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
Constipation: A decrease in a person’s normal frequency of defecation, accompanied by difficult or incomplete passage of stool and/or passage of excessively hard, dry stool.
May be related to
- Administration of opiod analgesics
Possibly evidenced by
- Straining with defacation
- Change in bowel habits
- Distended abdomen
- Client will verbalize understanding of methods to maintain normal bowel elimination.
- Client will maintain bowel elimination in his or her normal pattern.
|Assess the patient’s usual bowel pattern and habits.||Using effective and proven method will allow patients to achieve their usual bowel elimination pattern more quickly.|
|Auscultate abdomen for presence, location, and charecteristics of bowel sounds.||Determines bowel activity of the patient.|
|Encourage the patient to increase adequate fluid intake unless contraindicated.||Fluid intake helps make the stool soft and moist for easier elimination.|
|Encourage balanced fiber and bulk in diet.||Improve consistency in stool and facilitate passage through the colon.|
|Explain and instruct patient with other ways in managing pain (different combination of drugs, visualization techniques or relaxation techniques).||Nonopioid drugs used in combination may decrease the need for opioids, control pain, and lessen the side effects that contributes to constipation.|
|Encourage mobility to the limit of the prescribed activity.||Mobility aids peristalsis and therefore enhances bowel elimination. The patient thus should not be left in bed or allowed to use a bedside commode if additional mobility can be tolerated|
|Teach current influences on impaired bowel elimination.||Use of opiod analgesics, lack of food intake and decrease mobility can negatively affects bowel elimination.|
|Administer stool softeners, enemas, laxatives as prescribed. Evaluate response to medications and initate supplemental therapies as needed to reattain normal bowel function.||These medications may be given to maintain normal bowel elimination. If a stool softener or laxative is unsuccessful, a rectal suppository or enema administration may be administered to aid with elimination.|
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