Anyone here specializing in ortho? Need Help

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It's my final year in nursing college, I'm now working on my case study which is all about fracture of the distal femur. It's my 1st and I can't seem to do this alone. please help.:confused:

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Specializes in med/surg, telemetry, IV therapy, mgmt.

What help do you need? You are being too general.

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Specializes in Ortho, Neuro, Detox, Tele.

exactly...we need to know what you need help with. I work ortho/neuro and have for 3 years. but even I would be hard pressed to help you just from one sentance.

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Just anything about the fracture of the distal femur. I badly need references. A sample case study (any case) would be very helpful, so that I'll be guided as to how to go about with technicals and contextual structuring. Thanks! :imbar

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Specializes in med/surg, telemetry, IV therapy, mgmt.

the last sample case studies i found were pulled off the internet this past summer by the instructor who had posted them--probably for confidentiality reasons. they were all care plans written in essay form.

a care plan is how we solve a patient's nursing problems. there is a specific way to go about doing this. it involves using the nursing process which consists of 5 steps. are "technicals and contextual structuring" the instructions that you were given by your instructors? i am just guessing at what they mean, but, i suspect the "contextual structuring" is the nursing process itself and the "technicals" that you need are probably the assessment information you need to collect as part of step #1 of that process. i am posting the steps of the nursing process for you along with a link to a thread on allnurses that has links to websites where you can start you search for information on fractured femurs and how they are treated. follow the steps of the nursing process in the order they occur.

  1. assessment (collect data from medical record, do a physical assessment of the patient, assess adl's, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology)
    • a physical assessment of the patient
    • assessment of the patient's ability and any assistance they need to accomplish their adls (activities of daily living) with the disease
    • data collected from the medical record (information in the doctor's history and physical, information in the doctor's progress notes, test result information, notes by ancillary healthcare providers such as physical therapists and dietitians
    • knowing the pathophysiology, signs/symptoms, usual tests ordered, and medical treatment for the medical disease or condition that the patient has. this includes knowing about any medical procedures that have been performed on the patient, their expected consequences during the healing phase, and potential complications. if this information is not known, then you need to research and find it.
    • https://allnurses.com/forums/f205/medical-disease-information-treatment-procedures-test-reference-websites-258109.html - medical disease information/treatment/procedures/test reference websites

[*]determination of the patient's problem(s)/nursing diagnosis (make a list of the abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use)

  • it helps to have a book with nursing diagnosis reference information in it. there are a number of ways to acquire this information.
  • your instructors might have given it to you.
  • you can purchase it directly from nanda. nanda-i nursing diagnoses: definitions & classification 2007-2008 published by nanda international. cost is $24.95 http://www.nanda.org/html/nursing_diagnosis.html
  • many authors of care plan and nursing diagnosis books include the nanda nursing diagnosis information. this information will usually be found immediately below the title of a nursing diagnosis.
  • the nanda taxonomy and a medical disease cross reference is in the appendix of both taber's cyclopedic medical dictionary and mosby's medical, nursing, & allied health dictionary
  • there are also two websites that have information for about 75 of the most commonly used nursing diagnoses that you can access for free:

[*]planning (write measurable goals/outcomes and nursing interventions)

  • goals/outcomes are the predicted results of the nursing interventions you will be ordering and performing. they have the following overall effect on the problem:
    • improve the problem or remedy/cure it
    • stabilize it
    • support its deterioration

    [*]interventions are of four types

    • assess/monitor/evaluate/observe (to evaluate the patient's condition)
    • care/perform/provide/assist (performing actual patient care)
    • teach/educate/instruct/supervise (educating patient or caregiver)
    • manage/refer/contact/notify (managing the care on behalf of the patient or caregiver)

[*]implementation (initiate the care plan)

[*]evaluation (determine if goals/outcomes have been met)

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thank you sooo much. ^^

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And one more thing... Is there a soft copy of an orthopedic assessment tool in certain sites? It would be impractical to type my ortho assessment form to soft. I figured i could jst transfer my findings to the soft copy. ^^

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Specializes in med/surg, telemetry, IV therapy, mgmt.

For a case study only the abnormal data needs be included in the write up. If you need to include a copy of the assessment tool you turn in to the instructor, just Xerox it.

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Thank you! ^^

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