Laura Katherine Castano Barragan

Journal 8

Date: 8/5/2020

Professor El Kholy, Amira

I-Human, left supracondylar, intercondylar distal femur fracture, 87%

I started the scenario in I-Human with J. G., 16-year-old male who was admitted for left

supracondylar, intercondylar distal femur fracture. I achieved a score of 87%. The Pt had no

medical or surgical history; no relevant illnesses in his family were reported. Pt was hit by a car

while in his bike ride to school. He didn’t lose consciousness and was wearing a helmet. He had

an ORIF with no complications after admitted to the ER and was transferred to the ortho unit.

Dressing was CDI. His vital signs were normal during the assessment: BP: 124/74, RR: 24, HR:

76, Temp: 99.7, Pain: 2/10 after administration of 3 mg of morphine at 18:50. Nausea that

improved after admin of 8 mg of ondansetron. Acute rash and itchiness in chest were developed

after the administration of the two medications. Breathing and lungs sounds were normal.

Extremities with 2+ pulse, dry, no edema, inflammation, warm, capillary refill less than 2 sec.

DVT prophylaxis measures were SCD on RLE and enoxaparin every am. Education for incentive

spirometry was given. I recommended that the doctor came and evaluate the patient’s allergic

reaction to the medications. In the meantime, I suggested to give an antihistamine and to evaluate

changing his pain and nausea medication.

 I was able to select most of the correct assessments in the health history and the physical,

as well as prioritize the allergy to the medication as the acute finding most important to treat

first. I learned about ORIF done for a femur fracture and the LISS Synthes femoral locking

plates used specifically for condylar fractures. The patient was worried about how he was going

to get around; he was in the track team in his high school. I considered important to clarify that

psychical and occupational therapy were going to be there for him to guide him in the recovery

process. My weakness in this scenario was to overlooked the abrasions in his right arm that were

not being treated in any way. My strength in this scenario was to report promptly and

recommend adequate actions to manage the allergy to the medication given.