languha NgatiMedical surgical NursingCare plan for below the knee.1-8-20.Case Study, Chapter 43, Management of Patients With Musculoskeletal Trauma
1. Melinda Woods, a 14-year-old girl, was on a hiking trip with her family. Melinda slipped on a wet rock and fell on her right arm. She immediately began crying with pain. The skin is intact, butthere is an obvious deformity to the right lower arm. Her mother quickly transports her to the emergency room of the local hospital. (Learning Objective 3)a.What are the initial actions of the nurse?b.The fracture is reduced and immobilized by a cast. What discharge instructions will the nurse provide to the patient?2. Alan Dean, a 42-year-old patient, is admitted to the medical-surgical unit after a left below-the-knee amputation (BKA) for a traumatic injury at an industrial job. The patient has two Jackson Pratt drains, and a removable rigid dressing was placed over the soft dressing after surgery. There is a large tourniquet at the bedside. There are also ace wraps and bandaging supplies at the bedside. (Learning Objectives 8 and 9)a.What is the rationale for the removable rigid dressing, and what is the role of the nurse when caring for the patient with this type of dressing?b.On what areas should nursing care for the patient in this case study focus?
Generally, amputation of limbs is the result of trauma, peripheral vascular disease, tumors, and congenital disorders. For the purpose of this plan of care, amputation refers to the surgical/traumatic removal of a limb. This extremity amputations is due to trauma from industrial accidents. Lower-extremity amputations are performed much more frequently than upper-extremity amputations. Five levels are currently used in lower-extremity amputation: foot and ankle, below the knee (BKA), knee disarticulation and above (thigh), knee-hip disarticulation, andhemipelvectomy and trans lumbar amputation. There are two types of amputations, open which requires strict aseptic techniques and later revisions, and closed, or “flap.”Signs and symptoms:Signs and symptoms to look for if you have a condition putting you at risk for limb loss.-Intense pain or numbness in the limb while not moving-Sores or wounds unable to heal or heal very slowly-Gangrene-Shiny, smooth, dry skin on the limb-Thickening of toenails or nails-Absent or weakened pulse in the limb-An infection in the limb unresponsive to antibioticsHead to toe assessment.General appearance -Patient is alert and oriented to person, place, time, and situation. -Patient is clean -Patient is in bed-Patient had left below-the-knee amputation
-Patient is dependent and is in bed due to Left BKA-Full range of motion present in bilateral upper extremities. -Patient can speak without any difficulties.