James, aged 20, is a dispatch rider working for a food delivery company. He sustained an open fracture of his right tibia and fibula when his motorcycle skidded. He is admitted to the orthopedic ward and scheduled for surgery. An external fixation to his right tibia and fibula was done. IV Cefazolin 1g TDS for 72 hours is ordered. Â He will be discharged with the external fixators and oral antibiotics.
Single and staying with his parents. Studying full time at polytechnic and works part time to finance himself.Â
PHYSICAL EXAMINATION:
Temp 37.6°C, BP 120/75mmHg, PR 82/min, RR 20/min, SpO2 97% on room air
Pain score post op: 6/10
                        Â
QUESTIONS
1) Â Â Based on James history outline an open fracture of tibia and fibula.
2) Â Â Describe what an external fixator is and outline their purposes.
3) Â Â Explain the complications related to open fractures.
4) Â Â Discuss the nursing management and patient education for James.
Instructions
1. Support your answers with the latest guidelines and evidence. Referencing APA style â 10 references
5 booksÂ
5 research articles , from year 2017 Â onwards
2. You are required to prepare PowerPoint slides â 8-10 slides
3. 90 seconds video  - showing how to care for external fixators and different types of external fixators avail.
4. Provide script for each slide in MS Words formatÂ
5. Base on the above scenario, discuss patient education and what other resource can be made available for James. Patient education should include how to care for fixator as well importance of Physiotherapy for James, Medical Social Worker to see thru is financial needs and refer him to place where he can purchase / rent wheel chair or crutches.
Why does need to work while being a full time student,  provide ways to assist him  by giving him the useful resources avail and link him to the hospitals medical social worker Patient Education, some of the points you can use  but needs to be elaborated with examples Encourage early ambulation by using crutches and wheelchair. Encourage him to perform passive and active exercises.Â
Discuss prevention of recurrent fractures. Teach symptoms needing attention such as numbness, decreased function, increased pain, elevated temperature.Â
Encourage follow up medical supervision to monitor for union problems Encourage adequate balanced diet to promote bone and soft tissue healing. What type of food  is good  for patient . For vegetarian patient? What can he consume other wise what a norm patient is encouraged to eat Teach patient on importance of skin care Guide patient to care for his external fixator ( 90 secs video)Importance of Physio exercises upon discharge and the duration Arrange for Post Trauma Counselling for patient Financial assistance and evaluation by Medical Social Worker (MSW), where he can rent wheelchair and crutches Recommendation for external resources - SSO, Insurance (Despatch Rider/ Courier Company) Workmen Compensation Insurance.