K.J., a 17-year-old male, was in a motorcycle accident and sustained fractures of the lower jaw,…

K.J., a 17-year-old male, was in a motorcycle accident and
sustained fractures of the lower jaw, right humerus, left femur, and right
tibia and a dislocated shoulder. His mouth is wired shut, and he has a long arm
cast on his right arm, a sling on the left arm, a short leg case on the right
lower leg, and skeletal traction on the left leg. He is assigned to you, and
you are to complete an assessment on him.

1. You do not have a temporal artery thermometer on your
unit. How would you obtain a temperature on K.J.?

2. What would you include when completing the neurological
assessment? Why is
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K.J., a 17-year-old male, was in a motorcycle accident and
sustained fractures of the lower jaw, right humerus, left femur, and right
tibia and a dislocated shoulder. His mouth is wired shut, and he has a long arm
cast on his right arm, a sling on the left arm, a short leg case on the right
lower leg, and skeletal traction on the left leg. He is assigned to you, and
you are to complete an assessment on him.

1. You do not have a temporal artery thermometer on your
unit. How would you obtain a temperature on K.J.?

2. What would you include when completing the neurological
assessment? Why is the neurological assessment so important to this client?

3. When listening to heart tones, you notice a different
sound than the usual lubb-dubb. What would you do with this information?

4. Describe how you would listen to breath sounds on K.J.
Why is it so important to assess breath sounds on K.J.?

5. Describe how you would assess bowel sounds. Why is it so
important to assess bowel sounds on K.J.?

6. K.J. has a catheter inserted. Practice your documentation
skills by writing a normal urine finding as if you were charting on K.J.

7. How would you assess for edema? According to the edema
rating scale, how would you document pitting edema of 4 mm?

8. Describe how you would assess K.J.’s musculoskeletal
system and extremities.

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