Musculoskeletal Case Study
Case Study 1
H.A., a 30-year-old telephone lineman, was seen in the emergency department after
falling from a pole. His right lower extremity was splinted with a cardboard splint and a
large, bulky dressing. He complains of severe pain in the right leg, expresses concern
about notifying his wife about the accident and asks how long he will be off work.
Upon assessment, he has an avulsion of soft tissue on the anterolateral aspect of the tibia
and obvious deformity, marked swelling, and ecchymosis in region of injury.
1. What is the appropriate nursing neurovascular assessment of the injured
extremity?
• Pulse, pallor, pressure, paresthesias, paralysis and pain
2. What are the nursing interventions to prevent infection?
• Clean wound with normal saline. Control bleeding with sterile dressing
and administer antibiotics as needed.
3. What nursing actions should the nurse implement to alleviate H.A.’s pain?
• Elevating leg
• Applying ice to decrease swelling
• Administer analgesics
• Keeping right leg immobilized
4. How should the nurse notify the wife about her husband’s accident?
• The nurse should be careful not to create a panic, but should state that he
is alert and oriented but would need hospitalization because he has a
fractured leg.
5. What signs and symptoms would be present if the patient develops compartment
syndrome.
• Pallor, pressure, paralysis, and swelling
Case Study 1
H.A., a 30-year-old telephone lineman, was seen in the emergency department after
falling from a pole. His right lower extremity was splinted with a cardboard splint and a
large, bulky dressing. He complains of severe pain in the right leg, expresses concern
about notifying his wife about the accident and asks how long he will be off work.
Upon assessment, he has an avulsion of soft tissue on the anterolateral aspect of the tibia
and obvious deformity, marked swelling, and ecchymosis in region of injury.
1. What is the appropriate nursing neurovascular assessment of the injured
extremity?
• Pulse, pallor, pressure, paresthesias, paralysis and pain
2. What are the nursing interventions to prevent infection?
• Clean wound with normal saline. Control bleeding with sterile dressing
and administer antibiotics as needed.
3. What nursing actions should the nurse implement to alleviate H.A.’s pain?
• Elevating leg
• Applying ice to decrease swelling
• Administer analgesics
• Keeping right leg immobilized
4. How should the nurse notify the wife about her husband’s accident?
• The nurse should be careful not to create a panic, but should state that he
is alert and oriented but would need hospitalization because he has a
fractured leg.
5. What signs and symptoms would be present if the patient develops compartment
syndrome.
• Pallor, pressure, paralysis, and swelling
