SITUATION: Mr Potter, was brought in by ambulance after he had a head on collision with another player in a rugby league competition. The ambulance paramedics found Mr Potter conscious with multiple lacerations on his face, profuse maxillofacial bleeding and a substantial amount of blood in his oropharyngeal cavity. The ambulance paramedics had Mr Potter in a sitting position on the trolley throughout the journey to the hospital. BACKGROUND Mr Potter has no past medical and surgical histories. He lives at home with his parents and a younger sister. Mr Potter claims that he is of Jehovah Witness belief and refuses any blood and blood products. He is a non-smoker and non-drinker. Mr Potter denies any illicit drug use. ASSESSMENT His Glasgow Coma Scale (GCS) is 15, moving all limbs in equal strength with both pupils equal and reactive to light. His vital signs are as follows: Heart Rate 110 bpm Respiration 22 bpm Blood Pressure 110/70 mmHg SaO2 99%. He was unable to speak properly due to the swelling on his face. Mr Potter reported that his “bite was not normal” when assessed. All blood investigations were done, and haemoglobin was 115g/dL. CT Trauma done and showed a parasymphaseal fracture of the mandible (Fig 1). His 12 lead ECG showed sinus tachycardia (Fig 2). RECOMMENDATION Continue neurological observations. Mr Potter will have to be kept Nil By Mouth (NBM). He has IV Morphine infusion prescribed to manage his pain as well as intravenous therapy. He will be going to Operating Theatre for internal fixation of his fracture today.     Effective and accurate assessment skills are imperative for the Registered Nurse working with Mr Potter. Identify and discuss two priority problems (NB: Pain should not be one of the priority problems) for Mr Potter during his admission to the High Dependency Unit (HDU). Justify the priority with peer-reviewed evidence?

Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
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SITUATION: Mr Potter, was brought in by ambulance after he had a head on collision with another player in a rugby league competition. The ambulance paramedics found Mr Potter conscious with multiple lacerations on his face, profuse maxillofacial bleeding and a substantial amount of blood in his oropharyngeal cavity. The ambulance paramedics had Mr Potter in a sitting position on the trolley throughout the journey to the hospital.

BACKGROUND Mr Potter has no past medical and surgical histories. He lives at home with his parents and a younger sister. Mr Potter claims that he is of Jehovah Witness belief and refuses any blood and blood products. He is a non-smoker and non-drinker. Mr Potter denies any illicit drug use. ASSESSMENT His Glasgow Coma Scale (GCS) is 15, moving all limbs in equal strength with both pupils equal and reactive to light. His vital signs are as follows: Heart Rate 110 bpm Respiration 22 bpm Blood Pressure 110/70 mmHg SaO2 99%. He was unable to speak properly due to the swelling on his face. Mr Potter reported that his “bite was not normal” when assessed. All blood investigations were done, and haemoglobin was 115g/dL. CT Trauma done and showed a parasymphaseal fracture of the mandible (Fig 1). His 12 lead ECG showed sinus tachycardia (Fig 2). RECOMMENDATION

Continue neurological observations. Mr Potter will have to be kept Nil By Mouth (NBM). He has IV Morphine infusion prescribed to manage his pain as well as intravenous therapy. He will be going to Operating Theatre for internal fixation of his fracture today.

 

 

Effective and accurate assessment skills are imperative for the Registered Nurse working with Mr Potter. Identify and discuss two priority problems (NB: Pain should not be one of the priority problems) for Mr Potter during his admission to the High Dependency Unit (HDU). Justify the priority with peer-reviewed evidence?

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