A 50years old man is riding his bicycle when he fell off the bicycle. Brought in by ambulance to emergency room.🚑. Diagnosis: Left femoral head fracture. Secondary diagnosis: Hypertension, meth abuse, alcoholic abuse,homeless. Abrasion to bilateral upper extremity, laceration to right eyes, bilateral lower extremity, nose,ear,cannot open left eye. Standard precautions.High risk for fall,no advance Directive in the chart , copy of advance Directive on the chart.Alert and oriented x 2,confuse.Skin intergrity impaired.Transportation method is by bed.Weighs 160lbs.Height 5feet 6inches. Aspen collar to neck.Spinal precautions. NKDA.Regular diet .(+ )Etoh,speech garbled, drinks with straw.Uses urinal with assistance at his bedside. WBC 8.5.H/H 11.4/36.0.Respiratory treatment Q6hours prn. 02 at 2liters with saturation of 94%.
Spanish speaking only.Uses Cyracom phone for interpretation. ORIF left femoral fracture. Patient able to move all extremity. Wriggling all toes well.Surgical dressing intact.
LR at 75ml/hour infusing via pump to left forearm 18guage Clean, patent and dry.Zosyn 3.378gm IV Q8hours.Morphine sulfate 2mg IV Q4hours prn severe pain. Norco 10/325mg 2tablets po Q6hours prn moderate pain.Tylenol 650mg po Q4hours prn temperature. Vital signs Q4hours. Zofran 4mg IVP Q4hours prn nausea and vomiting.
Triple antibiotics applied to peri-orbital area.
1.What qualifies this patient for the need of a shelter?.
2.During assessment the nurse knows that a positive Homans’ sign is documented as?.
A.Pain in both legs.
B.Decrease in blood pressure after ambulation to the hallway.
C.Severe headaches after answering questions.
D.Pain in the calf with dorsiflexion of the foot.
Correct answer is D.A calf pain with dorsiflexion of the foot is a positive Homans’sign.
2. Can alcohol altar the body use of nutrients?.
Answer: Alcohol can influence and affect nutrients metabolism by decreasing nutrients storage, increase nutrients excretion and nutrients catabolism. Alcoholism can lead to liver damage and this can affect nutrients storage.