NRSG258: "Mathew (Matt) Fracture" - Case Study - Nursing Assignment

Internal Code: MAS5433

Nursing Assignment:

Scenario: Part 1: Perioperative- Mathew (Matt) is 15 years old, currently in year 10 at school. Was admitted via ambulance to the ED with an open (compound) fracture of his right tibia and fibula. His right leg was swollen and bruised and that bone was protruding through the skin. Matt complained of nausea and was administered 10mg IV Maxalon with good effect. Matt’s GSC is 15. He is drowsy but responsive and orientated. An orthopaedic consultation has confirmed an open fracture of both tibia and fibula requiring surgical intervention of debridement and external fixation. Part 2: The next day Matt is transferred to the operating theatre & had fracture reduction & external fixation of his right leg under general anaesthetic. The surgery was uneventful. After surgery Matt was transferred to the post anaesthesia recovery unit. You review his wound following surgery and note that the wound edges have now been sutured together. Part 3: Postoperative- On day two post-op you are doing Matt’s dressing and drain care. His wound appears to be healing and there is about 100mls fluid in his Bellovac drain. On day three post-op you are taking Matt’s observations and record that he has an elevated temperature of 39.4oC and he is lethargic and diaphoretic. A wound swab shows that Matt has Staphylococcus aureus in his wound. The doctor orders Matt IV Cephazolin 500mg 8th hourly. You go with your second RN to administer the drug to Matt. You go to see Matt but he says he is not hungry. His parents tell you they are concerned as ‘Matt doesn’t want to watch TV or play computer games, which he usually likes to do’. Part 4: Discharge- Matt is now ready for discharge home with his parents. Matt’s parents seem anxious about taking Matt home with his external fixature and crutches. Question: What do you need to know about the care of Matt’s IV cannula?