Nursing Care Plan to the Client with Fractures of the Extremities and Extremities SurgeryNursing 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.
1. Increased risk of hypovolemia and shock related to trauma and bleeding.
2. Increased risk of bone inflammation related to open fracture.
3. Increased risk of fat embolism related to fracture of the long bones.
4. Increased risk of severe fluid, electrolyte, and metabolic imbalances related to injury or inflammation.
5. Pain and immobility , related to diagnosis of fracture.
6. Increased risk of respiratory, cardiovascular, bowel, and skin complications related to a long period of immobility.
7. Anxiety related to the symptoms of disease and fear of the unknown.
Nursing Plan and Interventions
1. Increase comfort, decrease pain.
2. Prevent avoidable injury.
3. Prevent complications of immobility.
4. Provide optimal bone and wound healing.
5. Then surgical intervention prescribed, prevent postoperative complications.
6. Decreased anxiety with increased knowledge.
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.
1. Reports increased comfort, decreased pain.
2. No evidence of respiratory, vascular or skin complications of immobility.
3. Maintains stable vital signs, fluid and metabolic balance, nutritional state.
4. Has sufficient fracture healing rate.
5. Laboratory tests results shows no abnormalities.
6. No postoperative complications, or treatment complications.
7. Learned of crutch-walking, taking care of himself then possible.
8. Demonstration of understanding of fracture healing process, diagnostic and treatment procedures, trauma prevention, and need for follow-up.
This information has been published by the International Biopharmaceutical Association www.ibpassociation.org . Please note this information does not give any medical advice.
The project is sponsored by Kriger Research Center - CRO and Training Services ( www.kriger.com ) , ClinQua CRO (www.clinqua.com ), Biorole Free Resumes Data Base (www.biorole.com ) and Altaspera Designs ( www.altaspera.com )
Start your Clinical Research Career Now:
Clinical Research Associate Program
Data Management Program
Quality Assurance Program
Marketing & Management Program
Clinical Investigator Program
SAS Programming Trainig Program
Recruitment for the Bio Pharmaceutical Industry Program
Determine your eligibility
Check availability of in-class sessions in your city
For more information on Clinical Research Career Training and Clinical Trials Services please contact Kriger Research Group International ( www.kriger.com ) at firstname.lastname@example.org or call (866) 757-9791 (USA and Canada) or + 1(416) 630-0038 (Internationally).
[PDF] on Distal Extremities surgery and traumatologyFile Format: PDF/Adobe AcrobatDeposit for Distal Extremities surgery and traumatology: ... LAB 8) Fractures ofthe distal Radius and Ulna. LAB 9) Fracture of the Radial Carpal Bone ...www.esvot.org/PDF/2005/surg_dist0505.pdf - Similar pages
[Views on indication for surgery in fractures of the extremities ...[Views on indication for surgery in fractures of the extremities in geriatrics] [Articlein German] Hengst E, Schmidt E, Rick H, Bucklitsch W. MeSH Terms ...www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve& db=PubMed&list_uids=5593484&dopt=Abstract - Similar pages
Factors determining outcome in fractures of the extremities ...Fifteen patients with fractures of the extremities and associated arterial ...Arteries/surgery Child Female Fractures/complications Fractures/surgery* ...www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve& db=PubMed&list_uids=2023040&dopt=Abstract - Similar pages[ More results from www.ncbi.nlm.nih.gov ]
Orthopedic Injuries In The Victims Of The Earthquake Of Bam... according to a study conducted in Kartal Hospital, extremities fractures and... Table 1: The prevalence of orthopedic injuries in upper extremities ...www.ispub.com/ostia/ index.php?xmlFilePath=journals/ijos/vol2n1/bam.xml - 21k - 7 Nov 2005 - Cached - Similar pages
Acute lengthening of shortened lower extremities after malunion or ...... of shortened lower extremities after malunion or non-union of a fracture ...Fatigue fractures were seen in two tibial plates, two femoral plates, ...www.ejbjs.org/cgi/content/abstract/76/3/379 - Similar pages
Fractures in patients who have myelomeningocele -- Lock and ...... or upper lumbar involvement, sustained fractures of multiple extremities.All fractures of the lower extremity were distal to the level of neurological ...www.ejbjs.org/cgi/content/abstract/71/8/1153 - Similar pages
Bone fracture of the upper extremitiesImproper healing of fracture, Broken bone requiring surgery caused by Bone ...9) (required) Is your case of Bone fracture of the upper extremities the ...www.vedicvibration.com/apply/musculoskeletal/ bone_fracture/bone_fracture_upper_extremities.html - 40k - Cached - Similar pages
Burst Fractures: Treatment and RecoveryUnstable burst fractures usually do better with early surgery. ... therapy isusually instituted to help return strength to the trunk and lower extremities. ...www.spineuniverse.com/ displayarticle.php/article927.html - Similar pages
HealthWeb : Orthopedics: Clinical Resources: Hip,Knee & Lower ...Hip,Knee & Lower Extremities, Brief Display. Websites ... Effect and offset ofeffect of treatments for hip fracture on health outcomes ...www.healthweb.org/browse.cfm?categoryid=2601 - 12k - Cached - Similar pages
Common Stress Fractures - October 15, 2003 - American Family PhysicianThis article reviews common stress fractures of the lower extremity, ...insoles may prevent stress fractures and stress reactions of the lower extremities. ...www.aafp.org/afp/20031015/1527.html - 43k - Cached - Similar pages
Social Security OnlineTo use their upper extremities effectively, a child must be capable of ...101.07 Fracture of an upper extremity with nonunion of a fracture of the shaft of ...www.ssa.gov/disability/professionals/ bluebook/101.00-Musculoskeletal-Childhood.htm - 47k - Cached - Similar pages
Military Medical Standards for Continued Service - ExtremitiesUpper extremities. Amputation of part or parts of an upper extremity which resultsin impairment ... or with severe residuals from surgery. Fractures ...usmilitary.about.com/library/ milinfo/medstandards/blextremities.htm - 40k - Cached - Similar pages
Shock Trauma Center - Plastic, Maxillofacial and Reconstructive ...Shock Trauma's Plastic Surgery Division provides expert care for ... Challengingscar deformities involving the head/neck, extremities and/or trunk. ...www.umm.edu/shocktrauma/trauma_plastic.html - 23k - Cached - Similar pages
Shock Trauma Center - Orthopaedic TraumaSevere fractures of the upper and lower extremities, including open and complex... Residency: Long Island Jewish Medical Center, Orthopaedic Surgery ...www.umm.edu/shocktrauma/trauma_ortho.html - 26k - Cached - Similar pages
[DOC] Limb Salvage Surgery for Extremity SarcomasFile Format: Microsoft Word 2000 - View as HTML... Massive allografts are susceptible to fractures and infection,32 and adjuvanttreatment with ... sarcomas of the extremities [see comments]. Surgery ...bonetumor.org/tumors/images/Limbsal1.doc - Similar pages
West Penn Allegheny Health System Medical Specialties and Health ...Total Knee, Shoulder, and Hip Replacement Surgery; Unicompartmental Knee Prosthesis... Foot and ankle; Fracture repair; Hands and upper extremities ...www.wpahs.org/patients/services/index.cfm?sid=67 - 23k - 7 Nov 2005 - Cached - Similar pages
[PDF] University of Utah Hospitals and ClinicsFile Format: PDF/Adobe Acrobat - View as HTMLMetacarpal fractures. ___. Other. Lower Extremities. ___. Simple, no reduction... Extremities. ___. Incision-Abscess. ___. Nail bed-surgery. Amputation ...uuhsc.utah.edu/mso/pdfs/orthopedicSurgery.pdf - Similar pages
[PDF] Posterior Tibial Artery Pseudoaneurysm Following Tibial FractureFile Format: PDF/Adobe AcrobatOf all the challenges in orthopaedic surgery, the treatment of fracture remains... Arterial damage coinciding with lower extremity long bone fractures is ...www.sicot.org/IO_reports/07-2003/1-07-2003.pdf - Similar pages
Virtual Hospital: University of Iowa Family Practice Handbook ...For extremities, inflating a blood pressure cuff above systolic pressure assists... Check for open fracture or associated fractures. X-ray if any question. ...www.vh.org/adult/provider/familymedicine/ FPHandbook/Chapter15/01-15.html - 21k - Cached - Similar pages
Orthopaedic Surgery - Northwestern Memorial Hospital - ChicagoThe Department of Orthopaedic Surgery specializes in the diagnosis and treatment of:... Simple and complex fractures of the spine and extremities ...www.nmh.org/nmh/specialtiesandservices/ surgicalspecialties/orthosurgery/main.htm - 14k - 7 Nov 2005 - Cached - Similar pages
Timing of Surgery in Orthopaedic Patients with Brain Injury ...Multiple injuries: coma and fractures of the extremities. Sanker P, Frowein RA,Richard KE. Neurosurg Rev. 1989; 12 (suppl 1): 51-54. ...www.wheelessonline.com/ortho/timing_ of_surgery_in_orthopaedic_patients_with_brain_injury - 33k - Cached - Similar pages
The Physician and Sportsmedicine: Recognizing Upper-Extremity ...Stress fractures of the upper extremity are relatively rare. ... McBryde (3)reported that 3% of stress fractures occur in the upper extremities. ...www.physsportsmed.com/issues/1997/08aug/cervoni.htm - 24k - Cached - Similar pages
[PDF] Pathological fractures of the extremitiesFile Format: PDF/Adobe Acrobatfractures of the extremities caused by metastases and. primary bone tumours. ...surgery is potentially curative in the absence of metas- ...www.ingentaconnect.com/content/ arn/ta/2000/00000002/00000002/art00002 - Similar pages
American College of Osteopathic Surgeons - AnonymousCosmetic surgery of face, trunk, extremities including suction lipectomy and ...Hand surgery of traumatic amputations, fractures and lacerations as well as ...https://www.facos.org/scriptcontent/ aboutacosbylawsplastic.cfm - 46k - Cached - Similar pages
Yale Orthopædics and Rehabilitation Hand and Upper Extremity CenterWrist and hand fracture (including mal-unions and non-unions and percutaneous... invasive hand and wrist surgery; Athletic injury to upper extremities ...info.med.yale.edu/ortho/patient/hand.html - 9k - 7 Nov 2005 - Cached - Similar pages
Northwestern Medical Faculty Foundation: Clinical Areas and ConditionsSimple and complex fractures of the spine and extremities ... Hand surgery Ilizarovmethod for treatment of problem fractures and limb length disorders ...www.nmff.org/clinicaldepts/department.asp?id=11 - 14k - Cached - Similar pages
Wright Medical Technology – Orthopaedic Products, Extremity ImplantsExtremities Wrist. Each year, more than 300000 people in the US and ... More complexfractures require surgery, in which either internal metal plates or ...www.wmt.com/Patients/extremities/wrist.asp - 28k - 7 Nov 2005 - Cached - Similar pages
DePuy Orthopaedics Trauma & Extremities Group to Meet Needs of ...DePuy's new Trauma & Extremities Group matches the way many surgeons ... "It isnot unusual for patients treated with fractures to later require joint ...www.jnj.com/news/jnj_news/20040315_110501.htm - 31k - Cached - Similar pages
UCMG - Speakers Bureau - Orthopaedic SurgeryOrthopaedic Trauma for the Pediatrician - Upper Extremities ... Fractures;Pediatric Orthopaedic Trauma; Upper Extremity Problems in Children ...www.ucmg.org/cme/sb02/sb02_os.html - 8k - Cached - Similar pages
Extremities IrradiationSurgical Repair of Mandible (lower jaw) Fractures ... Procedures in theExtremities (formerly entitled "orthopaedic surgery on extremities") ...www.lammico.com/risk/ published.asp?published_category_id=22&published_id=121 - 52k - Cached - Similar pages
Specialty Services: Upper Extremities/HandUpper Extremities/Hand Johns Hopkins Orthopaedics Hand Surgery Program ...Distal radius, carpal (wrist) bones and finger fractures are routinely managed. ...www.jhbmc.jhu.edu/Ortho/specialties/hand.html - 12k - Cached - Similar pages
Combined vascular and skeletal trauma: Vascular Trauma: Trauma.OrgHowe HR, Poole GV, Hansen KJ, et al: Salvage of lower extremities following combined... gunshot wounds resulting in long bone fractures of the extremities. ...www.trauma.org/vascular/vascskeletal.html - 67k - Cached - Similar pages
EMR Textbook - Penetrating Trauma to the ExtremitiesExtremities with suspected fractures should be immobilized in order to reducepain and prevent any ... Surgery 1989;105:576-584. 44. Brunner RG, Fallon WF. ...www.thrombosis-consult.com/ articles/Textbook/128_extremities.htm - 59k - Cached - Similar pages
Posttraumatic Bacterial Infections in Extremities before and after ...Posttraumatic Bacterial Infections in Extremities before and after ... with longbone fractures operated at the Department of Surgery and Orthopaedics, ...www.vfu.cz/acta-vet/vol72/249-03.htm - 7k - Cached - Similar pages
Emory Healthcare: clinical_servicesHand and Upper Extremity Care and Surgery ... Severe fractures of the upper andlower extremities; Pelvic fractures; Spinal fractures; Complex femoral ...www.emoryhealthcare.org/departments/ ortho/services/orthopaedics.html - 22k - Cached - Similar pages
Residency Training Program - Description of Rotations... the treatment of open and closed fractures and dislocations of the extremitiesand the ... Hand and Microvascular Surgery Rotation (PGY 3 and 4 level): ...medicine.ucsd.edu/ortho/ educational_programs/rotations.shtml - 20k - Cached - Similar pages
Pediatric Considerations - Hospital for Special Surgery ...For surgery of the lower extremities, we routinely use narcotic-free epidural... Examples include pinning of olecranon fractures (potential for ulnar nerve ...www.hssanes.org/for-patients/ pediatric-anesthesia-at-hss.htm - 20k - Cached - Similar pages
UC Davis Health System: Department of Orthopaedic Surgery ...The Orthopaedic Trauma Service coordinates closely with general surgery, ...Complex fractures of the pelvis, acetabulum and extremities are of particular ...www.ucdmc.ucdavis.edu/orthopaedics/ education/residency/clinical_surgical.html - 28k - Cached - Similar pages
Barnes-Jewish Hospital - TraumaLong bone fractures of the extremities; Nerve and tendon injuries ... Orthopaedicsurgeons, who are fellowship-trained in trauma surgery, are involved in ...www.barnesjewish.org/groups/default.asp?NavID=330 - 12k - 7 Nov 2005 - Cached - Similar pages
AAOS On-Line Service Surgical Care of the Lower ExtremitiesReconstructive surgery on the foot, ankle and lower extremities includes, but isnot limited to, repair of fractures, amputations, replacement of joints, ...www.aaos.org/wordhtml/papers/position/1148.htm - 15k - Cached - Similar pages
Tumours of the ExtremitiesLumps around the extremities are common. It is true to say that most of the ...a soft-tissue mass to lessen the risk of pathological fracture (4) frozen ...www.hku.hk/ortho/ortho/ newsletter/newsletter01/news3.html - 13k - Cached - Similar pages
Apparatus for the surroundive fixation of extremities - Patent 6066107An apparatus is described for the surroundive fixation of extremities in which a... An apparatus for treating a fracture in an extremity comprising a ...www.freepatentsonline.com/6066107.html - 34k - Cached - Similar pages
Annals of Plastic Surgery - Fulltext: Volume 53(3) September 2004 ...From the *Department of Plastic and Reconstructive Surgery, ... of the lowerextremities due to pelvic fracture and lumber vertebra pressure fracture, ...www.annalsplasticsurgery.com/pt/ re/annps/fulltext.00000637-200409000-00017.htm - Similar pages
Annals of Plastic Surgery - Fulltext: Volume 52(3) March 2004 p ...1,2 High-energy fractures of the lower extremity often resulted in amputation... Salvage of lower extremities following combined orthopedic and vascular ...www.annalsplasticsurgery.com/pt/ re/annps/fulltext.00000637-200403000-00011.htm - Similar pages
[PDF] EAST PRACTICE MANAGEMENT GUIDELINES WORK GROUP: PRACTICE ...File Format: PDF/Adobe Acrobat - View as HTMLAn appropriate management plan for open extremity fractures would include ...deep infection after open fractures of the lower extremities caused by blunt ...www.east.org/tpg/openfrac.pdf - Similar pages
[PDF] Role of surgery in local treatment of Ewing's sarcoma of the ...File Format: PDF/Adobe Acrobat - View as HTMLBACCI et al: ROLE OF SURGERY IN EWING'S SARCOMA OF THE EXTREMITIES ... recommendedfor pathologic fractures that otherwise could ...188.8.131.52/OR/2004/volume11/number1/111.pdf - Similar pages
Avulsion injuries of extremities.Indian Journal of Plastic Surgery. 1987 Dec; 20(2): 80-3. ... Extremities/SU;Extremities/IN; Wounds And Injurues/ET; Fractures/SU; Surgical Flaps/MT; ...medind.nic.in/imvw/imvw21472.html - 3k - Cached - Similar pages
Techniques in Hand and Upper Extremity Surgery - Fulltext: Volume ...Hand and Upper Extremity Service; Department of Orthopaedic Surgery; ... Mast J.Internal fixation technique in pathologic fractures of the extremities. ...www.techhandsurg.com/pt/re/techhand/ fulltext.00130911-200303000-00002.htm - Similar pages
Combined Chicago Hand & Upper-Extremity Review Course... injuries to the hands and upper extremities, such as fractures and dislocations,... Hand and Upper Extremity Surgery The University of Chicago Pritzker ...www.uchicago.edu/bsd/cme/2002/handnupper.html - 24k - Cached - Similar pages
Medical College of Wisconsin Patient Care(Patient Age Range: All) Hand and Upper Extremity Surgery, Hand, ... Upper &Lower Extremity, Congenital Birth Disorders of the Upper and Lower Extremities, ...doctor.mcw.edu/clinic.php?57 - 17k - 7 Nov 2005 - Cached - Similar pages
Nursing Approach to Crohn’s Disease
Nursing Care Plan to a Peptic Ulcer
Nursing Approach to Ulcerative Colitis
Nursing Approach to Diverticulosis
Nursing Approach to Motoric Bowel Disorders
Nursing Care Plan to Pancreatitis
Nursing Approach to Gallbladder Disorder
Nursing Care Plan to Liver Disorders
Nursing Approach Recto-anal Disorders
Nursing Approach to Neoplastic GI tract