I am a first year student.. working on the below assignment. I would think in this scenarios i would first focus on pain and secondary on the fact this person will not have much movement with a fracture on both sides. What are your thoughts on this assignment..what would be the first two critical things you would address.
You have been assigned to care for Mr. J, who fell from the first story of his home while shoveling snow off his porch roof to prevent collapse. He landed on his feet and fractured his left ankle and right femur. He is currently on bed rest. Vital signs are T- 37, P- 78, R-20, and B/P 112/74. He is ordered diet as tolerated. Medications ordered for Mr. J include, morphine sulfate for pain. His order reads morphine sulfate 10 mg IM q 6-7 hours for pain.
If you look at the settings page, it says highest education and it has different degree options (mostly nursing). It also has an "other" option. It then has "years of experience". I chose "other" (non-nursing) and gave my engineering degree. The experience is 15 years of "other". If the site interprets this as 15 years of "nursing experience" when I clearly state otherwise, it needs to be rewritten.
But thanks for judging me. Makes me feel welcome at this site.
I agree that his impaired mobility puts him at serious risk. I'll even say based on the info presented here, that bedrest order is inappropriate. Non-weight bearing does not mean he must be immobile. As an RN I would address this with the provider (i.e. the ones who write the orders), and coordinate with PT to make time in a chair happen.
I'm an ICU nurse, and we advacate early mobility for the reason jm_emt listed. Among the reasons for bedrest: unstable VS or high ICP, ARDS or other conditions requiring high vent settings, open chest or belly, unstable spine, stroke pt's
We get the following types into chairs: intubated patients, a.m. after open heart surgery, neuro patients with controlled ICPs, VS controlled on one vasoactive drip..... most patients. The RN is expected to get an activity order for anyone who should have one (sometimes in their mass of work, the MD doesn't even think about it)
Of course most ICU patients can't walk themselves over to the chair -- this is where assistive devices (slide boards, mechanical lifts etc.) and PT/OT recs come in.
All that to say, a stable floor patient with leg fractures really shouldn't be on bedrest.
Otherwise, what you have in the pain nursing diagnosis looks good.
BuckyBadgerRN, ASN, RN
3,520 Posts
So no nursing experience. That is the he question asked under "years of experience" in your little sig line.