Case 2 J. B. is a 13-year old boy who fractured his right arm in a snowboarding accident. An X-ray of the arm reveals a distal fracture that extends through the epiphyseal plate. J. B. has had no previous medical conditions and is otherwise healthy. His fracture requires placement of a surgical pin to reattach the distal bone fragment. After the surgery, the extremity is casted.

1. Of what significance is the involvement of the epiphyseal plate in the fracture line?

2. The surgical pin procedure increases the risk for bone infection. How would bone infection be manifested?

3. In the early post-operative period, the extremity may swell within the cast, leading to compression of blood supply and compartment syndrome. How would compartment syndrome manifest and what should be done if it occurs?

Mr. will, a 67-year-old patient, is postoperative day 2 after a coronary artery bypass graft operation to revascularize his coronary arteries that were significantly blocked. he has a midline incision of his chest and a 7-inch incision on the inner aspect of his right thigh where a saphenous vein graft was harvested and used to vascularize the blocked coronary artery. the surgeon ordered oxycodone 5 mg every 4 hours prn for moderate pain and oxycodone 10 mg every 4 hours prn for severe pain. a. considering the patient's age, what medication administration considerations should the nurse incorporate into the pain management plan and why? b. what measures should the nurse provide the patient to prevent adverse effects of analgesic agents from occurring? c. what nonpharmacologic pain management methods should the nurse teach to mr. will to assist with pain management?