Mr. J is a 59-year-old male who presents to the Emergency Department with a painful right leg/thigh following a fall. Assessment reveals right thigh swollen with intact skin. There is some distortion of the normal contour of the leg/thigh. The left leg appears to be longer than the right. The leg was extremely tender to touch. Client’s color, sensory, and motion are intact below the level of the injury with positive palpable pedal pulses. Mr. J was sent for an x-ray diagnosing him with a right femur fracture in which traction will be needed until the orthopedic surgery team can be consulted. Lungs are clear to auscultation and SPO2 is 98% on RA and will continued to be monitored.
Address the following:
1. Diagnosis
2. Pathophysiology
3. Health promotion and disease prevention
4. Risk factors
5. Expected findings
6. Laboratory test
7. Diagnosis procedures
8. Safety considerations
9. Nursing care
10. Medication
11. Client education
12. Therapeutic procedures
13. Interprofessional care
14. Complications
Reference:
Capriotti, T. & Frizzell, J. (2016). Pathophysiology: Introductory concepts and clinical perspectives. Philadelphia, PA: F. A. Davis.
Colbert, B. & Woodrow, R. (2019). Essentials of Pharmacology for Health Professions (8th ed.). Boston, MA:Cengage.
This essay aims to provide an overview of the nursing care for Mr. J, a 59-year-old male presenting with a painful right leg/thigh following a fall resulting in a right femur fracture. The discussion will include the diagnosis, pathophysiology, health promotion, risk factors, expected findings, laboratory tests, diagnostic procedures, safety considerations, nursing care, medication, client education, therapeutic procedures, interprofessional care, and potential complications associated with Mr. J’s condition.
Mr. J’s diagnosis is a right femur fracture. This fracture occurs when there is a break or crack in the femur bone, which is the long bone in the thigh.
The pathophysiology of a femur fracture involves the disruption of the bone’s integrity and structure. The fracture may result from direct trauma or excessive force applied to the femur, such as a fall. The fracture can be categorized as a displaced or nondisplaced fracture, and it may involve the proximal, midshaft, or distal region of the femur.
Health promotion and disease prevention measures for Mr. J include promoting fall prevention strategies, such as ensuring a safe home environment, addressing underlying factors contributing to falls (e.g., balance issues, medication review), and promoting regular exercise to improve bone strength and stability.
Risk factors for femur fractures include advanced age, osteoporosis or reduced bone density, history of previous fractures, poor balance, certain medical conditions (e.g., cancer), and falls due to environmental hazards or gait abnormalities.
Expected findings in Mr. J’s case include pain, swelling, deformity or distortion of the right leg/thigh contour, tenderness on palpation, leg length discrepancy, intact sensory and motor function below the fracture site, and palpable pedal pulses.
Laboratory tests may include a complete blood count (CBC) to assess for signs of anemia or infection and coagulation studies to evaluate bleeding risk and clotting factors.
The diagnostic procedure performed for Mr. J was an x-ray, which confirmed the presence of a right femur fracture and helped determine the type and location of the fracture.
Safety considerations for Mr. J include ensuring a stable and safe environment, implementing fall precautions, providing pain management, using appropriate immobilization techniques (e.g., traction), and preventing complications such as pressure ulcers and deep vein thrombosis.
Nursing care for Mr. J includes assessing and managing pain, monitoring neurovascular status, implementing and maintaining traction as per medical orders, assisting with activities of daily living, promoting mobility and ambulation as appropriate, and providing emotional support and education.
Medication administration may involve analgesics for pain management, anticoagulants or antiplatelet agents for thromboprophylaxis, and antibiotics if infection is present or suspected.
Client education for Mr. J includes providing information on the nature of the fracture, treatment options, and expected outcomes. Topics may include weight-bearing restrictions, proper use of assistive devices, signs of infection or complications, and follow-up care.
Therapeutic procedures for Mr. J may include surgical intervention, such as internal fixation with the use of plates, screws, or rods to stabilize the fracture and promote proper healing.
Interprofessional care involves collaboration among the orthopedic surgery team, nursing staff, physical therapists, and other healthcare professionals to ensure comprehensive and coordinated care for Mr. J. This may include consultation for surgical management, physical therapy for rehabilitation, and ongoing monitoring of his condition.
Potential complications associated with a femur fracture include deep vein thrombosis, pulmonary embolism, infection, nonunion or delayed healing, malunion (improper alignment of the fracture), compartment syndrome, and pressure ulcers.
Effective nursing care for patients with femur fractures, such as Mr. J, requires a comprehensive approach that addresses the diagnosis, pathophysiology, health promotion, risk factors, expected findings, laboratory tests, diagnostic procedures, safety considerations, nursing care, medication, client education, therapeutic procedures, interprofessional care, and potential complications. By providing patient-centered care, promoting mobility and healing, and addressing potential complications, nurses can contribute to improved outcomes and facilitate Mr. J’s recovery.
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