diagnostiC results and physical assessment data

You have now performed a secondary survey of Natalie. Some diagnostiC results and physical assessment data gathered from this includes:
Vitals: BP 99/60mmHg: RR 28; Sp02 94% 10LHK4; HR 134bpm, Temperature 36.1 GCS 12 (E3V4M5); C•spine collar remains in situ. Periods. bruising noted. PEARL 3isluggish. Await head/neck/spine CT scan. Lung sounds remain unchanged from Prima, survey, rl. signs csif.s,unrstrse2o,u.sbezhiysema, nil tracheal deviation. Weak and thready radial pulses, heart Log•roll performed: palpation of spine NAD (No Abnormalities Detected) and posterior Inspection NAO. Tendemess and localising to abdominal palpation, bowel sounds decreased. Not passed urine. Right leg: immobilised in splint, CR 4 seconds, cool peripherally, dark bruising to leg and foot with right dorsalis p.is and posterior tibialis pulses weak. Quest. 2: /approx. 250 words, From the secondary survey data, rationalise one actual problem (different from Q1). Then discuss one independent nursing intervention and one dependent nursing intervemion for the actual problem. Underpin your responses with possible underlying pathophysiological causes to lushly your decision making. link to other signs and symptoms as applicable. (8 ma.
That evening Natalie goes to operating theatre for a laparotomy, splenmtomy, and stabilisation of the right open comminuted fracture tibial/fibula with an external fixation device. She returns to the trauma unit with an T9410 Epidural 18upwacainel in situ.
Six hours later, Natalie Is drowsy but complaining of abdominal Pain S/10 only on the left Rank when she is awake. Vital signs are BP 95/SOmmlig, T36.2C, RR 10 (asleep) RR 14 (awake), SP02 94% on 2LNP, HR 60 regular.
Question. (approx. inwards, Rationalise two immediate actions/interventions related to epidural care that you would undertake (hefere escalating to your M.O.) in this xenario, while linking causative factors underpinning these signs and symptoms.
,6 marks,
4 of S CCHS written Examination 1022
Quest. 4: (appro.. 175 words)
Natalie has an external fixation device Ins. to the right tibia and fibula. Identify and rationalise what signs and symptoms would alert you to compartment syndrome In this case considering the mechanisms by whkh Natalie’s epidural could mask compartment syndrome.
(6 marl. Day 9 post admission Natalie has developed a respiratory nosoconnal-acquired infection which has caused type t respiratory failure. A MET call was issued for signs of respiratory d�slress arse commenced, with lene 12cmrt20 and EPAP knilt20, F.02 0.6.
.‘37c1h; CISronXrensllf1N/16=:::1ig’ the’ increase in “”‘”‘ (on F’2 6)t° to 94/50mrnrtg