Question
What is the Care plan for this case below including sleeping position?
A patient admitted to orthopedic ward with right upper limb fracture( Humur, fourth phalanx) and left posterior 7 rib fracture too after beating by their their neighbor. And doctor apply full case on patient his limb.
A patient admitted to orthopedic ward with right upper limb fracture( Humur, fourth phalanx) and left posterior 7 rib fracture too after beating by their their neighbor. And doctor apply full case on patient his limb.
Answers
GPT-4o mini
Creating a care plan for a patient with an upper limb fracture (humerus, fourth phalanx) and a rib fracture requires consideration of pain management, mobility, positioning, and rehabilitation, as well as psychological support due to the nature of the injury. Here’s a structured care plan:
### Patient Care Plan
**Patient Profile:**
- **Age/Sex:** [Specify age and sex if available]
- **Admitted for:** Right upper limb fracture (humerus, fourth phalanx) and left posterior rib fracture
- **Mechanism of Injury:** Assault (beaten by neighbor)
---
### Nursing Diagnosis
1. **Acute pain** related to bone fractures as evidenced by patient reports of pain and discomfort.
2. **Impaired physical mobility** related to structural impairment of right upper limb and rib fractures.
3. **Risk for impaired skin integrity** related to immobilization and body positioning in bed.
4. **Anxiety or fear** related to the assault and current state of health.
---
### Goals and Outcomes
1. **Pain Management:**
- Patient will report pain levels of 3/10 or lower on a pain scale within 24 hours.
2. **Mobility:**
- Patient will demonstrate passive range of motion exercises on the unaffected limb within 24 hours.
3. **Skin Integrity:**
- Skin will remain intact and free from breakdown within the patient's hospital stay.
4. **Emotional Support:**
- Patient will verbalize feelings and concerns and demonstrate coping strategies by discharge.
---
### Interventions
**1. Pain Management:**
- Administer prescribed analgesics as required, assessing efficacy and side effects.
- Offer non-pharmacological pain relief strategies (e.g., ice application, relaxation techniques).
**2. Mobility:**
- Assist with passive range of motion exercises for the unaffected limb to prevent stiffness.
- Encourage use of mobility aids if necessary for getting out of bed.
- Educate the patient about the importance of moving to maintain circulation and muscle strength.
**3. Skin Integrity:**
- Regularly assess the skin for signs of pressure ulcers, especially in areas in contact with the cast.
- Encourage repositioning every 2 hours while in bed to relieve pressure on bony prominences.
- Use soft padding where necessary to protect skin.
**4. Emotional Support:**
- Provide emotional support by being an active listener and addressing any feelings of anxiety or fear.
- If indicated, involve a mental health professional for counseling.
- Offer resources about support groups for victims of violence.
**5. Sleeping Position:**
- Advise the patient to sleep on their back or on the uninjured side to avoid pressure on the right arm and left rib fracture.
- Use pillows for support to maintain a comfortable position that does not strain the injured areas.
- Ensure the limbs are positioned comfortably to reduce pressure and discomfort during rest.
**6. Education:**
- Educate the patient on the importance of adhering to the follow-up appointments and rehabilitation plans.
- Instruct on the signs and symptoms of complications (e.g., increased pain, swelling, numbness) that should prompt immediate medical attention.
---
### Evaluation
- Regularly assess pain levels, range of motion, skin integrity, and emotional well-being.
- Modify the care plan as necessary based on patient feedback and clinical observations.
---
### Notes
Ensure that all interventions are tailored to the specific needs and condition of the patient and involve the patient in their care decisions whenever possible.
### Patient Care Plan
**Patient Profile:**
- **Age/Sex:** [Specify age and sex if available]
- **Admitted for:** Right upper limb fracture (humerus, fourth phalanx) and left posterior rib fracture
- **Mechanism of Injury:** Assault (beaten by neighbor)
---
### Nursing Diagnosis
1. **Acute pain** related to bone fractures as evidenced by patient reports of pain and discomfort.
2. **Impaired physical mobility** related to structural impairment of right upper limb and rib fractures.
3. **Risk for impaired skin integrity** related to immobilization and body positioning in bed.
4. **Anxiety or fear** related to the assault and current state of health.
---
### Goals and Outcomes
1. **Pain Management:**
- Patient will report pain levels of 3/10 or lower on a pain scale within 24 hours.
2. **Mobility:**
- Patient will demonstrate passive range of motion exercises on the unaffected limb within 24 hours.
3. **Skin Integrity:**
- Skin will remain intact and free from breakdown within the patient's hospital stay.
4. **Emotional Support:**
- Patient will verbalize feelings and concerns and demonstrate coping strategies by discharge.
---
### Interventions
**1. Pain Management:**
- Administer prescribed analgesics as required, assessing efficacy and side effects.
- Offer non-pharmacological pain relief strategies (e.g., ice application, relaxation techniques).
**2. Mobility:**
- Assist with passive range of motion exercises for the unaffected limb to prevent stiffness.
- Encourage use of mobility aids if necessary for getting out of bed.
- Educate the patient about the importance of moving to maintain circulation and muscle strength.
**3. Skin Integrity:**
- Regularly assess the skin for signs of pressure ulcers, especially in areas in contact with the cast.
- Encourage repositioning every 2 hours while in bed to relieve pressure on bony prominences.
- Use soft padding where necessary to protect skin.
**4. Emotional Support:**
- Provide emotional support by being an active listener and addressing any feelings of anxiety or fear.
- If indicated, involve a mental health professional for counseling.
- Offer resources about support groups for victims of violence.
**5. Sleeping Position:**
- Advise the patient to sleep on their back or on the uninjured side to avoid pressure on the right arm and left rib fracture.
- Use pillows for support to maintain a comfortable position that does not strain the injured areas.
- Ensure the limbs are positioned comfortably to reduce pressure and discomfort during rest.
**6. Education:**
- Educate the patient on the importance of adhering to the follow-up appointments and rehabilitation plans.
- Instruct on the signs and symptoms of complications (e.g., increased pain, swelling, numbness) that should prompt immediate medical attention.
---
### Evaluation
- Regularly assess pain levels, range of motion, skin integrity, and emotional well-being.
- Modify the care plan as necessary based on patient feedback and clinical observations.
---
### Notes
Ensure that all interventions are tailored to the specific needs and condition of the patient and involve the patient in their care decisions whenever possible.