Tr i n i t y U n i v e r s i t y o f A s i a - S t . L u ke s C o l l e g e o f N u r s i n g | B a t c h E x a l e r o n
Case background|
18 year old client admitted to E.R. With right tibial and femoral fracture Has Allergies to Chicken and shrimp
Sexually active Ta k e s C o n t r a c e p t i v e P i l l s
Tr i n i t y U n i v e r s i t y o f A s i a - S t . L u ke s C o l l e g e o f N u r s i n g | B a t c h E x a l e r o n
List down nursing, medical and pharmacological interventions performed during acute phase and give the rationale.
Nursing Management| C h e c k y o u r A B C D s !
Tr i n i t y U n i v e r s i t y o f A s i a - S t . L u ke s C o l l e g e o f N u r s i n g | B a t c h E x a l e r o n
Nursing Management|
If there are any signs of bleeding Apply pressure with sterile Dressing
Tr i n i t y U n i v e r s i t y o f A s i a - S t . L u ke s C o l l e g e o f N u r s i n g | B a t c h E x a l e r o n
Nursing Management|
If there are open fractures Irrigate with normal saline
Tr i n i t y U n i v e r s i t y o f A s i a - S t . L u ke s C o l l e g e o f N u r s i n g | B a t c h E x a l e r o n
Nursing Management|
For pain and anxiety Pain medications as ordered s h o u l d b e a d m i n i s t e r e d S TAT Encourage Diversional activites
Others F r e q u e n t l y a s s e s s f o r 5 P s !
Tr i n i t y U n i v e r s i t y o f A s i a - S t . L u ke s C o l l e g e o f N u r s i n g | B a t c h E x a l e r o n
Medical management|
Open Reduction/Closed Reduction Immobilization
Tr i n i t y U n i v e r s i t y o f A s i a - S t . L u ke s C o l l e g e o f N u r s i n g | B a t c h E x a l e r o n
Pharmacological Management|
Analgesics Te t a n u s To x o i d Prophylactic Antibotics
Tr i n i t y U n i v e r s i t y o f A s i a - S t . L u ke s C o l l e g e o f N u r s i n g | B a t c h E x a l e r o n
Tr i n i t y U n i v e r s i t y o f A s i a - S t . L u ke s C o l l e g e o f N u r s i n g | B a t c h E x a l e r o n
Use of contraceptives
Studies found that Decreased Estradiol secretion leads to poor b o n e m a i n t e n a n c e ( Strokosch, 2006)
Tr i n i t y U n i v e r s i t y o f A s i a - S t . L u ke s C o l l e g e o f N u r s i n g | B a t c h E x a l e r o n
Useful information to prevent Reactions before contrast medium Administration on diagnostic exams
Tr i n i t y U n i v e r s i t y o f A s i a - S t . L u ke s C o l l e g e o f N u r s i n g | B a t c h E x a l e r o n
Rationalize the immediate diagnostic procedures performed on the patient and list possible diagnostic procedures that can be used for this case
Tr i n i t y U n i v e r s i t y o f A s i a - S t . L u ke s C o l l e g e o f N u r s i n g | B a t c h E x a l e r o n
Tr i n i t y U n i v e r s i t y o f A s i a - S t . L u ke s C o l l e g e o f N u r s i n g | B a t c h E x a l e r o n
CT scan
further characterize fractures of the tibial plateau
Tr i n i t y U n i v e r s i t y o f A s i a - S t . L u ke s C o l l e g e o f N u r s i n g | B a t c h E x a l e r o n
MRI
- clear assessment of the fracture pattern and to find out injuries to the ligaments
Tr i n i t y U n i v e r s i t y o f A s i a - S t . L u ke s C o l l e g e o f N u r s i n g | B a t c h E x a l e r o n
Arteriogram/ arteriography - useful if vascular compromise is suspected - may be used if popliteal artery injury is suspected
Tr i n i t y U n i v e r s i t y o f A s i a - S t . L u ke s C o l l e g e o f N u r s i n g | B a t c h E x a l e r o n
Planning
After 30 minutes of nursing intervention, reported pain will be minimized.
Tr i n i t y U n i v e r s i t y o f A s i a - S t . L u ke s C o l l e g e o f N u r s i n g | B a t c h E x a l e r o n
Independent Encourage use of relaxation techniques Render quiet environment and calm activities Review procedures and tell patient when treatment will cause pain Encourage adequate rest period
Tr i n i t y U n i v e r s i t y o f A s i a - S t . L u ke s C o l l e g e o f N u r s i n g | B a t c h E x a l e r o n
Impaired physical mobility related to injury of the right femur and tibia.
Fracture of the right femur and tibia Pain and discomfort Limited range of motion Swelling
Planning After 1 hour of nursing intervention, the patient will be able to demonstrate techniques and behaviors that enable resumption of activities.
Tr i n i t y U n i v e r s i t y o f A s i a - S t . L u ke s C o l l e g e o f N u r s i n g | B a t c h E x a l e r o n
Independent
Tr i n i t y U n i v e r s i t y o f A s i a - S t . L u ke s C o l l e g e o f N u r s i n g | B a t c h E x a l e r o n
Tr i n i t y U n i v e r s i t y o f A s i a - S t . L u ke s C o l l e g e o f N u r s i n g | B a t c h E x a l e r o n