Femoral fx

  1. 0
    Hi student nurses and nurses.
    Wednesday was my second week stage this week and my patient had a femoral fracture and it was her third day post op. She complains of nausea so i gave her gravol. She also reports pain 6/10 on her left hip (related to her surgery for femoral fx) and she asked me why it was so important to mobilize and do physical exercise. This is one of my dx (defficient knowledge about mobilization as evidenced by the patient doesn't want to get out of the bed) i am not really sure it is a good diagnosis. it was also the first time I was giving Lovenox subcu and i was really stressed at first but once it is done, i will never forget how to give meds. The book we are using at college is med-surg nursing in canada (cause i am from canada). So i have to write down 2 nursing diagnosis/priority for my patient. the first one would maybe be acute pain related to surgery for femoral fracture as evidenced by rating the pain 6/10. the second one would maybe be the deficient knowledge about mobilization.
    thanks for help
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  4. 11 Comments so far...

  5. 1
    Deficient knowledge would be a great diagnosis. She needs to understand that for intestinal mobility, strength, ease of recovery, pneumonia prevention and DVT prevention, she needs to get up and move! It sucks at first, but it is better to get up and move as early as possible. Certainly the hospital isn't going to let her go home if she can't or wont even get up and move around, if that was something she could do before admission.
    Rosiemenard likes this.
  6. 0
    Thank you very much for the quick comment ill take that in note!!
  7. 0
    You're welcome!
  8. 5
    There is no such approved nursing diagnosis as "Deficient knowledge about mobilization (or anything else)," though. What you're looking for is more like "Impaired bed mobility, related to deficient knowledge and pain, as evidenced by....(what do you observe?)..."

    People will tell you I NEVER answer homework for you, but here I have just gone and done exactly that. I must be losing my touch. Now, your part of the deal is that you promise to get the book so you can do it properly yourself from here on.

    Get the NANDA-I 2012-2014 book stat, free two-day shipping from Amazon, $29 US. It is an INTERNATIONAL reference book, so no worries about you being in Canada.
  9. 1
    Quote from GrnTea
    There is no such approved nursing diagnosis as "Deficient knowledge about mobilization (or anything else)," though. What you're looking for is more like "Impaired bed mobility, related to deficient knowledge and pain, as evidenced by....(what do you observe?)..."

    People will tell you I NEVER answer homework for you, but here I have just gone and done exactly that. I must be losing my touch. Now, your part of the deal is that you promise to get the book so you can do it properly yourself from here on.

    Get the NANDA-I 2012-2014 book stat, free two-day shipping from Amazon, $29 US. It is an INTERNATIONAL reference book, so no worries about you being in Canada.
    The book I have (Ackley and Ladwig, Nursing Diagnosis Handbook) does have deficient knowledge in it. The related factors applicable here (as listed in the book) could be cognitive limitation, information misinterpretation, lack of exposure, lack of interest in learning, lack of recall, or unfamiliarity with information resources. I'm not sure if maybe the OP is using the same text as me or not, but I wanted to chime in with what I have here.

    ETA: The way we would use this would be to say "deficient knowledge" and then we would say what the deficient knowledge was referring to, then say "r/t....", "AEB...."
    Esme12 likes this.
  10. 1
    mine book also has "Deficient knowledge related to lack of exposure" it wont be mobilization but you can add the rest based on e.g as evidenced by pt. questions need to ambulate or pt questions need for physical therapy....anything like that would be your evidence.

    your intervention then would be to educate the pt. and your outcome would be pt. acknowledge and states understanding of need to ambulate or whatever
    Last edit by man-nurse2b on Mar 30, '13
    Esme12 likes this.
  11. 0
    GrnTea is right...you need to have a good nursing care plan book and/or NANDA-I book to make you life SO much easier! I use Ackley and Ladwig, Nursing Diagnosis Handbook as well/

    However........Deficient knowledge (specify) is a NANDA-I diagnosis......and a good one.
    NANDA-I Definition
    Absence or deficiency of cognitive information related to a specific topic
    Defining Characteristics
    Exaggerated behaviors; inaccurate follow-through of instruction; inaccurate performance of test; inappropriate behaviors (e.g., hysterical, hostile, agitated, apathetic); verbalization of the problem

    Related Factors (r/t)
    Cognitive limitation; information misinterpretation; lack of exposure; lack of interest in learning; lack of recall; unfamiliarity with information resources

    OP remember that nursing care plans are all about the assessment of the patient and what the patient needs first according to Maslows Hierachy of Needs .....or whatever theory you use


    So looking at what information you gave.....

    patient had a femoral fracture and it was her third day post op. She complains of nausea so i gave her gravol. She also reports pain 6/10 on her left hip (related to her surgery for femoral fx) and she asked me why it was so important to mobilize and do physical exercise. This is one of my dx (deficient knowledge about mobilization as evidenced by the patient doesn't want to get out of the bed) i am not really sure it is a good diagnosis. it was also the first time I was giving Lovenox subcu and i was really stressed at first but once it is done, i will never forget how to give meds. The book we are using at college is med-surg nursing in Canada (cause i am from Canada). So i have to write down 2 nursing diagnosis/priority for my patient. the first one would maybe be acute pain related to surgery for femoral fracture as evidenced by rating the pain 6/10. the second one would maybe be the deficient knowledge about mobilization.
    I have highlighted important information. Look at the priority of needs.....so what is most important to this patient. She has Acute Pain, complains of Nausea (yes a NAND-I diagnosis) , she has Deficient knowledge (specify) about mobility that makes her Fearful of ambulation.
  12. 1
    Esme, are you in any way in education, maybe as a preceptor, or professor? I always adore your posts in the homework help sections and, really, anywhere on AN. I could just follow you around here all day long, and I'd become a better nurse as a result of it. Love your contributions!


    (OP, I apologize for the brief hijacking!)
    Esme12 likes this.
  13. 0
    Thanks .....I have always LOVED teaching and have been an educator and mentor, preceptor......But alas these days.....not any more....I am no longer "qualified". I don't have a high enough degree....sigh.

    I'm glad I can help...my goal is to make nursing better every day by helping the next generation become the best nurse they can be! Follow me anytime.......you can always PM me too...


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