A fracture (sometimes abbreviated FRX or Fx, Fx, or #) is a discontinuity or break in a bone. There are more than 150 fracture classifications (see this Wikipedia entry). Five major ones are as follow:
- Incomplete: Fracture involves only a portion of the cross-section of the bone. One side breaks; the other usually just bends (greenstick).
- Complete: Fracture line involves entire cross-section of the bone, and bone fragments are usually displaced.
- Closed: The fracture does not extend through the skin.
- Open: Bone fragments extend through the muscle and skin, which is potentially infected.
- Pathological: Fracture occurs in diseased bone (such as cancer, osteoporosis), with no or only minimal trauma.
- Prevent further bone/tissue injury.
- Alleviate pain.
- Prevent complications.
- Provide information about condition/prognosis and treatment needs.
- Risk for Trauma — Fracture Nursing Care Plan (NCP)
- Acute Pain — Fracture Nursing Care Plan (NCP)
- Risk for Peripheral Neurovascular Dysfunction — Fracture Nursing Care Plan (NCP)
- Risk for Impaired Gas Exchange — Fracture Nursing Care Plan (NCP)
- Impaired Physical Mobility — Fracture Nursing Care Plan (NCP)
- Impaired Skin Integrity — Fracture Nursing Care Plan (NCP)
- Risk for Infection — Fractures Nursing Care Plan (NCP)
- Knowledge Deficit — Fractures Nursing Care Plan (NCP)
- Fracture stabilized.
- Pain controlled.
- Complications prevented/minimized.
- Condition, prognosis, and therapeutic regimen understood.
- Plan in place to meet needs after discharge.
Diagnostic Studies for Fracture
- X-ray examinations: Determines location and extent of fractures/trauma, may reveal preexisting and yet undiagnosed fracture(s).
- Bone scans, tomograms, computed tomography (CT)/magnetic resonance imaging (MRI) scans: Visualizes fractures, bleeding, and soft-tissue damage; differentiates between stress/trauma fractures and bone neoplasms.
- Arteriograms: May be done when occult vascular damage is suspected.
- Complete blood count (CBC): Hematocrit (Hct) may be increased (hemoconcentration) or decreased (signifying hemorrhage at the fracture site or at distant organs in multiple trauma). Increased white blood cell (WBC) count is a normal stress response after trauma.
- Urine creatinine (Cr) clearance: Muscle trauma increases load of Cr for renal clearance.
- Coagulation profile: Alterations may occur because of blood loss, multiple transfusions, or liver injury.
- Trauma, risk for—loss of skeletal integrity, weakness, balancing difficulties, reduced muscle coordination, lack of safety precautions, history of previous trauma.
- Mobility, impaired physical—neuromuscular skeletal impairment; pain/discomfort, restrictive therapies (limb immobilization); psychological immobility.
- Self-Care deficit—musculoskeletal impairment, decreased strength/endurance, pain.
- Infection, risk for—inadequate primary defenses: broken skin, traumatized tissues; environmental exposure; invasive procedures, skeletal traction.
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