Question

Marilyn Hughes is a 45-year-old female who suffered a left mid shaft tibia-fibula fracture while slipping on icy stairs this morning. She was taken to surgery for an open reduction with internal fixation (ORIF). She returned from surgery 1345 hours. She has a below the knee splint dressing Vital signs have been stable and neurovascular checks have been within normal range. She has an intravenous of Normal Saline infusing at 75 mL/hour. She is tolerating liquids well without nausea. Her diet could probably be advanced to regular dinner for tonight. She has a family member at the bedside who has been with her throughout the day. She began complaining of pain shortly after returning from surgery. She has a PCA in for pain management with a background infusion of 1 mg/hr of Morphine, with a bolus of 1 mg per bolus with lockout interval of 15 minutes. She is now on every 30 minute post-op vital signs. Last vital signs were blood pressure: 130/82, heart rate: 88, respiration rate: 16 oxygen saturation 92%. 

NLN I, Surgical Scenario 1, Complex: Lower Leg Fracture/Compartment Syndrome, Marilyn Hughes 

Questions

 1. Please answer the following questions prior to your simulation time. Bring your answers with you to simulation. 

 2. What complications can occur to someone after having surgery involving general anesthesia 

 3. Discuss pathophysiology and pharmacological treatments of compartment syndrome.

 4. Which diagnostic tests are necessary to collect prior to a patient's surgery?

 5. What is a "time out" mean, in terms of a surgical procedure?

 6. What are the five Ps in regards to neurovascular assessment?

 7. Which assessment data would lead you to a conclusion of compartment syndrome?

 8. What will happen next with Marilyn? What orders and activities should you anticipate for a patient with compartment syndrome? ROM exercises are initiated.

Answer 1