Gavin, a 23 year old driver who was not wearing a seat-belt, suffered a compound fracture of the skull and facial fractures in a motor vehicular…

Question Answered step-by-step Gavin, a 23 year old driver who was not wearing a seat-belt, suffereda compound fracture of the skull and facial fractures in a motor vehicular accident. On admission to the hospital, he was immediately taken to surgery for evacuation of a right subdural hematoma in the temporal region and repair of facial fractures. On the fourth postoperative day, the nurse discovers that Gavin became increasingly difficult to arouse with a resulting change in his Glasgow Coma Scale.Objective Data Vital signs: Temp 102.2 degrees F (39 degrees C), BP 110/60, HR 114 bpmIntra Cranial Pressure (ICP) ranges between 20 and 30 mm Hg despite Cerebrospinal Fluid (CSF) drainage and MannitolQuestions:A. How would you explain Gavin’s change in neurologic status? (4 Mks)B. Describe three (3) contributing factors that put Gavin at risk forcomplications after a head injury and surgery? (6 Mks)C. Describe the pathophysiologic basis for the symptoms exhibited by Gavin. (6 Mks)D. On the basis of nursing assessment, what are five (5) interventions specificto Gavin’s condition? (5 Mks)E. With reference to the scenario, what are the possible ways in whichorganisms can gain access to the meninges?F. Based on the assessment data presented, formulate three (3) PRIORITYnursing diagnoses. (6 Mks)Richard, who works for the local telephone company, was brought to the Emergency Room after falling from a pole. His right lower extremity was splinted with a cardboard splint and a large bulky dressing. He complains of severe pain in right leg and expresses concern about notifying his wife about the accident and his whereabouts. He is concerned as to how long he will be off work for.Objective Data:Open oblique fracture of the antero-lateral aspect of the tibia Obvious deformity, marked swelling, and ecchymosis in region of injuryOtherTo be surgically treated with open reduction and internal fixation, and cast.Questions:A. Evaluate the effectiveness of the immobilization of the fracture at the accident scene. (4 Mks)B. As the nurse looking after Richard, how would you perform a neurovascularassessment of the injured extremity? (6 Mks)C. Describe three (3) priority nursing interventions to prevent infection. (6 Mks)D. Describe two (2) specific nursing interventions the nurse can implement to alleviateRichard’s pain (4 Mks)E. How should the nurse answer Richard’s question about time off from work? (6 Mks)F. Give four (4) examples of care to patients that can be provided by patientcare assistants (PCT’s). (4 Mks)Mary Jane, a 73 year old woman of African descent with no significant past medical history, came to the doctor’s office for a flu shot. She gained 20 pound since her husband died a year ago, eats a lot of convenient ‘fast-food’, and is not very active.Objective Data: Height: 5ft, 4 in (162.6 cm) Weight: 170 lbs (77.1kg) BP: 170/82 Physical exam shows no abnormalitiesSerum Potassium: 3.3 mEq/L (3.3 mmol/L)OtherThe health care provider diagnosed Hypertension and prescribed lifestyle modifications.Questions:A. What factors would cause the physician to make a diagnosis of hypertension? 2 MksB. What additional risk factors are present? 3 MksC. What specific changes would the nurse recommend for Mary Jane? 4 MksD. If drug therapy became necessary to treat Mary Jane’s hypertension, what diureticwould be indicated based on her laboratory results and why? 5 MksE. What priority teaching measures should be instituted by the nurse? 6 MksF. Formulate three (3) priority nursing diagnoses? 6 Mks Health Science Science Nursing Share QuestionEmailCopy link Comments (0)

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