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.
Applying the FITT Principle to Each Exercise Component of Health-Related Physical Fitness
ICD-10-CM Tabular List
Common phlebotomy issues.
How can we apply the categorical imperative to environmental issues?
Cross section of peritoneum with related organs and structures.
In Canada, disease-related deaths become increasingly common during middle adulthood