H.K. has no further complications with his leg wound and responds ...

[notis]

H.K. has no further complications with his leg wound and responds well to physical therapy. The discharge planner meets with him to discuss his posthospital care.
 
  What issues would the discharge planner need to address with H.K.?

Question 2

J.F., a 67-year-old woman, was involved in an auto accident and flown by emergency helicopter to your
  facility. She sustained a ruptured spleen, fractured pelvis, and compound fractures of the left femur.
 
  On
  admission (5 days ago) she underwent a splenectomy. Her pelvis was stabilized with an external fixation
  device 3 days ago, and, yesterday, her left femur was stabilized using balanced suspension with skeletal
  traction. She has a Thomas splint with a Pearson attachment on her left leg. She has 20 pounds of skeletal traction and 5 pounds applied to the balanced suspension. Her left femur is elevated off the bed at
  approximately 45 degrees. The lower leg is parallel to the bed and lies in a sling that the nurse adjusts on
  the frame, and the foot hangs freely. This morning, J.F. was transferred to your orthopedic unit for specialized care. you are the nurse assigned to care for her on the night shift.
  You enter J.F.'s room for the first time. What aspects of the traction will you inspect?
  What will be an ideal response?

[mmj22343]

Answer to Question 1

 Broken leg: Does he have family or friends who can help with rides to physical therapy and
follow-up appointments to health care providers, grocery shopping, laundry, and cooking? Does
he live on a bus line?
 How many steps into the house? Does he have any equipment like walker, crutches at home
already?
 How will he bathe or complete other activities of daily living (ADLs) and instrumental activities of
daily living (IADLs)? Are there stores in his area that are willing to deliver groceries?
 How is he going to pay the rent? Can he move in with parents or friends?
 When will he be able to go back to work?
 Does he need follow-up care for smoking cessation strategies?

Answer to Question 2

 Inspect body alignment. Does the traction maintain the leg in proper alignment with the rest of
the body (not at an angle)?
 Inspect the weights to make certain they hang freely and are well off of the floor.
 Inspect all knots to make certain they are secure and away from the pulleys.
 Inspect the ropes to make certain they move freely in the pulleys and are not frayed.
 Inspect all pulleys to make certain they are tightly attached to the support bars.
 Inspect the position of the sling that supports the lower leg. Make certain the Achilles tendon does
not support the weight of the entire lower leg.
 Inspect the skin around the skeletal pin. Make certain it is not in contact with the frame.
 Inspect the skeletal pin through the left femur. Make certain it is not in contact with the frame.