Professional Documents
Culture Documents
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 me
m u sc l e c on t ra c ti on s . W he n t he b o n e i s b ro ke n , a dj ac e n t st r uc t 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. Th e re a re d i ff e re nt t yp e s of fr ac t u re s an d t he se i nc l u de , co m p l e t e
f ra c tu re , incomplete fracture, closed fracture, open fracture and there are also
types of fractures t h a t m a y a l s o b e d e s c r i b e d a c c o r d i n g t o t h e a n a t o m i c
p l a c e m e n t o f f r a g m e n t s , particularly if they are displaced or non displaced. Such as
greenstick fracture, depressed fracture, oblique fracture, avulsion, spinal fracture, impacted
fracture, transverse fracture and compression fracture. A comminuted fracture is one that
produces several bone fragments and a closed fracture or simple fracture is one that not
cause a break in the skin. Comminuted fracture at the Right Femoral Neck is a fracture
in which bones of the Right Femoral Neck has splintered to several fragments. By
choosing this condition as a case study, the student nurse expects to broaden her
knowledge understanding and management of fracture, not just for the fulfillment of the
course requirements in medical-surgical nursing. It is very important for the nurses
now a day to be adequately informed regarding the knowledge and skill in
managing these conditions since hip fracture has a high incidence among elderly people,
who have brittle bones from osteoporosis (particularly women) and who tend to fall
frequently. O fte n, a f ra ct u re d hi p i s a c at a st ro p h i c e ve n t t ha t w i l l ha ve a
n e g a ti ve i m pa c t o n th e p a ti e n t s l i fe s ty l e a n d q ua l i ty of l i fe . T he re a re tw o
m aj or t y pe s of h i p fr ac t u re . Intracapsular fractures are fractures of the neck of the
femur, Extracapsular fracture are fractures of the trochanteric region and of the
subtrocanteric region. Fractures of the neck of the femur may damage the vascular
system that supplies blood to the head and the neck of the femur, and the bone may
die. Many older adults experience hip fracture that student nurse need to insure
recovery and to attend their special need effi ciently and effectively. True the
knowledge of this condition, a high quality of care will be provided to those people suffering
from it.
children even if they were not there physically and also her private nurses. Through this, she
may be able to cope up easily from her unhealthy condition. The treatment, managements,
medications and all out care rendered by the hospital to the patient assured her for the
improvement of her condition.
3.8. Sexuality/ Reproduction The patients husband just recently died. Now, the patient does
not allow anyone to see her getting undressed, changing diaper, changing clothes because
she believes thetas a woman, it should be keep as private.
3.9. Coping- Stress Tolerance Pattern The patient usually makes her decision as for now
since her children were busy in their work abroad, but they make sure they never forget to
support and help their mother recover from illness. Sometimes, the patient usually shares
her concerns to her private nurses and of course also to the student nurses. She usually
reads newspaper for her to bemire relaxed.
3.10. Value-Belief Pattern The patient find source strength and hope with God and her loved
ones. God is very much important to the patient. Before, she usually goes to church together
with her other children. They were not involved in any religious organizations or practices.
The patient knows how to pray and praise God for all the nice things he had given.
3.11. Relationship Pattern The patient understands more on English and Biscayan languages
but a little only intaglio language. The patient was living all by herself with her private
nurses but sometimes, her grandchildren will come over to visit her. She never uses the
support of her children even if they were away from their mother they always make sure
that their mother is safe and secure. The patient can easily communicate, cooperate, listen
and follow instructions easily.
The word skeleton comes from the Greek word meaning dried- up 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 appendicle
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 flexibility and allow movement to occur. Besides contributing
to body shape and form, or bones perform several important body functions such as support,
protection, movement, storage and blood cell formation. Classification of Bones The
diathesis, or shaft, makes up most of the bones length and is composed of compact bone.
The diathesis is covered and protected by a fibrous connective tissue membrane, the
periosteum. Hundreds of connective tissue fibbers, called Sharpes fibers,secure the
periosteum to the underlying bone. The epiphyses are the ends of the long bone. Each
epiphyses consist of a thin layer of compact bone enclosing the area filled with spongy bone.
Particular cartilage, instead of periosteum, covers its external surface.Because the articular
cartilage is glassy hyaline cartilage, it provides a smooth, slippery surface that decreases
friction at joint surfaces. In adult bones, there is a thin line of bony tissue spanning the
epiphyses that looks bit different from the rest of the bone in that area. This is the epiphysis
line. Theepiphyseal line is a remnant of the epiphyseal plate (a flat plate of hyaline cartilage)
seen in young, growing bone. Epiphyseal plates cause the lengthwise growth of the long
bone. By the end of puberty, when hormones stop long bone growth, epiphyseal plates have
been completely replaced by bone, leaving the epiphyseal lines to mark their
previouslocation.In adults, the cavity of the shaft is primarily a storage area for adipose (fat)
tissue. It is called the yellow marrow, or medullary, in infants this areas forms blood cells,
and red marrow is found these. In adult bones, red marrow is confined to the cavities of
spongy bone of flat bones and the epiphyses some long bones. Bone is one of the hardest
materials in the body, and although relatively light in weight, it has a remarkable ability to
resist tension and other forces acting on it. Nature has given us an extremely strong and
exceptionally simple (almost crude) supporting system without up mobility. The calcium salts
deposited in the matrix bone its hardness, whereas the organic parts (especially the collagen
fibbers) provide for bones flexibility and great tensile strength.
The femur, or thigh bone, is the only bone in the thigh. It is the heaviest, strongest bone in
the body. Its proximal end has a ball-like head, a neck, and greater and lesser trochanters
(separated anteriorly by the intertrochanteric line and posteriorly by theintertrochanteric
crest). The trochanters, intertrochanteric crest and the gluteal tuberosity,located on the
shaft, all serve us sites for muscle attachment. The head of the femur articulates with
acetabulum of the hip bone in a deep, secure socket. However, the neck of the femur is a
common fracture site, especially in old age. The femur slants medially as it runs downward
to joint with the leg bones; this brings the knees in line which the bodys center of gravity.
The medial course of the femur is more noticeable in females because of the wider female
pelvis. Distally on the femur are the lateral and medial condytes, which articulates the tibia
below. Posteriorly,these condytes are separated by the deep intercondylar notch. Anteriorly
on the distal femur is the smooth patellar surface, which forms a joint with the patella, or
kneecap.
Defining
characteristics
Nursing
diagnosis
Scientific
basis
Expected
outcome
Nursing
intervention
Rationale
Difficulty
in
changing
position while
lying on bed.Difficultyin
movingtheextre
mities.-Inability
to
walk
or
stand
alone.limitedrange of
motion
intheextremitie
s.Slowedmoveme
nt.Difficultyinitiati
nggait.diligiha
pon
mulihok
akongtiil day
as
verbalized
by the patient
Impaired
physical
mobility,
inability
to
standalon
e related
to skeletal
impairme
nt
to
facture of
the right
femoral
neck
Fractures
occur
when
the bone is
subjected to
stress greater
that it can
absorb. When
the bone is
broken,
adjacent
structures are
also affected,
resulting
in
soft
tissue
edema,
hemorrhage
in
to
the
muscles and
joints, joints
dislocations,
ruptured tendons,
severed
nerves, and
damaged
blood
vessels. Body
organs
maybe
injured by the
force
that
caused
the
fracture
fragments.
After
a
fracture, the
extremities
cannot
function
properly
because
normal
functions of
muscle
depend
on
the integrity
of the bones
which
they
After
8hours
nursepatient
interventio
n
the
patient will
be able to:
Demonstra
te
increasing
Function
of the
extremities
-Promote
adequate
mobility
of
the client.
to avoid patients
from falling to
sudden
movements
- instruct the
to keep side
rails up or
raised.
-to
improve
muscle strength
and joint mobility
assist
patient to do
active ROM
exercises on
the
lower
extremities.
-Provides
comfort
measures
such
as
backrub.
-Encourage
patient
to
stand
or
walk
as
tolerated
using
parallel bars.
-Support
affected
body parts
or
joints
using pillows
or rolls.
-administer
pain reliever
such
as
areoxia
as
prescribe by
the
physician.
-Consult
with physical
or
-to
develop
individual
exercise
or
mobility program
and identify
Appropriate
adjunctive
devices
are attached
Defini
ng
chara
cteris
tics
Nursing
diagnosis
Nursing
diagnosis
Outcomes
occupational
therapist as
indicated
Intervention
Rationale
2.
Risk
for alt
ered
blowfl
owRis
k
Facto
r:Imm
obilit
y
Risk
for
altered
bloodflow
rightimmo
bility
tofracture
of
the
rightfemo
ralneck
Defining
characteristi
cs
The
extremitiescann
ot
function properl
y
after
afracture,
thus,there
isimmobility bec
ause
normalfunction
of
themuscle
dependson the
integrityof
the
bones towhich
they
areattached.Im
mobility
of
a body
part
may possiblyint
errupt
thecirculation
of blood
throughthe
circuitousnetwor
k
of arteries
andveins
Nursing
diagnosis
Scientific
basis
Enhance
circulation
Outcomes
blood
2. prevent, blood
emboli-note
signs of changes
inrespiratory
rate,depth
use
of accessorymus
cles
purled-lip
breathing; Note
areas
of pallor
or cynosis.auscultate breat
h-soundsCheck if
there
isa
decrease
or adventitious b
reath soundsas
well asfremitusmonitor italsigns
andcardiac
rhythm-review
risk factorsreinforce needfor
adequaterest,
whileencouragin
gactivities
withinclientslimit
ationencouragefreque
nt positionchang
es
andDBE
or coughingexerc
ise.-administer m
edications
asindicated
Interventions
to
assessrespira
tory
insufficiencyserves
as
a baseline
data-note for
anychangesto
promote prev
entionmanag
ement
of risk -to
improvecircul
ation
of blood
to
the
bodysystems.
-to
treatunderlyi
ngconditions
Rationale
Risk
for additiona
l
injury
risk factors:
Loss
of skeletal
integrity*
skeletal
impartment*
Abnormal bl
ood
Risk
for additio
nalinjuryri
ght lossof
skeletalint
egrityto
fractureof
thefemor
alneck
A
fracture
occurs when
the
stress
placed on a
bone
is
greater than a
bone
can
absorb.
Muscle, blood
vessels,nerves
,
tendons, joints
and
other organs
maybe injured
when fracture
occurs.
This
condition may
result to a loss
of
skeletal
integrity that
may possibly
lead
to
further injury
as a result
of environmen
tal conditions
interacting
with
the
individuals
adaptive and
defensive
resources
to produce
risk factors
and protec
t
self
from
injury
to
reinforce
and
import
knowledge to
the patient
-to evaluate
degree
or
source
of
risk.
-for
early
detection.
-to promote
individual
safety.
-to
improve
skeletal
integrity.
-to promote
wellness