From the information given, it is clear that H.K. is a smoker. ...

[lunatika]

From the information given, it is clear that H.K. is a smoker. List at least three issues related
  to his smoking that can complicate his care and recovery. What interventions could be
  instituted to counter these complications?
 
  What will be an ideal response?

Question 2

What is the best way to immobilize the leg injury before surgery?
 
  What will be an ideal response?

[Jsherida]

Answer to Question 1

 Smokers might have polycythemia because of the increased burden of carbon monoxide in
the blood. But RBCs also become less likely to release any oxygen they carry to the tissues,
contributing to tissue hypoxia, even though their Hgb counts may appear normal or even a little
high.These conditions can impair both oxygen delivery and wound healing.
 The nature of H.K.'s injury and his smoking history make him at higher risk for venous
thromboembolism (VTE).
 Pain is more difficult to control because nicotine has a greater affinity for pain receptor sites than
pain medications (morphine or meperidine Demerol).
 Smoking increases the risk for pneumonia and vascular compromise.
Interventions include the following:
 Monitor his coagulation statuslet the physician or practitioner know about his smoking. He will
need to receive VTE prophylaxis. Generally, a prophylactic anticoagulant, such as heparin or a
low-molecular-weight heparin is ordered. If medications are contraindicated, intermittent
pneumatic compression devices can be placed on his unaffected leg. If VTE prophylaxis is not
ordered, then ask about it.
 Encourage fluid intake, encourage mobility, and monitor stools for occult blood. Because of the
increased risk for pneumonia and vascular compromise, a good assessment of the cardiovascular,
pulmonary, and emotional-neurologic systems is important.

Answer to Question 2

A posterior splint made of metal, plaster, or plastic (whatever is available) padded with a soft roll
then wrapped with gauze will allow for swelling of the extremity, bleeding of the wound, and further
assessment and management of the injury.