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What would the developmental level and nursing theorist be and what would be a good developmentally appropriate care to provide for the patient based on the supporting patient data below? Supporting evidence? What 3 nursing interventions would be appropriate for the patient from highest to lowest priority and why? Supporting evidence? Patient is in their mid 30s, male, climbs towers for a living, has a wife and 3 small boys as support, tobacco smoker (1 pack per day), on regular diet, no pertinent medical history or past illnesses. No isolation precautions, full code, fall risk, NKDA. Has a close relationship with wife and kids but rarely sees due to being in the hospital. Reason for admission: Patient presented to the ED status post auto vs. pedestrian accident. Patient states the accident on the road. Patient stopped their car and helped them and was hit by a car. Patient complained of severe right leg pain and found to have right proximal tibia/fibula fracture and left fibular diaphysis. Procedures: application external fixation and right tibia revision (done 3 days apart.) Admitted medical diagnosis: fracture of tibia and fibula, right, closed and initial encounter. Number of days hospitalized for current admission: 13 days. Progression of Illness/Wellness during Hospitalization: Pain well controlled in the morning, + BM, has been working well with PT, has not yet received wheelchair, SW currently working on DMF supply acquisition. Not a safe disposition w/o wheelchair. Discussed with orthopedic surgery, who will see client in the outpatient setting and plans to do the definitive fixation in the outpatient setting at a later date after evaluating in clinic. Pain (include PQRSTU): Patient’s stated pain goal: 3, pain score (intensity): 6 -moderate pain, Pain duration: less than 15 minutes, pain type: acute pain, pain orientation- right pain location: leg Effect of pain on daily activities: decreased ability to perform daily activities Pain interventions: medications Neuro: Alert and oriented to person, place, time and orientation. Pupils are equal, round, reactive to light and accommodated. Gag reflex is intact and speech is appropriate. Purposeful motor function, strength, and sensation in all extremities. Absence of confusion, mental status changes, posturing, seizures, headaches, or coma. Absence of spinal precautions, drains, or monitoring devices. Absence of facial droop, slurred speech, unilateral weakness or numbness. Cardiac: WDL, non-tele, S1 and S2 sounds, no JVD Pulmonary: abuses tobacco (pack/day: 1) Abdomen: soft, non-tender, non-distended. No adventitious sounds. Peripheral Vascular: no cyanosis, Left lower extremities – non-pitting, right upper extremities- none, right lower extremities edema- +1. Lower extremities are well perfused. Palpable pulses. Capillary refill less than 3 seconds. Skin: WDL. Skin is warm, dry and intact. Skin color is appropriate and even. Skin rises easily and returns to place immediately. Skin is free of any lesions, wounds, bruises, burns, abrasions, avulsions, rashes, or other abnormalities. IV Site/Drains/Tubes: Left forearm, 20 g peripheral IV 3/1/2022. Transparent dressing, saline locked, clean dry and intact Medications: Acetaminophen (Tylenol) 650 mg PO every 4 hrs PRN, Calcium Carbonate (Os-Cal) 1 tablet PO 2x daily w/meals, Cholecalciferol (Vitamin D3), 1,000 units (25 mcg), PO 1x daily, Enoxaprin (Lovenox), 30 mg, subcutaneous injection every 12 hrs Hydrocodone (Norco) 325 mg, 1 tablet oral every 6hrs PRN, Methocarbamol (Robaxin) 500mg oral 4x daily, Tramadol (Ultram) 50 mg oral every 6hrs PRN, Gabapentin (Neurontin) capsule 300 mg oral 3x daily, Labs: WBC 10.2 HGB 9.4 HCT 27.5 PLT 181 NA 133 K 4.0 CO2 25 CL 98 BUN 19 Creatinine 0.90 Glucose 107 Calcium 8.5 Vital signs: T 98.1 F P 74 RR 18 O2 Saturation 98, room air BP 118/59 Urine Output: 675 ml, uncloudy and yellow

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