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Answered Same Day Apr 01, 2020

Solution

Karan answered on Apr 02 2020
151 Votes
Case Study
(Critical Thinking Questions)
TABLE OF CONTENT
Case overview    3
1. Mechanism of injury    3
2. The medications both routine and those prescribed for this admission and their pharmacology    6
3. The immediate nursing priorities for this patient (i.e within the ED)    8
4. The ongoing holistic nursing care for this patient linking to both acute and chronic diagnosis and possible post-operative complications for this patient    10
REFERENCES    12
Case overview
OSTEOGENESIS IMPERFECTA is a disease that causes freqeuent
eakdown of bones and it is also considered as
ittle bone disease (Raggio, Pleshko, & Boskey, 2016). It can lead to many other problems such as hearing loss, weak muscle etc. It is mainly caused when genes are not working properly.
The scenario states that Ha
iet Potter an 8 year old girl has been diagnosed with the Osteogenesis Imperfecta cu
ently she has been admitted in the Emergency Department (ED) as she simply fall at school with injuring left femoral shaft. The below questions has been focused on the scenario and has been supported in gaining information regarding genetic disorders that mainly affects the bones.
1. Mechanism of injury
In case of Ha
iet who is 8 year old girl has been adversely affected due to fractured formal shaft. Generally in this type of fracture it is high energy injuries that are linked with life threatening conditions. The level of incidences is 3.71 per 100,000 person-years (Ortho Bulllets, 2018). The mechanism of femoral fracture is traumatic, high energy and it is mainly found in young population. People who have low energy are mainly affected due to this type of fracture. In case of Ha
iet also due to osteogenesis imperfecta her bones are quite weak and it leads to frequent occu
ence of fractures.
The overall conditions that are linked with this type of fracture is orthopaedic along with the bilateral femur fractures. At present in case of Ha
iet she has to face issue due to query fracture to her left femoral shaft. She is getting proper support from her mother but due to weak bones this type of fracture is taking place frequently. This type of injury posses symptom of pain in thigh and one of the main aspect that is considered for examination is tense, swollen thigh etc (Physiopedia, 2018). Further, the leg that is mainly affected gets shortened.
The imaging techniques that are mainly adopted for examination purpose is CT and radiographs. Furthermore, different treatments of femoral shaft fracture can be operative where gold standard can be adopted for the treatment of diaphyseal fracture. Operative treatment can be adopted in case of Ha
iet so that she can sustain easily. The main outcome of this treatment can be stabilization within the time period of 24 hours along with improved rehabilitation, decline in level of pulmonary complications etc.
Generally it has been identified that one of the main cause of this type of fracture is high energy collision in the body and this is applicable in case of Ha
iet also. Lower force standing has become main cause of fracture in the younger child. So, in this case both non surgical and surgical treatment is present. Many time in case of younger children this fracture is treated with cast (OrthoInfo, 2018). On the other hand surgical treatment is also regarded to be effective like external fixation where it is a type of operation in which screw or metal pins are placed into the bone and it contributes a lot in maintaining the stability of the bones. But on the other hand it provides temporary stability until the unless the patient is fit and healthy. So, in this way Ha
iet can sustain.
It is important for the nurse to observe for limb length disparity as it is considered as the difference between length of arms. It is required to observe so that doctors can understand the issue properly that is faced by Ha
iet. The bones that are affected by leg length discrepancy are the femur. Mainly the cause of limb leg discrepancy can be any sort of previous injury in the leg. Through proper observation it is easy to know what type of treatment can be rendered to Ha
iet as per the present condition.
External rotation is considered to be most significant as its absence is mainly perceived as undisplaced fracture and along with this if the leg of patient is very short then it can indicate that fracture is displaced (OrthoInfo, 2018). It is necessary for the nurse to undertake external rotation seriously as fracture displacement can be sort of unfavorable condition that sometimes becomes difficult to be handled. Apart from this, in the surgical technique linked with interlocking screws the method that is mainly adopted is adjustment in the external or internal rotation (Arakawa, et al. 2015). So, in this way it is necessary to observe for external rotation in case of Ha
iet.
2. The medications both routine and those prescribed for this admission and their pharmacology
With the help of reviewing the case scenario it was stated that Ha
iet Potter an 8 year old girl has simply fall in the school with the query facture to her left femoral shaft that is injury or fracture to the left thighbone (Femur). It is consider as one of the strongest and longest bone of the body that
eak or get crack with the huge force. However, Ha
iet medical history clearly states that she suffers from Osteogenesis imperfecta it is considered as inherited disorder that results in
eaking bones easily (Zelle, We
, & Cromack, 2016).
For maintaining the overall health condition of Ha
iet she has been prescribed four medicines. Paracetamol is one of the medications that is used for its antipyretic actions. It possess spectrum of actions that are close to NSAIDs. Paracetamol is considered to be weaker analgesic as compared with COX-2 or NSAIDs (Jóźwiak-Bebenista, & Nowak, 2014). In case of pain this drug is mainly prescribed or given. Under the age of 2 years no recommended dose is present, in 2-3 years 160 mg is recommended, 4-6 years 240 mg, 6-9 years 320 mg and 9-11 years 320 mg.
Oxycodone is considered to be...
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