The following 6 questions are part of a Next Gen Case Study.
Read the following case study, then refer to the case study to answer the questions.
The nurse is caring for a 22-year-old male client admitted with multiple injuries resulting from a motor vehicle accident.
\begin{tabular}{|l|l|l|}
\hline \begin{tabular}{l}
Primary Care Provider \\
Admitting Notes
\end{tabular} & Nurse's Notes & Prescriptions \\
\hline
\end{tabular}
1955 Alert and oriented 22-year-old client admitted post motor vehicle accident (rear-ended) after being seen in ED. Diagnosis: Fracture of right femur, right clavicle, and right ribs 5 \& 6. Seat belt contusion noted across chest. Chest wall symmetrical. No lifts, heaves, or thrills. No murmurs, gallops, or rubs are auscultated. S1 and S2 are of normal intensity. No S3, S4. EKG shows sinus tachycardia at [tex]$114 / \text{min}$[/tex]. Pulse oximetry reading [tex]$98\%$[/tex] on oxygen [tex]$2 \, L / \text{nc}$[/tex]. Lungs clear bilaterally. Radial pulses equal [tex]$+3 /+4$[/tex] and regular. Pedal pulses: Right [tex]$+2 /+4$[/tex], Left [tex]$+3 /+4$[/tex]. Pain of 9 on a 1-10 pain scale to right shoulder, right chest, and right leg relieved with morphine 4 mg IV. Vital signs: [tex]$T 98.2^{\circ} F \left(36.7^{\circ} C \right)$[/tex], RR 24 shallow, BP [tex]$148 / 88$[/tex]. Skin warm and dry. Right arm immobilized in sling. Scheduled for open reduction and internal fixation (ORIF) right femur.
2230 Client stable following ORIF right femur. Alert, oriented. Vital signs within normal limits/afebrile. Lactated Ringers 1 liter infused. Postop Hct: 36. Fiber cast dry/intact. Post op plan: IV hydration, Cefoxitin 1 gram every 8 hours, physical therapy.
Complete the following sentence(s) by choosing from the list of options:
The nurse should recognize that the client has developed a complication related to the [tex]$\square$[/tex] , based on the clinical findings of [tex]$\square$[/tex] , and
Select an option:
- ecchymosis over clavicle
- clavicle deformity
- pulses
- lung sounds
- bowel sounds
- cast assessment
- vital signs
- oxygen saturation