 110/70 mm of Hg now. The CT scan reported an open book fracture of the pelvis. Blood reports from this morning indicated a rise in Serum Creatinine level from 1.1mg/dl to 5.2mg/dl. She was diagnosed with Hypovolemia induced Acute Kidney Injury with fracture pelvis. She is now being monitored by a team of Nephrologists, Orthopaedic and Trauma surgeons.

Content of the presentation:

The following questions should be answered in corresponding slides.

Slide 1	Introduction slide
Slide 2	State the Scenario
Slide 3 -4	How should a nurse obtain accurate information about the physical health status of the case · By Observation · Taking Patient History· Checking case files · What questions were asked to the patient.

Answer:

Hip fractures can cause significant mortality and morbidity in women. Most of the hip fractures and kidney injuries are associated to falls due to accidents or decreased bone mineral density (Magee, 2014). A proper physical assessment is necessary take up proper treatment regimen for the patient.

Diana Prince, who is 15 years old has met with an accident while riding her bicycle yesterday. She has suffered from blunt trauma to the pelvis. Due to her falling Blood pressure she was shifted to the ICU where she was being transfused with 3 units of Packed RBS. Her BP is 110/70 mm of Hg now.

According to the CT scan reports she has suffered from an open book fracture of the pelvis. Blood reports from this morning has indicated an augmented Serum Creatinine level of about 5.2mg/dl. She was diagnosed with Hypovolemia induced Acute Kidney Injury with fracture pelvis. She is now under the surveillance of a multidisciplinary team of Nephrologists, Orthopaedic and Trauma surgeons.

By observation- It is necessary to understand the source of the bleeding.
Normally the bleeding takes place from the cancellous bone, iliac vessels or presacral venous plexus.
Examination of the pelvis may show deformity, tenderness and gross motion.
Pelvic ring fractures can be recognized by the use of the magnetic resonance imaging (MRI).
Patient should be assessed with haematuria, hypotension, history of a rapid deceleration injury (Halawi, 2015).

Pelvic stability has to be assessed by the application of rotational, super-inferior and anterior-posterior stress to the pelvis. Physical findings includes deformity in the pelvic region or pelvic instability, abnormal position of the lower limb, pain (Magee, 2014). The initial parameter is to assess the hemodynamic status of the patient.

It is necessary to review the patient’s factors and complete imaging studies such as the anterior-posterior, inlet and outlet radiographs and computed tomography before a definitive treatment (Halawi, 2015).
Checking the bone mineral density T-score.
Checking the vitamin D levels.
Checking the uptake of any medications.

In which part of are you feeling the pain?
Are you feeling pain? How would you rate your pain?
Have you had any past history of pelvic injury?

References

Halawi, M. J. (2015). Pelvic ring injuries: Emergency assessment and management. Journal of clinical orthopedics and trauma, 6(4), 252-258.

Magee, D. J. (2014). Orthopedic physical assessment-E-Book. Elsevier Health Sciences.

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ANP8010 Advanced Practice In Nursing

Question:

Answer:

References

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