Medical-Surgical Nursing 8th Edition by Donna Ignatavicius , Linda Workman

Exercise 3

A 50-year-old tree trimmer has been brought to hospital after coming in contact with an 8000-volt power line while trimming trees with a pole trimmer. The emergency medical technicians (EMTs) report that they recovered this man from an insulated bucket in which he was working. According to bystanders, the metal polesaw made contact with the power line. The patient was rendered unconscious only momentarily. The EMTs report that he had pain in both arms when they transported him to the hospital. He now has pain in the neck. The patient is agitated and restless and continues to report increasing pain in both arms and hands and in the neck even though there is no area of burn on the neck. The exit wound is the right hand, including the fingers and thumb. The right arm is cyanotic and tense, and the wrist is acutely flexed and rigid in that position. There is an arc burn in the right axilla. The left arm is tense and cyanotic, and the wrist, hand, and fingers are charred.
A Foley catheter has been placed in this patient, and it is documented that the urine is wine pigmented. What is the etiology and potential complication if this symptom persists?