Compartment Syndrome and its Treatment

Student number:
CNA253 AT2 Scenario: Mrs Gwen Boren
Interpret:
In the following table, list the data that you consider to be normal/abnormal (not included in word count)
Normal (Subjective & Objective) Abnormal (Subjective & Objective)
The pain experienced by Mrs Gwen Boren is because of the
fracture in her left ankle sustained due to a fall. It is because of
this that the patient has restricted mobility and is confined to a
wheelchair. The oxygen saturation, heart rate and body
temperature was observed to be around the normal range.
According to the situation of Gwen Boren, it could be understood that the respiratory rate
of the patient is above the range of normal at 15-24 breaths per minute. The systolic
blood pressure that has been recorded is higher than the usual level of 120 mm/Hg. For
the patient, it is recorded above 130 mm/Hg.
Relate & Infer (550 words):
According to the case study of Gwen Boren provided, it could be understood that the pain that is experienced by the individual is because of the fracture in
her left ankle due to a fall at her place. The end of the fibula, also known as, lateral malleolus, is the bone which has been observed to be broken in the CT
scan. One of the major symptoms which are experienced by the patient is the swelling and a sensation of pain in the ankle area. Hence, it can be
comprehended that the patient is suffering from compartment syndrome. Because of the old age, it is possible that the patient may have slipped and should be
recommended bed rest for nearly a month and a half such that the ligaments near the area of fracture gets the necessary time to heal (Sherrington et al. 2016).
Depending upon the condition of the patient and assessing the degree of pain of the patient, mild head injuries could be reported because of her getting a
score of 15 on the Glasgow Coma Scale. It could be associated with her being generally confused about her surroundings and the treatment which would be
provided to her (Willett et al. 2016).
The intense compartment syndrome is a condition wherein expanded pressure inside a constrained space bargains the dissemination and capacity of the
tissues, subsequent in tissue ischemia; necrosis and nerve harm (von Keudell et al. 2015). This ascent in tissue pressure starts in a decline of the compartment
size or increment of the intracompartmental volume by oedema or potentially discharges (Raza and Mahapatra 2015). Following the arterio-venous angle
hypothesis, fine blood stream might be debilitated through expanded venous pressure, diminished blood vessel pressure and expanded fringe vascular

obstruction. Regularly, compartment disorders create during reperfusion following a time of ischemia (Han et al. 2015). During ischemia, there is a
continuous exhaustion of intracellular stores of high vitality phosphate bonds and glycogen stores. There is a development of results of glycolysis, especially
lactic corrosive, with going with hydrogen particle collection just as an expansion in intracellular diminishing agents (Wallin et al. 2016). Reperfusion may,
rather than re-establishing ordinary muscle metabolic action, cause destructive impacts by cleaning out fundamental antecedents for adenine nucleotide
resynthesis. Creation of oxygen free radicals happens with following lipid peroxidation, and calcium deluge happens upon reoxygenation with resultant
disturbance of oxidative rephosphorylation in the mitochondria (Lollo and Grabinsky 2016). Moreover, a few lines of proof propose that white platelets are
significant in the pathogenesis of reperfusion injury. Up regulation of both neutrophil receptors and endothelial leukocyte attachment particles prompts the
sequestration of white platelets in the muscle with prolongation of the reperfusion injury (Flores et al. 2018). This along these lines brings about harm to
remote organs, for example, lungs, liver, heart and kidneys.
When the patient was first found, she seemed to be confused which could be ascertained to the fact that she may have sustained the fracture because of some
other underlying complications or a decrease in the sodium/potassium balances (Rittenhouse et al. 2015). Hence, it was important to assess the level of
sodium/potassium in the blood of the patient such that it could be estimated that because of the level imbalanced, she experienced a fall.
Predict (150 words):
If the condition of the patient is not improved, there is a likeliness that the patient may not be able to walk by herself because of death of the tissue (van
Vlijmen et al. 2015). Moreover, if proper care is not undertaken of the ankle casts, there is a high chance that the patient may experience pressure sores, joint
stiffness and skin infection which may lead to her subsequent death (Marican, Fook-Chong and Rikhraj 2015). There is a risk of formation of infection
because of the skin infections which require immediate attention of the nursing professional.
Develop, Articulate and Prioritise Nursing Diagnoses – at least 3 (not included in word count)
Diagnosis 1: Tissue Ischemia
Diagnosis 2: Acute pain
Diagnosis 3: Impaired physical mobility
Goals, Actions and Evaluation 2 highest priority diagnoses only (550 words)
Diagnosis 1 Goal/Desired outcome/s Related actions Rationale Evaluate outcomes
DO NOT REWRITE
DIAGNOSIS
The primary goal is to
reduce the incidence of
a. Peripheral pulses are
required to be
a. Those are signs of arterial
obstruction, which can lead to
After the interventions have
been administered to the