One week ago, you started your dream job as an orthopedic nurse at…

Question Answered step-by-step One week ago, you started your dream job as an orthopedic nurse at… One week ago, you started your dream job as an orthopedic nurse at a Level 1 Trauma Center in a metropolitan city of 3.7 million people. The hospital has ranked as the #5 Trauma Orthopedic Specialty Unit in the United States for eight years. At this point during orientation, you are permitted to care for one stable client per 12-hour shift. Today you start your shift with Ryan; a 25-year-old admitted through the Emergency Room after a motor vehicle accident with rollover resulting in a fractured right femur, multiple rib fractures, sternal bruises, and multiple abrasions. He is two hours post-op from an open reduction internal fixation of the right femur and appears alert and oriented. When you enter the room his first statement is, “Can someone please get me a cigarette or a patch; I have not had a smoke since yesterday morning!”Assessment Data:The client is sitting up in bed with thigh-high anti-embolism stockings on the left leg only.Dressings to multiple abrasions appear dry.Urine in Foley Bag amber colored and urinary output in the past 2 hours 40ccPain reported as 8 on a scale of 10 with a goal of 5Vital signs:BP 130/80Heart Rate 92O2 Sats 94% on 4L Nasal CannulaBlood Gases:pH 7.32PaCO2 53 mmHgHCO3 22mmol/LPao2 84mm HgPhysician’s Orders:Bed Rest OnlyClear Liquid DietOxygen to maintain Spo2 of 92% or greaterABGs repeated every 4 hoursDiscontinue PCA and consult pain managementAdminister tetanus and flu immunizations before dischargeAdminister 1-2mg Morphine IV every 4-6 hours as needed for breakthrough painAs you review the assessment data and physician orders, you plan client care and determine six nursing interventions you believe are appropriate and should be completed in this order within the next hour:Administer 2mg Morphine IV now for breakthrough painApply anti-emoblism stockings bilaterallyCall the physician to get an order for Nicotine Patch and report decreased urinary output with amber urineInput consult for pain management into the electronic order systemDecrease O2 to 2L Nasal Cannula and continue Sp02 monitoringAdminister tetanus immunizationInstructions interventions, the nurse manager stops by to check on your progress and asks you a few questions regarding your decisions. The nurse manager is disappointed and states, “One of these actions is not correct I want you to write down what you believe is the best choice from your list to do immediately and the action you believe is incorrect and should not be done. I will be back in 10 minutes to discuss your thoughts.” detailed responses to these questions:What is the best action to perform first from the six actions identified as part of planned client care for this particular client?What is the best action to perform second from the six actions identified as part of planned client care for this particular client?What is the best action to perform third from the six actions identified as part of planned client care for this particular client?What is the best action to perform fourth from the six actions identified as part of planned client care for this particular client?What is the incorrect action?ResourcesAPA Guide Health Science Science Nursing NURSING RN 4153 Share QuestionEmailCopy link Comments (0)