Nursing Care Plan To The Client With Fractures of The Extremities and Extremities Surgery
Nursing Care Plan To The Client With Fractures of The Extremities and Extremities Surgery
Nursing Care Plan To The Client With Fractures of The Extremities and Extremities Surgery
Extremities Surgery
Nursing Assessment
1. Assess for history of the injury, presence of factors that may cause pathologic fractures
(osteoporosis, osteomyelitis, neoplastic diseases, etc.).
2. Assess presence of signs of fracture (edema, pain, loss of motion, crepitus, extremity
disproportion or abnormal positioning).
3. Assess presence of signs and symptoms of soft tissues involvement (swelling, hemorrhage,
impaired sensation in the extremity).
4. Assess extremity for presence of open fracture and severe external hemorrhage.
5. Assess vital signs, fluid balance and urine output.
6. Assess diagnostic tests and procedures for abnormal values.
7. Assess routine preoperative history.
Nursing Diagnosis
Goals
Interventions
1. Provide emergency care if requires (hemostasis, respiratory care, prevention of shock).
2. Provide fracture fixation to prevent following injury of tissues.
3. Observe signs of fat embolism (especially during first 48 hours after the fracture).
4. Monitor fluids input and output continuously, insert IV catheter, urinary catheter.
5. Monitor client’s vital signs.
6. Monitor client’s laboratory tests results for abnormal values.
7. Administer IV therapy, analgesics, antibiotics, and other medications as prescribed.
8. Prepare client and his family for surgical intervention if required.
9. For client after surgical intervention provide routine postoperative care and teach about
possible postoperative complications.
10. Provide care to client with cast (observe signs of circulatory impairment – change in skin
color and temperature, diminished distal pulses, pain and swelling of the extremity; protect the
cast from damage).
11. Provide care to client in traction (check the weights are hanging freely, observe skin for
irritation and site of skeletal traction insertion for signs of infection; use aseptic technique when
cleaning the site of insertion).
12. In case of hip fracture and hip replacement maintain the adduction of the affected extremity.
13. Provide respiratory exercises to prevent lung complications.
14. Observe for signs of thrombophlebitis, report immediately.
15. Provide appropriate skin care to prevent pressure sores.
16. Encourage fluid intake and high-protein, high-vitamin, high-calcium diet.
17. Teach the client appropriate crutch-walking techniques .
18. Provide emotional support to client, explain all procedures to decrease anxiety and to obtain
cooperation.
19. Instruct client regarding fracture healing process, diagnostic procedures, treatment and its
complications, home care, daily activities, diet, restrictions and follow-up.
Evaluation