Emergency Nursing

 1a. What are the possible injuries to the patient according to the information presented in the initial presentation, and what medical-surgical management is anticipated?

The chest of the patient continues to move in an inconsistent manner which indicates a failed chest injury. The patient moves inwards as he breathes in and outwards with expiration. The physician should use an X-ray to determine the extent of the damage. The injuries can be managed through surgical stabilization and mechanical ventilation. The trachea deviated on the right side, decreased breath sound on the left side of the chest, and the lack of movement on the left side indicate the possibility of tension pneumothorax. The imprint of the steering wheel indicates the possibility of cardiac or pulmonary contusions. The patient losing consciousness and the period of lucidity can be the presence of an epidural hemorrhage. 

1b. What are the priorities for care for this individual based on the information presented?

 The physician should emphasize establishing efficient airways and ventilation for the patient. It is crucial to check for any injuries to the neck and head. Hemorrhages in the brain and other parts should be assessed and controlled to avoid life-threatening conditions. The nurse should also check for and prevent the possibility of getting a shock.

2a. What emergent management should the nurse anticipate for the patient?

The first step is to remove the patient’s clothing and assess his body temperature. The physician should work towards lowering the patient’s temperature to 102 Fahrenheit. Some of the methods to attain this include cooling blankets or ice. Cooling blankets will continue to monitor the core temperature and stop when the goal temperature is attained in the body. Ice is applied to the neck, chest, groin or axillae while a fan blows cold air towards the patient. Applying a towel or sponge dipped in cool water can also work.

 2b. What patient education should the nurse provide once the patient is stable?

The nurse should advise the patient to avoid long periods of sunlight, especially between ten in the morning and noon. The patient should make sure to drink two to three liters of water a day, especially during exercising. Caffeinated drinks are also not appropriate.