Question

Twenty-eight-year-old Joanne is a trauma patient in the ICU with significant orthopedic trauma. Immediately after surgical reduction of her bilateral femur fractures, Joanne starts to develop petechial hemorrhages and is noted to have excessive bleeding from her IV sites, her indwelling urinary catheter and her incision sites. a. Analyze what is happening with Joanne and why the ICU team needs to determine Joanne's primary problem. b. Outline anticipated medical orders to treat this condition and explain why they might be selected

Answer 1

a. Joanne is suffered from internal hemorrhage. Petechial hemorrhage is the tiny clots of blood less than 3mm in size that leaks into the surrounding tissue. It occurs as a result of a complication of orthopedic surgery. Most of the red cell production occurs in bone marrow, and the surgery followed by the femoral fracture results in internal hemorrhage. So the patient had bleeding at the iv site and urinary catheter.

b.Petechial hemorrhage should be treated immediately, otherwise, the patient will develop shock. the goal of the management is to find the exact location of the bleeding and to treat it. Corticosteroids should be administered to reduce inflammation. The patient should be continuously monitored for BP and heart rate. Check Hb level and blood transfusion if needed. Blood thinners if any, should be stopped immediately. repetitive surgery if required.