NCP- Impaired Mobility Rt Fracture & Traction

Patient’s Name: Johanny Jaromay Age: 32 / Address: Paranaque City

Medical Diagnosis: Fracture Cl M3 Femur at left knee; Fracture Cl Patella at left knee Date Admitted: October 23, 2006

ASSESSMENT

DIAGNOSIS

RATIONALE

PLAN

INTERVENTION

RATIONALE

EVALUATIO N

Subjective: The patient verbalized, “ Hindi ko pa rin maigagalaw ang paa ko. Nabali kasi ung buto ko sa hita kaya nga nilagyan muna nila ng traction.”

Partially impaired physical mobility related to musculoskeletal disorder (femoral fracture) and external device (skeletal traction)

Femoral fractures are seen to those people who have been involved in a motor vehicle crash or who have fallen from a high place. The patient presents with, enlarged deformed, painful thigh and cannot move the hip or the knee. Skeletal traction is applied directly to the bone to treat fractures like the femur by use of metal pin (steinman pin) that is inserted through the bone distal to the fracture. Often skeletal traction is balanced traction, which supports the affected extremity thus limits patients mobility but it also allows for some patient movement.

Goal: After 4 hours of nursing intervention, the patient will be able to maintain position of function with maximum mobility within the therapeutic limits of traction.

1. Assess for correct position of traction and alignment of bones

1.To maintain good body alignment when mechanical devices are used

After the nursing intervention, the patient was able to maintain position of function and exerted maximum mobility within the therapeutic limits of traction.

Objectives: - Noted deformity of thigh due to fracture - Limited ROM of left lower extremity - Presence of restrictive device (skeletal traction) - Insertion of steinmann pin

2. Maintain limbs in 2. This prevents footdrop functional alignment and excessive plantar (with pillows, sandbags, flexion etc.). Support feet in dorsiflexed position 3. Perform passive and active ROM exercises on extremities and joints, using slow smooth movements on the unaffected body parts

3. Enhances circulation maintains muscle tone and joint mobility and prevents disuse contractures and muscle atrophy.

4. Allow patient to perform tasks at his own rate. Encourage independent activity as able as safe.

4. To increase patient’s recovery and increase his self-esteem.

Reference: Medical Surgical Nursing (Brunner and Suddarth’s)

5. Encourage use of trapeze

5. Strengthen shoulders an arm muscles necessary for safe positioning and mobilization

6. Instruct and assist in position changes and transfers.

6. Encourages active participation while preventing stress on fractured bone

7. Keep side rails up and bed in low position

7. This promotes a safe environment.