HELP !!!! New nursing student and a case study

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Hey everyone !!!! I'm a new nursing student and I really need help with this case study if anyone could help me out that would be great !!!

David Jones is a 50 year old man who tried to light a cigarette while driving and lost control of his truck. The truck flipped and landed on passenger side. David was transported to the emergency department with a deformed edematous right lower leg and a deep puncture wound approximately 5 cm long over the deformity. Blood continues to ooze from the wound. David's temp is 102.2 f right lower leg warm to touch and he can't beat weight on the right leg. David takes aspirin 81 mg P.O. daily

I need 2 nursing problems

1 goal per nursing problem

3 rationals per nursing problem

3 evaluation per nursing problem

signs and systems

applicable medications

This is for me to learn how to do a case study for the test! Thanks so much!!!!

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"Help" usually means you're trying and got stuck somewhere. What I see is, "Do my homework for me." Am I wrong?

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Specializes in Public Health, TB.

So what do you think are his problems?

And most goals have to do with correcting or addressing that problem.

How do you know its a problem? (rationale)

What are you going to do about that problem (interventions)

Signs and systems?

What are you going to assess?

I only see one med listed, although I am guessing that more may be administered, depending on problems and signs.

And what numbskull would ask someone to bear weight on a deformed, edematous, bleeding leg, after an MVA? D'oh!

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Who makes these things up?! It seems like they always try to throw in a fact or two (however unlikely) just to make it a little more complicated. There's definitely a major primary problem here, and that's where I'd start.

Anyway, OP, what do you think the main problem is?

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Would the main problem be risk for infection or impaired Musculoskeletal system?

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Specializes in NICU, ICU, PICU, Academia.

The main problem (priority) can always be identified by asking yourself "What will kill my patient the fastest?"

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So the bleeding out while on aspirin? Idk I'm confused sorry.

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I think it does help to have a decent idea about medical diagnoses - I believe they're trying to say your patient has an open fracture. Being able to read about that may help you prioritize your problem list.

I think you're generally on the right track with ideas for nursing problems, although we wouldn't say "impaired musculoskeletal system" too often but rather

Impaired ___________. Check your nursing diagnosis reference. :)

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Specializes in 15 years in ICU, 22 years in PACU.

This whole thing started with trying to light a cigarette. What about pamphlets on the hazards of smoking and driving?

If you give him opioids for pain he'll probably get addicted to those too, so stick with essential oils and therapeutic music.

Always refer to the patient as Mr. Jones until you get permission to use a familiar term.

Maybe getting help from a bunch of internet strangers isn't such a good idea.

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Your 2 nursing problems are listed in the paragraph you wrote:

First, "Blood continues to ooze" and "takes aspirin". Look up aspirin and what it's effects are on blood and how it relates to the situation.

Second, "deep puncture wound" and "temp is 102.2 F and leg is warm to touch". What is normal body temperature and what could it mean if it's elevated? Also, what does it mean for skin to be warm to touch? Hint: all of this information points to one specific problem.

These questions should help guide you to your problems. The rest you should be able to navigate using the NANDA book or whatever else is being used today for nursing diagnosis. I'm with the others in that it seems like you are asking others to give you the answers, but really that won't do much for you in the long run. You're going to need to be able to take the information you are given and apply your critical thinking skills to give yourself the best chance at being successful. You can do this.

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Specializes in Critical Care.
This whole thing started with trying to light a cigarette. What about pamphlets on the hazards of smoking and driving?

If you give him opioids for pain he'll probably get addicted to those too, so stick with essential oils and therapeutic music.

Always refer to the patient as Mr. Jones until you get permission to use a familiar term.

Maybe getting help from a bunch of internet strangers isn't such a good idea.

You nearly got me :roflmao:

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Specializes in Phlebotomy credential.

I am not a nurse but I do read alot about the disease process.

Edematous lower leg...possible heart/lung issues?

Deformed....broken bone? (assuming it wasn't deformed before the accident)

Blood continuously seeping from wound...aspirin would make this worse (thins blood)

Wound warm to the touch...lots of inflammation going on...underlying tissue damage (Bone, etc)

Fever....infection

Diabetes and heart issues complicating matters

I know this was an old post..but it seemed fun to try out.. I just got accepted into Nursing school..little excited :-) Hoped I was close??

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