Client Concept Map

Presentation: Fractures
Angelina Matute
NUR 120 Fundamentals of Nursing
May 09, 2019
 78yrs. Old
Introduction- Ms. Bones
 African American

 Female

 AOX 3

 Status: Full Code

 No Known Allergies (NKA)

 Diet: Regular, LCS, & thin liquids

 Admission: 04-11-2019
Pathophysiology: Fracture
Definition:
Complete or Incomplete break femur
or disruption in the continuity
of a bone

Process:
Fractures occur when a bone
is subjected to an excessive
humerus
amount of stress-more than it
can absorb
Medications
NKA

Not always compliant

Takes a total of 11 medications

2 are subcutaneous injections
3 are topicals
5 are PO (likes with applesauce and
cut in half)
 Etiology

Caused by trauma and the blood supply to the bone being disrupted.
 Signs & Symptoms
Deformity at the site
(bruising/swelling/edema)
Numbness
Pain
Poor Circulation
Muscle weakness
Inability to move extremity
Complications
Neurovascular injury

Deformity

Shock

Infection

Nonunion & shortening

Angulation
 Medical/Surgical Treatment
Closed Reduction: Splint

Open Reduction: Surgery

Internal Fixation: Immobilization

External Fixation: Immobilization

Nursing Treatment & Management
Follow doctors orders

ROM

Educate

Medication

Assess
 Nursing Diagnosis #1
Impaired Physical Mobility R/T Musculoskeletal
Impairment (fractures LUE & LLE)
AEB
1.Decrease gross ROM & alteration in gait
2.Discomfort
3.Poor motor coordination & muscle strength
 Nursing Diagnosis #2
Risk for falls R/T motor deficit (LUE & LLE fracture)
Possible Signs & Symptoms
1.Unsteady balance/assisted devices
2. Visual acuity/age related changes
3. History of fall
 Nursing Diagnosis #3
Risk for infection R/T Surgical Procedure
Possible Signs & Symptoms
1.Respiratory complications
2.Purulent discharge from surgical cite
3.Elevated WBC
Top Priority Nursing Diagnosis
Impaired Physical Mobility R/T Musculoskeletal
Impairment (fractures LUE & LLE)
AEB
1.Decrease gross ROM & alteration in gait
2.Discomfort
3.Poor motor coordination & muscle
strength
 Client Goal
Client will maintain muscle strength and perform ROM by
the end of the clinical week (4-23-19  4-25-19)
 Expected Outcomes
Client will :
1. Perform ROM to the best of her ability

2. Report satisfactory pain control

3. Be able to maneuver with assistive devices in her room

 Assess/Monitor
Assess:

1. ROM exercises and gait

2. Pain/discomfort level before and after activities/ ambulating using

a standardized pain scale (0-10)

3. Independence with assistive devices

 Do/Implement
1.Help perform ROM exercises as tolerated

2. Encourage to verbalize when experiencing pain

and encourage relaxation techniques.

3. Assist and encourage the use of assistive devices

 Teach/Discharge
Teach Ms. Bones:

1. How to properly perform ROM

2. Importance of taking medications properly & Relaxation

techniques

3. How to correctly use assistive devices

Ms. Bones met her goal & I did not have to
change or modify her plan!
 Ms. Bones is a pretty independent woman with two
fractures. However, she still has to use assistive devices. I
enjoyed taking care of Ms. Bones it was a pleasant
experience. I helped her with her ADL’s, made sure her pain
level was low none, and observed her physical therapy
sessions. She will go back to her house (lives with youngest
daughter) and live out normal lifestyle.
 References
Gulanick, M., and Myers, J.(2017) Nursing Care Plans, Diagnoses, Interventions, and Outcomes. (9 th ed).
St. Louis: Mosby
https://www.newhealthadvisor.com/Femoral-Neck-Fracture.html
https://www.sports-health.com/sports-injuries/shoulder-injuries/proximal-humerus-fractures-shoulder