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Multiple Injuries Description Is a physical injury or wound thats inflicted by an external or violent act; it may be intentional or unintentional; involve

injuries to more than one body area or organ Weapons Automobile collision Physical confrontation Falls Unnatural occurrence to the body

Etiology

*Type of trauma which determines the extent of injury Pathophysiology Blunt trauma leaves the body intact Penetrating trauma disrupts the body surface Perforating trauma leaves entrance and exit A physical injury can create tissue damage caused by stress and strain on surrounding tissue which results to infection, pain , swelling and potential compartment syndrome or it can be life threatening if it affects a highly vascular or vital organ Chest Xray detect rib and sterna fractures, pneumothorax, flail chest, pulmonary contusion and lacerated or ruptured aorta Angiography studies performed with suspected aortic laceration or rupture Ct scan, cervical spine Xrays, skull Xrays, Angiogram test for a patient with head trauma ABG analysis to evaluate respiratory status and determine acidotic and alkalotic states CBC to indicate the amount of blood loss Coagulation studies to evaluate clotting ability Serum electrolyte levels to indicate the presence of electrolyte imbalances Ineffective Airway Clearance

Diagnostics

Nursing Diagnoses

Nursing Management -

Ineffective Breathing Pattern Impaired Gas Exchange Deficient Fluid Volume Decreased Cardiac Output Impaired Tissue Perfusion Impaired Skin Integrity Risk for infection Anxiety Pain Disturbed Body Image Assess the patients ABCs and initiate emergency measures Administer supplemental oxygen as ordered Immobilize the patients head and neck with an immobilization device, sandbags, backboard and tape Assist with cervical Xrays Monitor VS and note significant changes Immobilize fractures Monitor the patients oxygen saturation and cardiac rhythm for arrhythmias Assess the patients neurologic status, including LOC and papillary and motor response Obtain blood studies, including type and crossmatch Insert large bore IV catheter and infuse normal saline or lactated Ringers solution Assess the patient for multiple injuries Assess the patients wounds and provide wound care as appropriate; cover open wounds and control bleeding by applying pressure and elevating extremities Assess for increased abdominal distention and increased

diameter of extremities Pharmacotherapy Client Education Administer blood products as appropriate Monitor the patient for signs of hypovolemic shock Provide pain medication as appropriate Provide reassurance to the patient and his family Tetanus immunization Antibiotics for infection control Analgesics for pain Provide explanations of all procedures done Families usually require emotional support and honest discussions about therapeutic interventions and plans