Hypothetical Nursing Care Plan
This assignment aims to implement a hypothetical nursing care plan for a patient that I been involved with recently whist on clinical placement. I have used a published nursing model in order for me to apply an appropriate nursing care plan for my chosen patient. I will explain my reasoning for the purposed care, whilst also including an explanation of how pathophysiology contributes to the patient experience.
In accordance with the Nursing and Midwifery Council (NMC 2008) and the Data Protection Act (1998), all names and locations have been changed in order to maintain confidentiality.
The Patient
Thelma is a 75-year-old female who had fallen from a chair when changing a light bulb. Her husband was out walking the dog at the time, …show more content…
Firstly, those occurring within the capsule of the hip joint between the head of the femur and the pelvic acetubum, making it intracapsular. Secondly, those occurring outside the hip joint capsule making it extracapsular. Walsh and Crumbie (2007a) also state that fractures of the femur neck are generally divided into two categories, intracapsular or extracapusular. Intracapsular fractures occur through the capsule at the base of the femur head. Extracapsular fractures pass through either of the trochanters or the intertrochanteric …show more content…
When this is the case hemiarthroplasty is the chosen surgical intervention (Santy 2005a).
With extracapsular fractures however, the viability of the blood supply to the femur head is not usually at issue (Walsh and Crumbie 2007b) and the choice of fixation is either dynamic hip screw or an intrameddullary nail (Kunkler 2002).
In her fall Thelma sustained a closed and undisplaced intertrochanteric fracture of the proximal femur therefore making her fracture extracapsular. Because of the nature of her fracture it was decided that a dynamic hip screw under general anesthetic would be the choice of surgical intervention. Specifically a four hole 135 DHS plate with an 85mm DHS lag screw. The wound was closed with 3/0 Monocryl and dressed with steripad. No drains were inserted.
A dynamic hip screw is the implant of choice for stable trochanteric fractures (Harrington, et al 2002, Lorich, Geller and Nielson 2004). This is considered to be particularly so in the elderly (Koval and Zuckerman
In accordance with the Nursing and Midwifery Council (NMC 2008) and the Data Protection Act (1998), all names and locations have been changed in order to maintain confidentiality.
The Patient
Thelma is a 75-year-old female who had fallen from a chair when changing a light bulb. Her husband was out walking the dog at the time, …show more content…
Firstly, those occurring within the capsule of the hip joint between the head of the femur and the pelvic acetubum, making it intracapsular. Secondly, those occurring outside the hip joint capsule making it extracapsular. Walsh and Crumbie (2007a) also state that fractures of the femur neck are generally divided into two categories, intracapsular or extracapusular. Intracapsular fractures occur through the capsule at the base of the femur head. Extracapsular fractures pass through either of the trochanters or the intertrochanteric …show more content…
When this is the case hemiarthroplasty is the chosen surgical intervention (Santy 2005a).
With extracapsular fractures however, the viability of the blood supply to the femur head is not usually at issue (Walsh and Crumbie 2007b) and the choice of fixation is either dynamic hip screw or an intrameddullary nail (Kunkler 2002).
In her fall Thelma sustained a closed and undisplaced intertrochanteric fracture of the proximal femur therefore making her fracture extracapsular. Because of the nature of her fracture it was decided that a dynamic hip screw under general anesthetic would be the choice of surgical intervention. Specifically a four hole 135 DHS plate with an 85mm DHS lag screw. The wound was closed with 3/0 Monocryl and dressed with steripad. No drains were inserted.
A dynamic hip screw is the implant of choice for stable trochanteric fractures (Harrington, et al 2002, Lorich, Geller and Nielson 2004). This is considered to be particularly so in the elderly (Koval and Zuckerman