Nursing care plan fractures

I. Pathophysiology
a. Discontinuity or break in a bone
b. May be associated with serious injury to nerves, blood
vessels, muscles, and/or organs
c. More than 150 fracture classifications with five major
types: incomplete, complete, closed, open, and pathologic

II. Etiology
a. Common causes: trauma, including abuse; overuse injury;
osteoporosis; bone tumors; infections
b. Severity of fracture increases with age.

III. Statistics
a. Morbidity: Approximately 6.8 million Americans seek
treatment for fractures annually; in the United States,
osteoporosis accounts for 70% of fractures in people over
age 45; there were more than 2 million cases of fractures in
the United States in 2005 (National Osteoporosis
Foundation [NOF], n.d.).
b. Mortality: Dependent upon multiple factors including the
specific bone affected—humerous versus veterbra—and
severity of fracture, associated soft tissue and organ
involvement, age of individual, and presence of comorbidities;
of the 80,000 males who suffer a hip fracture annually,
one-third will die within 1 year (National Institute of
Arthritis and Musculoskeletal and Skin Diseases [NIAMS],
2007).
c. Cost: In 2005, osteoporosis-related fractures were responsible
for an estimated $19 billion in costs (NOF, n.d.).

Care Setting
Most fractures are managed at the community level.
Although many of the interventions listed here are appropriate
for this population, this plan of care addresses more
complicated injuries encountered on an inpatient acute
medical-surgical unit.

Related Concerns
Craniocerebral trauma—acute rehabilitative phase
Pneumonia
Psychosocial aspects of care
Renal failure: acute
Spinal cord injury (acute rehabilitative phase)
Surgical intervention
Thrombophlebitis: deep vein thrombosis

Nursing Priorities
1. Prevent further bone/tissue injury.
2. Alleviate pain.
3. Prevent complications.
4. Provide information about condition, prognosis, and treatment
needs.

Discharge Goals
1. Fracture stabilized.
2. Pain controlled.
3. Complications prevented or minimized.
4. Condition, prognosis, and therapeutic regimen understood.
5. Plan in place to meet needs after discharge.

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