Patients Name: Johanny Jaromay Age: 32 / Address: Paranaque City ASSESSMENT Subjective: The patient verbalized, Hindi ko pa rin

n maigagalaw ang paa ko. Nabali kasi ung buto ko sa hita kaya nga nilagyan muna nila ng 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 DIAGNOSIS Partially impaired physical mobility related to musculoskeletal disorder (femoral fracture) and external device (skeletal traction) RATIONALE 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.

Medical Diagnosis: Fracture Cl M3 Femur at left knee; Fracture Cl Patella at left knee Date Admitted: October 23, 2006 PLAN 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. INTERVENTION 1. Assess for correct position of traction and alignment of bones RATIONALE 1.To maintain good body alignment when mechanical devices are used EVALUATIO N After the nursing intervention, the patient was able to maintain position of function and exerted maximum mobility within the therapeutic limits of traction.

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 4. Allow patient to perform tasks at his own rate. Encourage independent activity as able as safe. 3. Enhances circulation maintains muscle tone and joint mobility and prevents disuse contractures and muscle atrophy. 4. To increase patients recovery and increase his self-esteem.

Reference: Medical Surgical Nursing (Brunner and Suddarths)

5. Encourage use of trapeze

5. Strengthen shoulders an arm muscles necessary for safe positioning and mobilization 6. Encourages active participation while preventing stress on fractured bone 7. This promotes a safe environment.

6. Instruct and assist in position changes and transfers. 7. Keep side rails up and bed in low position