Escolar Documentos
Profissional Documentos
Cultura Documentos
Fracture
LEARNING OBJECTIVES:
General:
This case study aims to identify and determine the general health
problems
and
needs of
a patient
suffering
from
fracture
SPECIFIC OBJECTIVES:
To gain knowledge and acquire more information regarding
to the cause of the disorder, anatomy , pathophysiology.
To identify the different signs and symptoms and even
complications.
To identify appropriate nursing interventions by using of
nursing skills and knowledge.
INTRODUCTION:
This is a case of 35 year-old male from manila city. The patient
rushed to the hospital (emergency dept.) after hitted by a
motorcycle. He was diagnosed with a closed right arm fracture.
A fracture is a break in the continuity of bone and is defined
according to its type and extent. Fractures occur when the bone is
subjected to stress greater that it can absorb. Fractures are
caused by direct blows, crushing forces, sudden twisting motions,
and even ex t re m e m u s c l e co n t r a c t i o n s. W h e n t h e b o n e
i s b ro ke n , a d j a c e n t s t r u ct u re s a re a l s o aff ected,
resulting in soft tissue edema, hemorrhage into the muscles
and joints, joint dislocation,
ruptured tendons, severed nerves, and damaged blood
vessels. Body organs maybe injured by the force that cause the
fracture or by the fracture
fragments.T h e re a re d i f f e r e n t t y p e s o f f r a c tu re s a n d t h e
s e i n c l u d e , c o m p l e t e f r a c t u r e, incomplete fracture, closed
fracture, open fracture and there are also types of fractures
Patients Profile:
Name: P.C
Age: 35y/o
Sex: Male
Civil Status: Married
Address. Manila City.
Religion: Catholic
Date of Admission: Sept. 22, 2015
Admitting Dx: Close Right Arm Fracture
Chief Complaint: Pain of the right Arm
Family Hx: (-)DM, (-)HPN
Personal Hx: (+) Smoker, (+) Alcoholic Drinker
Anatomy&Physiology:
The word skeleton comes from the Greek word meaning driedup body, our internal framework is so beautifully designed and
engineered and it puts any modern skyscraper to shame. Strong,
yet light, it is perfectly adapted for its functions of body protection
and motion. Shaped by an event that happened more than one
million years ago when a being first stood erect on hind legs
our skeleton is a tower of bones arranged so that we can stand
upright and balance ourselves. The skeleton is subdivided into
three divisions: the axial skeleton, the boned that form the
longitudinal axis of the body, and the appendicular skeleton, the
bones of the limbs and girdles. In addition to bones, the skeletal
system includes joints, cartilages, and ligaments (fibrous cords
that bind the bones together at joints). The joints give the body f
Pathophysiology:
Predisposing Factors:
Precipitating:
Trauma
Falls
Vehicular Accident
Osteoporosis
Circulatory Compromise
Pain
Loss of Function
Deformity
Swelling
Paresthesia
DRUG STUDY
Drug/Class
Action
Indicatio
n
Contraindicate
d
Adverse
Rxn
PARACETAMOL
Allergy to
Headache,
Antipyretic
on heat-
of fever,
acetaminophen
Dyspnea,
regulating
back and
u/c impaired
hepatotoxicit
center to
muscle
hepatic, chronic
y and liver
cause
aches
alcoholism
failure
vasodilation
& sweating
Intervention
- Perform skin
test
- Give drug
with food
- DC if hypersensitivity
occurs
Diagnosis
Hyperther
mia r/t the
body
response
to
disorder
AEB:
Increased
body temp,
weakness,
skin fushed
and warm
to touch.
Plannin
g
After 4
hours of
nursing
care, the
patient
will
appear
more
relaxed
and
display
reduced
body
temp.
Intervention
Establish
rapport.
Monitor VS
carefully
Place patient
in low-back
rest, change
position
frequently
Rationale
Build trust
while
making
comparative
data
To maximize
breathing
effort
Provide Tepid
Sponge Bath
To promote
surface
cooling
Instruct to
increase oral
fuid intake
To replace
fuid loss
Monitor urine
output and
skin turgor
To identify
signs of
dehydration
Instruct to
avoid darkcolored foods
Encourage
high calorie
diet
To meet
metabolic
demands
To conserve
body energy
Encourage
To identify
signs of
bleeding
Evaluatio
n
After 4
hours of
nursing
care, the
patient
appeared
more
relaxed
and
displayed
reduced
body temp.
AEB:
Less
weakness,
skin less
warm to
touch
(+) cold
sweat
T 37.9
P 95
R 19
BP 120/80
Goal is
partially
met.
adequate
rest or sleep
Instruct to
wear loosefit clothing
Provide
bedside care
(side rails
up)
To limit
contributing
factors
For comfort
and bed
safety
DISCHARGE PLAN
Medication: Advise the client or significant other to take paracetamol as indicated.
Exercise and Activity: Instruct patient to take adequate rest breaks when tired, do not
over exert. Advice to perform ADLs as tolerated and do range of motion and repetitive
body movements for promotion of exercise.
Treatment: Instruct to client or significant others to follow treatment regimen.
Health Teaching: Instruct client or significant others to watch out for or report any sign
of 4Ps (Pain, Pallor, Pulselessness, Paresthesia,) also watch out for yellowish
discharge that may indicate infection and report any signs of compartment syndrome.
Out-patient: Instruct for a return checkup as advised by the physician
Diet: Advice Patient to Increase fluid intake.
Encourage patient to eat high calcium foods/drinks and nutritious foods for faster
and better bone healing.
Medical Management:
Temporary skin traction
Open or Closed of fracture or internal fixation
Cast
NSAID for Pain