In assessing H.K.'s cast on the third day postoperatively, you ...

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In assessing H.K.'s cast on the third day postoperatively, you notice a strong foul odor.
  Drainage on the cast is extending, a Vital signs are 123/78, 102, 18, 102.2 F (39 C). What is
  your analysis of these findings?
 
  What will be an ideal response?

Question 2

you evaluate the room air ABG results.
  What is your interpretation of the ABGs, and what do you think the physician will order
  next, and why?
 
  What will be an ideal response?

[Dnite]

Answer to Question 1

H.K. exhibits signs and symptoms of infection and is a likely candidate for a posttraumatic
osteomyelitis. Findings must be reported to the physician so that further treatment can be initiated.

Answer to Question 2

The ABGs show an acute respiratory alkalosis with hypoxemia. The physician will probably order a
spiral (or helical) CT scan to evaluate for a pulmonary embolus (PE). This is now the most frequently
used test to diagnose PE. If the patient cannot have the contrast medium that is used for the CT scan,
then the physician will probably order a ventilation/perfusion ( ) scan. If the scan shows a
probable PE, a heparin infusion will be initiated. If the patient cannot tolerate the ventilation portion
of the scan, the physician will probably order a pulmonary arteriogram. A D-dimer blood test
may also be ordered; but other conditions may cause elevation, and many patient with small
pulmonary emboli have normal D-dimer results.

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TYSM

[alexanderhamilton]

Excellent