Pathophysiology and Clinical Manifestation of Jamie's Injury

This report discusses the pathophysiology and clinical manifestation of Jamie's injury, along with the rationale for the medication given to him. It also explores alternative medication options and provides recommendations for change. Read more on Desklib.

Nursing

Contents
INTRODUCTION...........................................................................................................................1
PART A...........................................................................................................................................1
Pathophysiology and clinical manifestation related to Jamie’s injury........................................1
Rationale been provided for the medication given to Jamie........................................................2
PART B...........................................................................................................................................4
Reason for medication been given to Jamie................................................................................4
Alternative medication with justification and recommendation of change.................................5
CONCLUSION................................................................................................................................6
REFERENCES................................................................................................................................7

INTRODUCTION
Nursing can be defined as the profession of practice which is being needed to cure patients.
It basically means utilizing the patient's environment to improve their conditions and assist in
their recovery. Present report will lay emphasis on Jamie who has met with an accident and has
medical history of asthma and depression. Report will describe the pathopshyiology related to
Jamie’s injury. It will also provide the rationale for medication being given to patient.
Assignment will also give detail about the contradiction and side effects related to medication. It
will also provide mechanism of action based on drugs given to service user.
PART A
Pathophysiology and clinical manifestation related to Jamie’s injury
It has been analysed from the case study that Jamie a 47 year old builder has met with an
accident. Patient has the past medical history of asthma and depression. He has been on
salbutamol and Flixotide. Jamie has been hit by a car on his way home and suffered a
comminuted opened fracture in Tibia and fibula. He has been transferred to orthopaedic ward.
Clinical manifestation: The clinical manifestation based on the case study provides the
detail that patient has gone through comminute fracture which means bone breaks in such a way
that bone fragments stick out through the skin or a wound penetrates down to the broken bone. It
is also known as opened or compound fracture (Smith & Liehr, (Eds.). (2018. It has been
analysed that patient can only heal from this type of fracture after 3 to 5 months if right drugs
and steps are been taken by Jamie. It has been analysed that generally fracture in Tibia can cause
swelling or pain in the lower part of leg. It has been analysed that current pain of patient is 4/10
(Wright et.al., (2019).. This type of fracture can lead to uneven length of leg. It can reduce the
health outcome and quality of life of patient as they will be unable to walk. The fracture in tibula
can also cause limited range of motion in knees and ankle. This type of fracture can also indicate
damage to vessels of blood. This can lay negative impact on health outcome of patients. The
healing related to this fracture can depend upon the pain and intensity of farcture. It can take
several months to get healed from this fracture. It has been analysed that currently parcetamol is
been given to patient in order to have a control over the pain. It has been analysed that in this
patient will not be able to walk in broken leg. It can reduce their health outcome.
Pathophysiology: The pathophysiology also provides with the details that service user is
been engaged in making use of salbutamol and Flixotide. There are also various side effects of
1

these nebulizers. It has been analysed that Flixotide can reduce the bone density which is the
possible reason that fracture of bone has been occurred to service user. Pathophysiology of
depression can include that patient is been suffering from loss of interest, reduced appetite,
unable to sleep. Depression can occur because of trauma or personal life experiences. This can
lay negative impact on health outcome of service users. It has also been analysed that depression
can be the factor because of which patient can suffer from anxiety. It can be described as feeling
sadness, loss or anger (Harding et.al., (2018). It can reduce the physical and emotional abilities
of an individual who is going through it. Depression can also be caused due the side effects of
certain drugs. From the case study it can be analysed that various drugs for curing asthma is been
taken by Jamie. Depression can also be caused because of drugs. Jamie is been engaged in
making use of salbutamol a rescue inhaler. It has been analysed that making use of this inhaler
can cause problem of depression in service users. It can be caused when the therapy is been
overused. It is suggested to Jamie to take advice from health care professionals about the use of
salbutamol. This will support patient in overcoming the problem that has been faced by them. It
wills assist Jamie in recovering from these health issues.
Rationale been provided for the medication given to Jamie
It has been analyzed from the case study that Jamie has been met with an accident that has
caused fracture in Tibia and Fibula. Case study also provides with the detail that Jamie has been
suffering from depression and also he has a medical history of Asthma. Currently it has been
analyzed that Jamie score of pain is 4/10. He is one the following medication Morphine 5 mg
PRN, Indomethacin 25 mg PR BD. Patient is also been provided with Paracetamol so that his
pain can be controlled. It has been analyzed that Morphine 5 mg is been given to service user in
order to treat pain. It is one of the opiod which is being really useful in treating pain. It works in
the brain to change how body feels and respond to change. This medication is basically been
given by injection into vein or into muscle. Dosage of medication is fully based on medication
condition of patients. This medication is basically been given first in clinical care setting so that
it can be easily monitored by the health care professionals. This being done in order to check
whether the medication do not have any side effect on patients body. It is really necessary for
health care professionals to change the injection site with each dose to avoid problems areas
under skin. It has also been analyzed that Morphine only needs to be taken if prescribed by
health care professionals. It can also become an addiction and also this medicine has severe life
2

threatening side effects. If the patient has been suffered from depression here is a greater risk that
you will overuse morphine if you have or have ever had any of these conditions. It is only been
given in order to cure the problem of pain so health care professional needs to lay special
emphasis on it before providing these medication to patient. Morphine is usually being provided
for severe pain (Braun et.al., (2019). The dosage needs to be changed by health care
professionals if they have found out patient with any such condition like nausea, vomiting,
sleepiness, dizziness. This medication has this severe impact on overall health outcome of
service user. It can also make them face depression again. Jamie also has the medical history of
depression so special care needs to be taken by health care professional.
The other medication which is being provided to patient is Indomethacin- 25 MG. it is
used to relieve pain, swelling, and joint stiffness caused by arthritis and many other. It is also
been given in order to relive pain from many other parts of body. It has been analyzed that this
medication is been given through mouth directly and also at least 2-3 times a Day. It has been
analyzed that patient must not been engaged in taking this medication if it has not been
prescribed by health care professionals (Zaccagnini & Pechacek, (2019). . This is because that
this medication also has several side effects such as stomach bleeding, increase risk of heart
failure. This medicine can be taken with food, milk or water. It has also been analyzed that the
main purpose of making use of this medication is to remove pain from lower ankle that has been
faced by Jamie. It will assist health care professionals in improvising health outcome of patients.
This medication can be best used when the early signs of pain occur. If the pain is at worsening
stage, the medication might not work as well as prescribed.
The dosage and frequency of taking medication must be adjusted according to the needs and
demands of patients (Peters et.al., (2019). It has been analyzed that 25 MG is been provided to
Jamie has he is being going through the acute pain. Careful instructions need to be provided by
health care professional to patient so that no adverse reaction can be seen in patient while they
are consuming this type of medication. It has also been analyzed that while consuming this
medication the service user must not be engaged in consuming alcohol or any type of other
liquor. This can lay severe impact on health outcome of patient, it can also make patient more ill
and weak. There are various side effects that can be caused by this medication. It includes the
following such as dizziness, headache. It has also been analyzed that there are also severe
symptoms that can be seen in patient of they are involved in taking this medication. Health care
3

professionals must be engaged in checking dosage that has been provided to patient. It has also
been analyzed that patient who has been suffering from asthma are at higher risk of facing
allergic reaction (Alligood, (2017). . It is been suggested not to provide patient with this
medication. In this patient can also go through several other problems like ulcer, impairment of
kidney function or congestive heart failure. It has been analyzed that asthmatic patient must not
been engaged in making use of this medication as this can lay severe impact on the functioning
of body function.
PART B
Reason for medication been given to Jamie
The chosen medication which has been given to Jamie for treating the fracture is
Indomethacin- 25 MG. It has been analyzed that this medication is basically been provided to
Jamie in order treat and help him overcoming the pain that has been caused because of fracture
in Tibia and Fibula.
Mechanism of action: Indomethacin is a nonsteroidal anti-inflammatory drug
(NSAID) which is being commonly used in order to cure pain and also the infection from which
patient is been suffering. It has also been analyzed that this medicine is also been provided to
Jamie in order to cure fever, pain and swelling in lower ankle that has been caused because of
fracture in Tibia and Fibula. This medication is basically been provided with mouth and the
dosage is based on patients need. It has also been analyzed that this medication also produces
analgesic effects that can be used in curing veterinary pain. This medication is been approved for
use of human and also the experience related to this drug is limited. It has also been analyzed
that giving this medication totally depends on health care professionals. Dosage is been given
according to needs of patient.
This is been given in order to stop the individual fluctuations. It has also been analyzed that
the main purpose of making use of this medication is to remove pain from lower ankle that has
been faced by Jamie. It will also assist in strengthening physical system of patient which is really
necessary for them to reduce the pain that has been seen in patient. This medication will assist
Jaime in overcoming from the pain related to fracture which has been faced by him. It is
basically been given to service user in order to treat the moderate to intense pain. This
medication is also been given by health care professionals in order to treat fever. This can be
useful in improvising the health outcome of service users. This medication is been provided by
4

health care professional to Jamie so that pain he is facing because of the facture in Tibia and
Fibula can be cured. This will help him in overcoming the consequences that has been faced by
him because of the accident.
Indication and contradiction: Case study has been provided us with the details that Jamie
has been provided with Indomethacin-25 mg for providing relief to his pain. It has been analyzed
from the research that there are various contradiction related to this medication which can be
faced by patient. It has been evaluated that Jamie also has a medical history of asthma and
depression. This drug can cause allergic reactions especially to those patients who are been
suffering from asthma (Butcher et.al., M (2018). This can worsen health outcome of service user.
They can face severe consequences like itching, skin allergies and many more. Health care
professionals must be engaged in analyzing the medical history of patients so that this
consequence is not being faced by them. It will help them in improvising health outcome of
service user.
They must be engaged in protecting patient from contradiction of this drug by analyzing and
evaluating the medical history of Jamie. It has also been analyzed from the research that
Indomethacin can also cause problem like headache, dizziness, sleepiness, nausea, headache,
vomiting (Early et.al., (2016). . These are the mild side effects of this medication. It has been
analyzed that dosage of this drug must be given according to the intensity of pain that is being
faced by service user. It is also really important while consuming this medication patient must
not be engaged in taking or consuming alcohol as this can cause breathing problem. Jamie is
already asthmatic so more worsening conditions can be seen in him. Patient can also face severe
side effects such as cardio vascular problem, hypertension. It can also reduce the ability of blood
to clot. So there are chances of increase in bleeding after injury. It can reduce and lower down
the quality of life of service user. It has also been analyzed that this drug can also cause severe
problem such as impairment in kidney.
Alternative medication with justification and recommendation of change
It has been analyzed that Jamie can be given with alternative medication other than
Indomethacin, as this drug can cause severe allergic reaction to service user suffering from
asthma. It is recommended that health care professional must make use of drug like
Lumiracoxib. This medication can be provided in order to treat pain after the surgery. It also
relives pain if patient has been gone through severe injury such in case of Jamie. This drug can
5

be taken by mouth, it has been analyzed that consumption of this drug includes less amount of
contradiction in comparison to Indomethacin. It has been analyzed that this medication can be
easily take by those who have a history of depression as well as stahma. This drug only have
mild side effect. Jamie must be provided with this medication.
CONCLUSION
From the above study, it has been summarized that various medication has been given to
Jamie in order to cure his pain after the injury. It has been analyzed that Jamie has fracture of
Tibia and Fibula. Patient has been given with Morphine so that he has a relive from his pain
because of the injury. It has also been analyzed that patient also had a medical history of
depression and asthma. The medication provided to Jamie has several contradictions and
consequences. It has also been analyzed that certain allergic reaction can be face by patient.
6

REFERENCES
Books and Journals
Butcher, H. K., Bulechek, G. M., Dochterman, J. M. M., & Wagner, C. M. (2018). Nursing
Interventions classification (NIC)-E-Book. Elsevier Health Sciences.
Alligood, M. R. (2017). Nursing theorists and their work-e-book. Elsevier Health Sciences.
Smith, M. J., & Liehr, P. R. (Eds.). (2018). Middle range theory for nursing. Springer Publishing
Company.
Zaccagnini, M., & Pechacek, J. M. (2019). The doctor of nursing practice essentials: A new
model for advanced practice nursing. Jones & Bartlett Learning.
Wright, N. C., Daigle, S. G., Melton, M. E., Delzell, E. S., Balasubramanian, A., & Curtis, J. R.
(2019). The design and validation of a new algorithm to identify incident fractures in
administrative claims data. Journal of Bone and Mineral Research, 34(10), 1798-1807.
Harding, B. N., Weiss, N. S., Walker, R. L., Larson, E. B., & Dublin, S. (2018). Proton pump
inhibitor use and the risk of fractures among an older adult cohort. Pharmacoepidemiology
and drug safety, 27(6), 596-603.
Peters, A. W., Corona, B. T., Milto, A. J., Tucker, A., Brinker, A., Savaglio, M., ... & Natoli, R.
M. (2019). Minimally Invasive, Non-Terminal In Vivo Muscle Testing of a Porcine Tibia
Fracture Model. Insight: Indiana University Medical Student Research Journal, 2(1).
Braun, B. J., Pohlemann, T., Herath, S. C., Klein, M., Rollmann, M. F., Derr, R., ... & Roland,
M. (2019). An individualized simulation model based on continuous, independent, ground
force measurements after intramedullary stabilization of a tibia fracture. Archive of Applied
Mechanics, 89(11), 2351-2360.
Early, J., Brage, M. E., Pomeroy, G., Carpenter, B., Miller, D. W., & Bales, J. (2016). U.S.
Patent Application No. 29/518,084.
7

8