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Jamie is a 47 year old builder, he works 6 days a week and has a very physical job. He has a past medical history of depression and asthma and is on salbutamol and flixotide. On his way home from work on his motorcycle last night he was hit by a car and suffered a comminuted open fracture to his tibia and fibula. He has arrived on your orthopaedic ward post Open Reduction and Internal Fixation (ORIF). He is now 1 hour post ORIF, has no drains in place and his wound was sutured. In recovery he was administered 75 microgs Fentanyl intravenously, as well as lg paracetamol. His current pain score is 4/10 and he is on the following medications: Nursing Assignment Help

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Part A 
Describe the pathophysiology and clinical manifestations of Jamie’s injury in the immediate 24 hour postoperative period. Give a rationale for the medications being given and relate them back to the pathophysiology of Jamie’s condition including his medical history.

Part B 
Choose one of the medications above and describe why this medication is being given to Jamie, including:
• the medications mechanism of action

• indications and contraindications  Provide evidence of another medication that can be used as an alternative and provide justification (or your recommendation of change  Nursing Assignment Help

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