Nursing Care Plan: Femur Fracture
Assessment:
- Patient's Condition: Fracture of the femur (right/left)
- Vital Signs: Monitor for any abnormal changes due to trauma or surgical intervention.
- Pain Level: Assess pain using a pain scale (0-10) and observe for signs of distress.
- Mobility: Restricted due to fracture.
- Skin Integrity: Inspect for signs of bruising, swelling, or open wounds.
- Mental Health: Anxiety, fear of immobility, or adjustment to reduced independence.
- Pre-operative and Post-operative Assessment: If surgery is involved (e.g., internal fixation), assess for post-operative complications such as infection, hemorrhage, or complications related to anesthesia.
Nursing Diagnoses:
- Acute Pain related to the femur fracture, surgical interventions, and muscle spasms.
- Impaired Physical Mobility related to the femur fracture and postoperative limitations.
- Risk for Infection related to open fractures or surgical incisions.
- Risk for Impaired Skin Integrity related to immobility and use of traction or casts.
- Anxiety related to the injury and potential long-term disability or complications.
Goals/Expected Outcomes:
- Acute Pain: The patient will report a pain level of 3 or below (on a 0-10 scale) within 48 hours of intervention.
- Impaired Physical Mobility: The patient will demonstrate the ability to perform some degree of movement or assistive device use, depending on the fracture's severity, by discharge.
- Risk for Infection: The patient will maintain an infection-free surgical site and show no signs of systemic infection (e.g., fever, redness, swelling) during hospitalization.
- Impaired Skin Integrity: The patient will not develop pressure ulcers or skin breakdown during the hospital stay.
- Anxiety: The patient will express a reduction in anxiety or a greater sense of control over their situation by the end of the nursing intervention period.
Interventions:
-
Acute Pain:
- Administer prescribed analgesics (opioids, NSAIDs) as per physician’s orders and evaluate effectiveness.
- Reassess pain regularly and provide additional pain management as needed.
- Encourage the patient to use non-pharmacologic pain management techniques (e.g., relaxation, deep breathing).
- Position the patient comfortably with proper limb alignment to avoid strain on the fracture site.
-
Impaired Physical Mobility:
- Encourage passive or active range-of-motion exercises as tolerated to promote circulation.
- Assist with positioning and turning every 2 hours to avoid complications related to immobility.
- Provide or encourage the use of assistive devices (e.g., walker, crutches) once weight-bearing is permitted.
- Collaborate with physical therapy for mobilization plans after surgery.
-
Risk for Infection:
- Assess surgical site for signs of infection (redness, swelling, purulent discharge).
- Ensure aseptic technique during dressing changes and wound care.
- Administer prescribed antibiotics if applicable.
- Monitor vital signs regularly, especially for signs of systemic infection (fever, increased heart rate, low blood pressure).
-
Risk for Impaired Skin Integrity:
- Keep the affected area clean and dry, particularly if a cast or dressing is in place.
- Check for signs of pressure ulcers around areas of prolonged pressure (e.g., heels, sacrum).
- Ensure the use of proper positioning to avoid skin breakdown.
- Use specialized mattresses or cushions to relieve pressure.
-
Anxiety:
- Provide emotional support and clear, concise information about the injury, treatment, and recovery process.
- Encourage family involvement and visitation to provide comfort and reduce feelings of isolation.
- Promote relaxation techniques and offer distractions (e.g., music, reading material).
- Refer the patient to a counselor or support group if necessary for ongoing emotional support.
Evaluation:
- Acute Pain: Evaluate the effectiveness of pain management strategies by assessing pain levels and adjusting the care plan as needed.
- Impaired Physical Mobility: Assess the patient’s ability to perform mobility tasks and collaborate with the physical therapy team to modify the care plan.
- Risk for Infection: Monitor for signs of infection and evaluate the effectiveness of preventative measures, adjusting as needed.
- Impaired Skin Integrity: Evaluate the skin condition regularly, especially in areas at risk for pressure ulcers.
- Anxiety: Reassess the patient’s level of anxiety through verbal communication and non-verbal cues, adjusting interventions as needed.
This care plan is general and can be tailored to each patient’s specific needs and conditions, depending on the severity of the fracture, the patient’s overall health, and the interventions they are receiving.
#### **Assessment:**
- **Patient's Condition:** Fracture of the femur (right/left)
- **Vital Signs:** Monitor for any abnormal changes due to trauma or surgical intervention.
- **Pain Level:** Assess pain using a pain scale (0-10) and observe for signs of distress.
- **Mobility:** Restricted due to fracture.
- **Skin Integrity:** Inspect for signs of bruising, swelling, or open wounds.
- **Mental Health:** Anxiety, fear of immobility, or adjustment to reduced independence.
- **Pre-operative and Post-operative Assessment:** If surgery is involved (e.g., internal fixation), assess for post-operative complications such as infection, hemorrhage, or complications related to anesthesia.
---
### **Nursing Diagnoses:**
1. **Acute Pain** related to the femur fracture, surgical interventions, and muscle spasms.
2. **Impaired Physical Mobility** related to the femur fracture and postoperative limitations.
3. **Risk for Infection** related to open fractures or surgical incisions.
4. **Risk for Impaired Skin Integrity** related to immobility and use of traction or casts.
5. **Anxiety** related to the injury and potential long-term disability or complications.
---
### **Goals/Expected Outcomes:**
1. **Acute Pain:** The patient will report a pain level of 3 or below (on a 0-10 scale) within 48 hours of intervention.
2. **Impaired Physical Mobility:** The patient will demonstrate the ability to perform some degree of movement or assistive device use, depending on the fracture's severity, by discharge.
3. **Risk for Infection:** The patient will maintain an infection-free surgical site and show no signs of systemic infection (e.g., fever, redness, swelling) during hospitalization.
4. **Impaired Skin Integrity:** The patient will not develop pressure ulcers or skin breakdown during the hospital stay.
5. **Anxiety:** The patient will express a reduction in anxiety or a greater sense of control over their situation by the end of the nursing intervention period.
---
### **Interventions:**
1. **Acute Pain:**
- Administer prescribed analgesics (opioids, NSAIDs) as per physician’s orders and evaluate effectiveness.
- Reassess pain regularly and provide additional pain management as needed.
- Encourage the patient to use non-pharmacologic pain management techniques (e.g., relaxation, deep breathing).
- Position the patient comfortably with proper limb alignment to avoid strain on the fracture site.
2. **Impaired Physical Mobility:**
- Encourage passive or active range-of-motion exercises as tolerated to promote circulation.
- Assist with positioning and turning every 2 hours to avoid complications related to immobility.
- Provide or encourage the use of assistive devices (e.g., walker, crutches) once weight-bearing is permitted.
- Collaborate with physical therapy for mobilization plans after surgery.
3. **Risk for Infection:**
- Assess surgical site for signs of infection (redness, swelling, purulent discharge).
- Ensure aseptic technique during dressing changes and wound care.
- Administer prescribed antibiotics if applicable.
- Monitor vital signs regularly, especially for signs of systemic infection (fever, increased heart rate, low blood pressure).
4. **Risk for Impaired Skin Integrity:**
- Keep the affected area clean and dry, particularly if a cast or dressing is in place.
- Check for signs of pressure ulcers around areas of prolonged pressure (e.g., heels, sacrum).
- Ensure the use of proper positioning to avoid skin breakdown.
- Use specialized mattresses or cushions to relieve pressure.
5. **Anxiety:**
- Provide emotional support and clear, concise information about the injury, treatment, and recovery process.
- Encourage family involvement and visitation to provide comfort and reduce feelings of isolation.
- Promote relaxation techniques and offer distractions (e.g., music, reading material).
- Refer the patient to a counselor or support group if necessary for ongoing emotional support.
---
### **Evaluation:**
- **Acute Pain:** Evaluate the effectiveness of pain management strategies by assessing pain levels and adjusting the care plan as needed.
- **Impaired Physical Mobility:** Assess the patient’s ability to perform mobility tasks and collaborate with the physical therapy team to modify the care plan.
- **Risk for Infection:** Monitor for signs of infection and evaluate the effectiveness of preventative measures, adjusting as needed.
- **Impaired Skin Integrity:** Evaluate the skin condition regularly, especially in areas at risk for pressure ulcers.
- **Anxiety:** Reassess the patient’s level of anxiety through verbal communication and non-verbal cues, adjusting interventions as needed.
---
This care plan is general and can be tailored to each patient’s specific needs and conditions, depending on the severity of the fracture, the patient’s overall health, and the interventions they are receiving.
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