I -PATIENT ASSESMENT DATA BASE

A. GENERAL DATA
1. Patients Name: M.F.
2. Address: Sta. Maria, Pangasinan
3. Age: 23 years old
4. Sex: male
5. Birth date: February 9, 1990
6. Rank in the Family: husband and father of 2 children
7. Nationality: Filipino
8. Civil Status: married
9. Date of Admission: December 28, 2013
10. Order of Admission:
Admit patient to ward
NPO
V/S every 4 hours and record
Request for:
CBC, CT, urinalysis
X-ray:
Skull
Right thigh
Pelvis
Right leg
Right forearm
Right arm
Right ankle
IVF: plain LRS 1 liter 200ml fast drip then every 8 hours
IV meds:
Cefuroxime 750mg Q12 hours (ANST)
Ketorolac 1amp Q8 hours (ANST)
Tetanus toxoid 4500 units (ANST)
11. Attending Physician: Dr. Olivar
12. Admitting diagnosis:
Closed fracture, right medial malleolus
Closed fracture, right humerus

Closed fracture, comminuted, right radius and ulna

Closed fracture, middle third, right femur
Lacerated wound:
Right knee
Right leg
Left frontal
B. CHIEF COMPLAINT: acute pain
C. HISTORY OF PRESENT ILLNESS: traumatic injury (vehicular accident)
D. PAST HEALTH HISTORY/STATUS:
Childhood Illness: chicken pox, cold and cough
Immunization: incomplete
Major Illness: none
Current Medications: none
Allergies: no known allergies

E. FAMILY ASSESMENT:
NAME

RELATION

AGE

SEX

K.F.

wife

19 years old

female

C.F.
K.F.

daughter
daughter

2 years old
1 month old

female
female

OCCUPATION

housewife

EDUCL
ATTAINMENT
1st year college
(education)

F. SYSTEM REVIEW:
1. HEALTH PERCEPTION- HEALTH MANAGEMENT PATTERN
The purpose of it is to determine how the client perceives and manage her health
According to the patient health is important but disgrasya ngarud di awan maaramidak ah
2. NUTRITIONAL -METABOLIC PATTERN
The purpose of this is to determine the clients dietary habits and metabolic needs.
The patients typical diet consist of the following:
Breakfast
Lunch
Tuyo (dried fish)
fish
Egg
Kamote tops
Rice
1 cup of coffee

Monggo
Gulay (dinengeng)
rice

dinner
Adobo (balun-balunan, chicken
heads)
rice

Patient also added he drinks 8-10 8oz. cups of water, he doesnt smoke and doesnt drink alcoholic beverages
3. ELIMINATION PATTERN:
The purpose of this is to determine adequacy of function of the clients bowel and bladder elimination
Bowel Habits: once a day
Color: Yellow
Odor: Foul Odor
Consistency: varies

Bladder:
Frequency of urine: 4x a day
Characteristics of urine: increase urine output
Color: clear
Odor: Strong smell

4. ACTIVITY PATTERN EXERCISE PATTERN

The purpose of this is to determine the clients activity of daily living
The patient stated, he can perform all his activities of daily living before his accident. Now that he is just lying on bed
his family does his ADLs for him
5. COGNITIVE PERCEPTUAL PATTERN
Purpose of these is to determine the functioning status of the 5 senses, vision, hearing, touch (including pain perception), taste
and smell. Devices and methods used to assist the client with deficits any of this 5 senses are assessed.
According to Mr. M.F., he can hear, smell, feel, taste, and see clearly. He doesnt use any device to help his senses
work.
6. SLEEP REST PATTERN
The purpose of this is to determine the clients perception of her sleep, relaxation and energy levels. Methods used to promote
relaxation and sleep is also assessed.
According to patient, he sleeps around 10:00 pm and wakes up at 3:00 am. He also takes an afternoon sleep after
lunch whenever he is not busy on his farm.
7. SELF- PERCEPTION AND SELF-CONCEPT PATTERN:
The purpose of this is to determine the clients perception of her identity, body image and self- worth. The clients behavior,
attitude and emotional patterns are assessed.
According to the patient, although he cant perform his ADLs, he is not upset on his current situation because he has
his family that is always there for him.
8. ROLE-RELATIONSHIP PATTERN:
The purpose of this is to determine the clients perception of responsibilities and roles in the family, work and in social life.
The patient told that they live in a compound with 11 families and most of them are relatives. he also added, mayat
met ngem dadduma adda met apa
9. SEXUALITY REPRODUCTIVE PATTERN
The purpose of this is to determine the clients fulfillment of sexual activities and perceive level satisfaction.
The patient stated that, he doesnt have any problem in his sexuality or reproductive pattern. He never used or tried
any contraceptives before.
10. COPING STRESS TOLERANCE PATTERN
The purpose of this is to determine the areas and amount of stress in the clients life and the effectiveness of coping methods
used to deal with it.
The patient told that whenever he is stressed, agtagba-tagbet ti kayo pangsungrod

11. VALUE BELIEF PATTERN

The purpose of this is to determine the clients life, values and goals, philosophical beliefs and spiritual beliefs that influence
her own choices and decisions.
According to the patient, he is an Iglesia ni Cristo by faith.
G. DEVELOPMENTAL HISTORY
THEORIST
Erik Erikson

AGE
23

SEX
Male

DESCRIPTION
Intimacy vs. isolation
(+) lasting relationship or
commitment.
(-) isolation and a fear of
commitment

PATIENT DESCRIPTION
During our interview,
with his current situation,
the patient answered my
questions without any
hesitations. He doesnt
isolate himself even he
cant do his ADLs
because he has his family
and he admits that it
happened because of an
accident, and no one
should be blamed.

H. PHYSICAL ASSESSMENT
a. GENERAL SURVEY
1. Overall appearance and grooming: client is neat and well groomed.
2. Actual height and weight: 57 in height and 75 kilograms BMI: 25.90
3. Symptoms of distress:
4. Posture, gait: lying on bed
5. Affect, mood: despite of the patient condition, he still manages to tell us the whole scenario how his accident happened.
b. VITAL SIGNS (initial)
BP: 110/70 mmHg
RR: 20 respirations per minute
PR: 75 beats per minute
TEMP: 37.1c

c. REGIONAL EXAM utilize IPPA technique

1. Head, Skin, Hair, Nails: lacerated wound on the left forehead, stitched and covered with gauze.
The clients skin tone is brown. It is cold and moist. The skin turgor is good and do not have any signs of dehydration.
Hair is black and straight. No scalp lesions or flaking.
The clients nail shape is convex, not well-trimmed and slightly dirty. The nail is smooth and the nail bed is pink. The capillary
refill is within 3 seconds.
2. Eyes: patient has no complains of blurring of vision or any visual problems; the eye brows are evenly distributed. Eyelids have
effectively closure. The blink response is bilateral, eye balls are symmetrical, conjunctiva is pinkish, and the sclera is white.
The color of his eyes is brown, the shapes are equal, and it is uniform in color. Pupils are equal in size. Pupils are equally round
and reactive to light and accommodation.
3. Nose: The color of the clients nose is the same as the color of his face. His septum is in the midline. The mucosa is pink;
nostrils are both patent, no nasal flaring.
4. Ears: The color of the ear is brown, it is symmetrical. The pinna is symmetrical. The pinnas are elastic and recoil when folded.
The mastoid process is non-tender. No discharges noticed.
5. Mouth and throat: The lips is symmetrical and pink, the consistency is smooth, buccal mucosa is pink, the gums is pink, the
tongue is pink and it is smooth. The color of the hard and soft palate is pink and is intact. The tonsils are not inflamed. Uvula is in
the midline, gag reflex is present. The teeth have a complete set of 32 teeth.
6. Neck and lymph nodes: no pulsations visible, no thyroid enlargement upon palpation and inspection. No tenderness or
stiffness noted. No swollen lymph nodes.
7. Thorax and lungs: The color of the chest is brown. The chest expansion is symmetrical. Respiratory rhythm is regular.
Respiratory pattern is normal. When palpated she doesnt feet any tenderness. When percussed the sound is resonance. No
adventitious sound heard upon auscultation. Respiratory rate is 20 breaths per minute.
9. Cardiovascular: The rhythm is regular. No jugular vein distension. Heart rate is 75 beats per minute.

10. Breast and axilla: symmetrical with no signs of dimpling or retraction. Nipples are equal in size, no lesions, no abnormal
discharges and tenderness.
11. Abdomen: Peristalsis is non-visible. The bowel sound normal: every 15-20 seconds. When percussed the sound is tympany.
When palpated he doesnt have any tenderness.
12. Extremities: skin color is the same as the other parts of the body which is brown. The client can resist force when asked to
resist (unaffected area). There is swelling on the affected site. The IV site is in his left arm.
13. Genitals: Not performed.
14. Rectum and anus: not performed.
15. Neurological/cranial nerves:
Olfactory: he is able to differentiate smell from that of an alcohol and perfume.
Optic: reacts on both sides.
Oculomotor: eyes move smoothly in a coordinated motion in all directions (the six cardinal fields).
Trochlear: Bilateral pupils constricts simultaneously when illuminated.
Trigeminal: temporal and masseter muscles contract bilaterally when chewing.
Abducens: pupils are equally rounded reactive to light and accommodation.
Facial nerve: patient is able to smile, frown, wrinkles forehead, shows teeth, puff out cheeks, purses lips, raises
eyebrows, and closes eyes against resistance in symmetrical movement.
Acoustic: patient is able to hear whispered words from 1-2 feet.
Glossopharyngeal: has no difficulty in swallowing.
Vagus: the gag reflex is present.
Spinal Accessory: there is symmetric, strong contraction of trapezius muscles when asked to shrug the shoulders
against resistance. There is also a strong contraction of sternocleidomastoid muscle on side opposite the turned face when
turning the head against resistance.
Hypoglossal: can move tongue and can swallow without difficulties.

II- PERSONAL/SOCIAL HISTORY

A. HABITS / VICES
a. Caffeine: 1 cup of coffee everyday for breakfast
b. Smoking: no
c. Alcohol: no
d. Tea/juice: no
e. Soda: occasionally
f. Drugs: never used any prohibited or illegal drugs

III- ENVIONMENTAL HISTORY (LIVING/NEIGHBORHOOD/CIRCUMSTANCES)

According to the patient, their house is made of bamboo and tin roof located in a compound of 11 families. Their water source for drinking
is from a water pumping station. They live about 1 kilometer from the barangay hall and about 2 kilometers away from the market and
towns health center.

IV- INTRODUCTION (RELATED TO THE DISEASE / CASE OF THE PATIENT)

FRACTURES
A fracture is a disruption or break in the continuity of the structure of bone. Traumatic injuries account for the
majority of fractures, although some fractures are secondary to a disease process (pathologic fractures from
cancer or osteoporosis).
Fractures can be classified as open (formerly called compound) or closed (formerly called simple) depending
on communication or noncommunication with the external environment. In an open fracture, the skin is
broken, exposing the bone and causing soft tissue injury. In closed fracture the skin has not been ruptured and
remains intact.
Fractures can also be classified as complete or incomplete. Fractures are termed complete if the break is completely through the bone and described
as incomplete if the fracture occurs partly a bone shaft but the bone is still in one piece. An incomplete fracture is often the result of bending or
crushing forces applied to a bone.
Fractures can also be described and classified according to the direction of the fracture line. Types include linear, oblique, transverse, longitudinal,
and spiral fractures.
Fractures can also be classified as displaced or nondisplaced. In a
displaced fracture the two ends of the broken bone are separated
from one another and out of their normal positions. Displaced
fractures are usually comminuted (more than two fragments) or
oblique. In a nondisplaced fracture the periosteum is intact across
the fracture and the bone is still in alignment. Nondisplaced
fractures are usually transverse, spiral, or greenstick.

CLINICAL MANIFESTATIONS
The patients history indicates a mechanism of injury associated
with the clinical manifestations, including immediate localized
pain, decreased function, and inability to bear weight on or use the
affected area

CLINICAL MANIFESTATIONS OF FRACTURE

Edema and swelling
Pain and tenderness
Muscle spasm
Deformity
Ecchymosis/contusion
Loss of function
Crepitation

SIGNIFICANCE
Unchecked bleeding, swelling, and edema in closed space can occlude circulation and
damage nerves.
Pain and tenderness encourage splinting of muscle around fracture with reduction in
motion of injured area.
Muscle spasms may displace nondisplaced fracture or prevent it from reducing
spontaneously.
Deformity is a cardinal sign of fracture; if uncorrected, it may result in problems with
bony union and restoration of function of injured part
Ecchymosis may appear immediately after injury and may appear distal injury. Reassure
patient the process is normal and discoloration will eventually resolve.
Fracture must be managed properly to ensure restoration of function to limb/part
Crepitation may increase chance for nonunion if bone ends are allowed to move
excessively. Micromovement of bone-end fragments (postfracture) assists in osteogenesis
(new bone growth)

COLLABORATIVE CARE
The overall goals of fracture treatment are (1) anatomic realignment of bone fragments (reduction), (2) immobilization to maintain realignment,
and (3) restoration of normal or near normal function of the injures part.
DIAGNOSTIC:
History and physical examination
X-ray
CT scan, MRI
COLLABORATIVE THERAPY
FRACTURE REDUCATION
Manipulation
Closed reduction
Skin traction
Skeletal traction
Open reduction/internal fixation

FRACTURE IMMOBILIZATION
Casting or splinting
Traction
External fixation
Internal fixation
OPEN FRACTURES
Surgical debridement and irrigation
Tetanus and diphtheria immunization
Prophylactic antibiotic therapy
Immobilization
NURSING MANAGEMENT

A brief history of the traumatic episode, mechanism of injury, and the position in which the victim was found can be obtained from the
patient or witnesses.
Document clinical finding before fracture treatment is initiated to avoid doubts about whether a problem discovered later was missed
during original examination or was caused by the treatment.
Neurovascular assessment; peripheral vascular assessment (color, temperature, capillary refill, peripheral pulses and edema) and
peripheral neurologic assessment (sensation, motor function, and pain)
Assess an extremitys color (pink, pale, cyanotic) and temperature (hot, warm, cool, cold) in the area of the affected extremity.
Compare pulses on both the unaffected and injured extremity to identify differences in rate and quality
Evaluate the ulnar, median, and radial nerves by assessing sensation and motor innervations in the upper extremity.

GOALS
Have physiologic healing with no associated complications.
Obtain satisfactory pain relief.
Achieve maximal rehabilitation potential.

V- ANATOMY AND PHYSIOLOGY

A bone fracture is an injury or break in a bone. A bone breaks when there is a force which
a bone cannot withstand. There are many situations that can cause a bone fracture like a
fall or a car accident. The symptoms of a bone fracture depend on the type of bone that
was broken, or the damage to muscles, nerves, or blood vessels. Bone fractures also vary
among children and adults because childrens bones are more flexible than adults bones.
Adult's fractures heal slower than childrens fractures. Many people fracture at least one
bone during their lifetime.

Fractures are classified by the cause and nature of the initial break. A traumatic fracture is
one due to an initial injury. A pathologic fracture is one caused by a pre-existing
conditions or disease. An open fracture is one exposed to the outside world by a rupture to
the skin, while a closed fracture remains protected by the skin. Fractures can further be
classified by the size, orientation, and location of the break. Further classifications of bone
fractures include greenstick, transverse, fissured, oblique, comminuted, and spiral.
Greenstick fractures are incomplete and do not go completely through the entire bone.
Transverse fractures are completely across the bone while the break happens at a right
angle to the main axis of the bone. A fissure fracture is one of a longitudinal break that
does not go completely through the bone. An oblique fracture is one at an angle other than
90 degrees and usually goes completely through the bone. A comminuted fracture is one
that completely destroys the bone into smaller pieces. A spiral fracture is caused by
pressure when a bone is twisted and can cause a seemingly circular break in response to
such jagged motion. All of the above are few of the various types of fractures.

VI LABORATORY AND DIAGNOSTIC EXAMINATIONS

DATE: December 28, 2013
TYPE OF EXAMINATION: HEMATOLOGY

RBC
HEMOGLOBIN
HEMATOCRIT
WBC COUNT
SEGMENTERS
LYMPHOCYTES
MONOCYTES
EOSINOPHILS
BLOOD TYPE
BLEEDING TIME
CLOTTING TIME

NORMAL VALUES
4.69 - 6.13 x 10(12) /L

RESULTS
4.3

140 - 180g/L
0.40 - 0.54
4-10 x 10(9)/L
0.50 0.70
0.20 0.40
0.0 0.07
0.0 0.07

129
0.41
16.9
0.65
0.28
0.07
0.07
O+
210
320

1 5 mins
2 8 mins

SIGNIFICANCE
Decreased. Related to fracture,
production of RBC
Decreased. Blood loss
Normal
Increased. Indicates blunt trauma
Normal
Normal
Normal

Normal
Normal

DATE: January 3, 2014

TYPE OF EXAMINATION: HEMATOLOGY

HEMOGLOBIN
HEMATOCRIT

NORMAL VALUES
140 - 180g/L
0.40 - 0.54

RESULTS
99
0.32

SIGNIFICANCE
Decreased. Blood loss
Decreased. Blood loss

VII DRUG STUDY

GENERIC NAME: ketorolac
BRAND NAME: toradol
DRUG CLASSIFICATION: non-steroidal anti-inflammatory drug
DOSAGE: ketorolac 30mg slow IVP every 12 hours PRN for pain
INDICATION: Short-term management of moderately severe, acute pain for multiple-dose treatment
MECHANISM OF
ACTION

ADVERSE REACTIONS

CONTRAINDICATIONS

SIDE EFFECTS

May inhibit prostaglandin

synthesis, to produce antiinflammatory, analgesic,
and antipyretic effects.

Arrhythmias, renal failure.

Contraindicated in patients Headache, dizziness,

hypersensitive to drug and drowsiness, sedation.
in those at risk for bleeding
Edema, hypertension,
palpitations.

NURSING
CONSIDERATION
Assist with ambulation if
any of these side effects
occurs.
Advise patient to be alert
for signs and symptoms of
CV events (chest pain,
shortness of breath,
weakness, slurred speech)
and to seek medical
attention immediately if
they occur.

Tell patient to promptly

report edema and weight
gain.

GENERIC NAME: cefuroxime

BRAND NAME:
DRUG CLASSIFICATION: antibiotic (2nd generation cephalosporin)
DOSAGE: 750mg IVP q12hours
INDICATION: for skin or skin structure infection and bone infections
MECHANISM OF
ACTION

ADVERSE REACTIONS

CONTRAINDICATIONS

Inhibits cell-wall synthesis,

promoting osmotic
instability; usually
bectericidal

Pseudomembranous
colitis, thrombocytopenia,
transient neutropenia,
anaphylaxis

Contraindicated in patients
hypersensitive to drug or
other cephalosporins

SIDE EFFECTS`

NURSING
CONSIDERATIONS
Skin test the patient first
before administration to
see if patient is allergic to
drug.

Temperature elevation and

pain at injection site.

Massage gently the site f

injections while
administering the drug to
facilitate movement and
decrease the pain felt by
the patients

GENERIC NAME: chlorphenamine maleate

BRAND NAME:
DRUG CLASSIFICATION: antihistamine (alkylamine)
DOSAGE: 1amp IVP 30 minutes prior to blood transfusion
INDICATION: for allergic reaction during blood transfusion
MECHANISM OF
ACTION
Competes with histamine
for H1-receptor sites on
effector cells. Drug
prevents, but doesnt
reverse, histaminemediated responses.

ADVERSE REACTIONS

CONTRAINDICATIONS

SIDE EFFECTS

Contraindicated in patients
having acute asthmatic
attacks and in those with
angle closure glaucoma,
symptomatic prostatic
hyperplasia,
pyloroduodenal
obstruction, or bladder
neck obstruction

Drowsiness, sedation

Dry mouth

NURSING
CONSIDERATIONS
Raise side rails to prevent
patient from falling
Give patient sips of water

VII- LIST OF IDENTIFIED PROBLEM ACCORDING TO PRIORITY

Acute pain
Impaired physical mobility
Risk for ineffective tissue perfusion
Risk for pneumonia
Risk for constipation

XI- NURSING CARE PLAN

ACUTE PAIN
ASSESSMENT
SUBJECTIVE:
nurse sumasakit na
naman yun bali ko
Pain scale: 7/10
OBJECTIVE:
-facial grimace
-crying
-complaints of pain

NURSING
DIAGNOSIS
Pain related to
fracture (movement of
bone fragments and
muscle spasms)

PLANNING

INTERVENTIONS

RATIONALE

EVALUATION

After 15-30 minutes

of nursing
interventions, the
patient reports
satisfaction with pain
relief measures with
pain scale from 7/10
2/10

Perform a
comprehensive
assessment of pain to
include location,
characteristics, onset/
duration, intensity or
severity of pain, and
precipitating factors

To plan appropriate
interventions

After 30 minutes of
nursing interventions,
the goal was fully met
as evidenced by
patients reports with
satisfaction with pain
relief measure and
pain scale decreased
from 7/10 to 2/10

Teach the patient and

watcher the use of
nonpharmacologic
techniques (e.g.,
relaxation, hot/cold
application, and
massage) before,
after, and , if possible
during painful
activities; before pain
occurs or increases;
and along with other
pain relief measures

To reduce edema and

promote comfort

Provide patient
optimal pain relief
with prescribed
analgesics such as
ketorolac

May inhibit
prostaglandin
synthesis, to produce
anti-inflammatory,
analgesic, and
antipyretic effects. To
relieve pain and
promote comfort.

IMPAIRED PHYSICAL MOBILITY

ASSESSMENT
OBJECTIVE:
-limited ROM
-decreased
muscle strength
and/or control

NURSING
DIAGNOSIS
Impaired physical
mobility loss of
integrity of bone
structures, movement
of bone fragments and
prescribed movement
restrictions

PLANNING

INTERVENTIONS

RATIONALE

EVALUATION

After 5 8
hours of nursing
interventions,
the patient
experiences no
complication of
immobility

Assess ROM of unaffected

joints and distal to the
immobilization device

Patients with casts will

experience some degree of
limited ROM to the
affected area. Optimal
ROM is critical for
movement and necessary
for rehabilitation

Assess muscle strength in all

extremities.

The rehabilitation
program will be geared
toward maximizing as
much strength as possible
in the affected or
immobilized extremity.

After 8 hours of
nursing
interventions the
goal was fully
met as evidenced
by increased
ROM in
coordination to
prescribed
movement
restrictions

Perform flexion and extension

exercises to proximal and distal
joints of the affected extremity,
when indicated.

These exercises serve to

maintain mobility

Instruct patient not to scratch

skin under the cast with any
objects

To prevent skin injury and

infection

Position cast on pillows

To lessen strain on other

body parts.

Pad rough edges and traction

connections

To prevent skin irritation

and breakdown of cast.

Instruct patient to direct cool

air under cast

To decrease itching

Apply ice for the first 24-36

hours

To reduce swelling or
inflammation

RISK FOR INEFFECTIVE TISSUE PERFUSION

ASSESSMENT
OBJECTIVE:
-immobility
-presence of cast
-inflammatory
process

NURSING
DIAGNOSIS
Risk for ineffective
tissue perfusion
related to vascular
insufficiency and
nerve compression

PLANNING

INTERVENTIONS

RATIONALE

EVALUATION

After 1-2 hours of

nursing
interventions, the
patient experiences
no peripheral
neurovascular
dysfunction

Perform a
comprehensive
appraisal of peripheral
circulation (e.g. check
peripheral pulses,
edema, capillary refill,
color, temperature or
extremity)

To monitor for
diminished tissue
perfusion and plan
appropriate
intervention.

After 2 hours of
nursing interventions,
the goal was met
seeing that the patient
did not experience
peripheral
neurovascular
dysfunction

Prevent infection in
wounds with iodine
solution and cover it
with gauze

To prevent further
edema and
inflammation, this
may contribute further
to vascular
insufficiency and
nerve compression.

Maintain adequate
hydration.

To prevent increased
blood viscosity.

Support affected body

part

To prevent pressure
and injury

Maintain position and

integrity of traction

To prevent
compression of blood
vessels and nerves

Elevated limb 20
To reduce edema by
degrees of greater above promoting venous
the heart
return (note: if
compartment
syndrome is
suspected, elevate
extremity no higher
that heart level)

VIII- ONGOING APPRAISAL

The patients health status improved; decreased patients pain from his injury, increased his ROM and prevented the patient from
experiencing peripheral vascular dysfunction due to his condition
IX - DISCHARGE PLAN (HEALTH TEACHINGS)
For pain management, patient can take OTC oral analgesics and /or nonpharmacological techniques like positioning or hot/codl application
Teach patient and caregiver about proper cast care
o Do not get cast wet. Dry cast thoroughly after exposure to water.
o Do not remove any padding
o Do not insert objects onside cast. If itching occurs, use a hair dryer on cool setting or a fan to relieve itching.
o Do not bear weight on new cast for 48 hours (not all casts are made for weight bearing; check with health care provider when
unsure)
Teach patient and caregiver about ROM exercises to maintain mobility and prevent contractures
Report signs of possible problems to health care provider
o Increase pain
o Swelling associated with pain and discoloration of toes or fingers
o Pain during movement
o Burning or tingling under cast
o Sores or foul odor under the cast
Keep appointment to have fracture and cast checked

PANPACIFIC UNIVERSITY NORTH PHILIPPINES

Urdaneta city, Pangasinan

College of Nursing

CASE STUDY ON FRACTURES

Submitted by:
Prince OMar R. Perez, BSN3

Submitted to:
Ms. Glecy C. Ventura, RN, MAN