A fracture is the medical term used for a broken bone. They occur when the physical force exerted on the bone is stronger than the bone itself. They commonly happen because of car accidents, falls or sports injuries. Other causes are low bone density and osteoporosis, which cause weakening of the bones. Fracture is sometimes abbreviated FRX or Fx, Fx, or #.
Types of Fracture
There are many types of fractures, but the main categories are complete, incomplete, open, closed and pathological. Five major types are as follows:
- 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.
Nursing care planning of a patient with a fracture, whether in a cast or in traction, is based upon prevention of complications during healing. By performing an accurate nursing assessment on a regular basis, the nursing staff can manage the patient’s pain and prevent complications. On emergency trauma care basic include triage, assessment and maintaining airway, breathing, and circulation, protecting the cervical spine and assessing the level of consciousness.
Here are eleven (11) nursing care plans (NCP) and nursing diagnosis (NDx) for fracture:
- Risk for Trauma: Falls
- Acute Pain
- Risk for Peripheral Neurovascular Dysfunction
- Risk for Impaired Gas Exchange
- Impaired Physical Mobility
- Impaired Skin Integrity
- Risk for Infection
- Deficient Knowledge
- NEW Risk for Injury
- NEW Self-Care Deficit
- NEW Constipation
- Other Nursing Diagnoses
Self-Care Deficit (Bathing, Dressing, Toileting)
Self-Care Deficit: Impaired ability to perform or complete activities of daily living for oneself, such as feeding, dressing, bathing, toileting.
- Self-Care Deficit
May be related to
- Neuromuscular or muscoskeletal impairment
- Physical limitations present with a cast, orthotic devices, or immobilizers
Possibly evidenced by
- Inability to wash body or body parts
- Inability to get bath supplies
- Inability to get in and out of bathroom
- Inability to dry body
- Inability to choose clothing, pick up clothing, use of assistive devices
- Inability to obtain or replace articles of clothing
- Inability to put on or take off items of clothing
- Inability to get to toilet
- Inability to carry out proper toilet hygiene
- Client will demonstrate optimatal performance of activities of daily living.
|Assess the self-care limitations of the patient.||A comprehensive assessment allows implementation of applicable methods related to self-care.|
|Make sure that the patient receives the prescribed pain management.||Pain that is not managed can adversely restrict attempts to mobilize, resulting in the difficulty in carrying out self-care tasks.|
|Initiate an efficient exercise regimen that will promote endurance, strength, and improvement of muscle groups necessary for the particular activity deficit of the patient.||Patients in a cast or immobilizer may require a planned exercise to aid in the management of self-care. Increased strength and endurance contribute to autonomy in self-care.|
|Refer the patient to occupational therapy if indicated, and make use of assistive devices and dressing/grooming aids as needed.||Utilizing these assistive tools can strengthen the ability of the patient to perform dressing, bathing, and personal hygiene routines. Adaptive clothing can be also be used to ease in dressing.|
|Instruct significant others how to assist the patient during self-care activities.||Involving the significant other can decrease the need for skilled home services. A significant other who is well learned in dealing with these activities also can reinforce health care instructions given to the patient.|
|Refer to care management/social services department of the hospital as needed.||Patients may need financial support to gain assistive equipment or home help. Social services staff can also determine community agencies that loan equipment or have other volunteer services.|
References and Sources
Recommended references and sources for this fracture nursing care plans:
- Black, J. M., & Hawks, J. H. (2009). Medical-surgical nursing: Clinical management for positive outcomes (Vol. 1). A. M. Keene (Ed.). Saunders Elsevier. [Link]
- Gulanick, M., & Myers, J. L. (2016). Nursing Care Plans: Diagnoses, Interventions, and Outcomes. Elsevier Health Sciences. [Link]
- Hommel, A., Kock, M. L., Persson, J., & Werntoft, E. (2012). The Patient’s view of nursing care after hip fracture. ISRN nursing, 2012. [Link]
- Willis, L. (2019). Professional guide to diseases. Lippincott Williams & Wilkins. [Link]
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Musculoskeletal Care Plans
Care plans related to the musculoskeletal system:
- Amputation | 4 Care Plans
- Congenital Hip Dysplasia | 4 Care Plans
- Fracture | 8 Care Plans
- Juvenile Rheumatoid Arthritis | 4 Care Plans
- Laminectomy (Disc Surgery) | 8 Care Plans
- Osteoarthritis | 4 Care Plans
- Osteoporosis | 4 Care Plans
- Rheumatoid Arthritis | 6 Care Plans
- Scoliosis | 4 Care Plans
- Total Joint (Knee, Hip) Replacement | 5 Care Plans