8/8/2019 Camille Fracture http://slidepdf.com/reader/full/camille-fracture 1/15 9 Fracture Nursing Care Plans A bone fracture (sometimes abbreviated FRX or Fx, Fx, or #) is a medical condition in which there is a break in the continuity of the bone. A bone fracture can be the result of high force impact or stress, or trivial injury as a result of certain medical conditions that weaken the bones, such as osteoporosis, bone cancer, or osteogenesis imperfecta, where the fracture is then properly termed a pathological fracture. Nursing goal for a patient with fracture is to relieve pain, education about upcoming surgery, promote comfort and promote healing. Types of Fractures:yComplete fracture: A fracture in which bone fragments separate completely. yIncomplete fracture: A fracture in which the bone fragments are still partially joined. yLinear fracture: A fracture that is parallel to the bones long axis. yTransverse fracture: A fracture that is at a right angle to the bones long axis. yOblique fracture: A fracture that is diagonal to a bones long axis. ySpiral fracture: A fracture where at least one part of the bone has been twisted. yComminuted fracture: A fracture in which the bone has broken into a number of pieces. yCompacted fracture: A fracture caused when bone fragments are driven into each other. Pathophysiology The natural process of healing a fracture starts when the injured bone and surrounding tissues bleed, forming a fracture Hematoma. The blood coagulates to form a blood clot situated between the broken fragments. Within a few days blood vessels grow into the jelly-like matrix of the blood clot. The new blood vessels bring phagocytes to the area, which gradually remove the non-viable material. The blood vessels also bring fibroblasts in the walls of the vessels and these multiply and produce collagen fibres. In this way the blood clot is replaced by a matrix of collagen. Collagen¶s rubbery consistency allows bone fragments to move only a small amount unless severe or persistent force is applied. At this stage, some of the fibroblasts begin to lay down bone matrix (calcium hydroxyapatite) in the form of insoluble crystals. This mineralization of the collagen matrix stiffens it and transforms it into bone. In fact, bone is a mineralized collagen matrix; if the mineral is dissolved out of bone, it becomes rubbery. Healing bone callus is on average sufficiently mineralized to show up on X-ray within 6 weeks in adults and less in children. This initial ³woven´ bone does not have the strong mechanical properties of mature bone. By a process of remodeling, the woven bone is replaced by mature ³lamellar´ bone. The whole process can take up to 18 months, but in adults the strength of the healing bone is usually 80% of normal by 3 months after the injury.
A bone fracture (sometimes abbreviated FRX or Fx, Fx, or #) is a medical condition in which there is a break
in the continuity of the bone. A bone fracture can be the result of high force impact or stress, or trivial injury asa result of certain medical conditions that weaken the bones, such as osteoporosis, bone cancer, or osteogenesis
imperfecta, where the fracture is then properly termed a pathological fracture. Nursing goal for a patient with
fracture is to relieve pain, education about upcoming surgery, promote comfort and promote healing.
Types of Fractures:
y Complete fracture: A fracture in which bone fragments separate completely.
y Incomplete fracture: A fracture in which the bone fragments are still partially joined.
y Linear fracture: A fracture that is parallel to the bones long axis.
y Transverse fracture: A fracture that is at a right angle to the bones long axis.
y Oblique fracture: A fracture that is diagonal to a bones long axis.
y Spiral fracture: A fracture where at least one part of the bone has been twisted.
y Comminuted fracture: A fracture in which the bone has broken into a number of pieces.
y Compacted fracture: A fracture caused when bone fragments are driven into each other.
Pathophysiology
The natural process of healing a fracture starts when the injured bone and surrounding tissues bleed, forming a
fracture Hematoma. The blood coagulates to form a blood clot situated between the broken fragments. Within afew days blood vessels grow into the jelly-like matrix of the blood clot. The new blood vessels bring
phagocytes to the area, which gradually remove the non-viable material. The blood vessels also bring
fibroblasts in the walls of the vessels and these multiply and produce collagen fibres. In this way the blood clotis replaced by a matrix of collagen. Collagen¶s rubbery consistency allows bone fragments to move only a smallamount unless severe or persistent force is applied.
At this stage, some of the fibroblasts begin to lay down bone matrix (calcium hydroxyapatite) in the form of
insoluble crystals. This mineralization of the collagen matrix stiffens it and transforms it into bone. In fact, boneis a mineralized collagen matrix; if the mineral is dissolved out of bone, it becomes rubbery. Healing bone
callus is on average sufficiently mineralized to show up on X-ray within 6 weeks in adults and less in children.This initial ³woven´ bone does not have the strong mechanical properties of mature bone. By a process of
remodeling, the woven bone is replaced by mature ³lamellar´ bone. The whole process can take up to 18months, but in adults the strength of the healing bone is usually 80% of normal by 3 months after the injury.
Several factors can help or hinder the bone healing process. For example, any form of nicotine hinders the process of bone healing, and adequate nutrition (including calcium intake) will help the bone healing process.
Weight-bearing stress on bone, after the bone has healed sufficiently to bear the weight, also builds bonestrength. The bone shards can also embed in the muscle causing great pain. Although there are theoretical
concerns about NSAIDs slowing the rate of healing, there is not enough evidence to warrant withholding theuse of this type analgesic in simple fractures
1Acute Pain
Pain is a subjective unpleasant sensation resulting from stimulation of sensory nerve endings by injury, or otherharmful factors. Pain is activated when a pt¶s pain threshold is reached. Pain threshold is the point at which a
stimulus activates pain receptors to produce a feeling of pain. Pain usually accompanies inflammation. It resultsfrom the synthesis of prostaglandins, which are hormones produced during the inflammatory process.
Deficient Knowledge is the absence or deficiency of cognitive information related to specific topic. The preoperative client may not be completely knowledgeable about surgical procedures, particularly hepati
surgery. This may be due to low educational background because of financial matters.
Due to limitations in the individual¶s ability to ambulate, she is prevented from performing ADLs that allow herto manage her hygiene such as bathroom privileges, bathing, clothing oneself.
Mobility impairments include upper body and/or lower body disabilities. The condition may be caused by birthdefect, injury, or illness. Some patients use their leg or hand braces, canes, walkers, prostheses, or do without
A person normally have a confidence to whatever he may do, to be able to do the things that are needed for her care, having a social life and interaction to people in the case of the patient having a low self esteem happens
when your capabilities were altered and you can no longer do the usual routines that you are doing before willshe is recovering from operative state.
Therapeutic management regimen is a set of program for the treatment of the illness and is sequelae that is
satisfactory for meeting specific health goals. Patient is exhibits readiness to this regimen when he/shedemonstrates eagerness to integrate these into his/her daily living.
Risk for infection occurs when a person is at risk for being invaded by pathogenic organisms. Transmission of
an infectious agent from a source to a susceptible host occurs within an environment. Organisms live and
multiply in a reservoir. The reservoir provides what the organisms needs for survival at a specific stage in itslife cycle. In this case, the dressing and broken skin can be the reservoir that may lead to infection.
