nursing care plan help

a care plan is an organized and structured plan that addresses the problems that a patient has to deal with. a basic nursing care plan, in particular, addresses how a patient is going to be able to accomplish their daily activities of living (adls). this is primarily what nurses do. in working up this care plan you also have to consider the person's underlying medical, physical, social, cultural and personal resources and conflicts that might impact their care. there is an established process to do this. it is called the nursing process. a written plan of care is based upon the nursing process. it includes the following steps:

1. assessment (collect data)

   
   

2. nursing diagnosis (group your assessment data, shop and match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnosis to use)

   
   

3. planning (write measurable goals/outcomes and nursing interventions)

   
   

4. implementation (initiate the care plan)

   
   

5. evaluation (determine if goals/outcomes have been met)

   
   

• fractures of both wrists and right femur

  
  

• needs to be on crutches for the next 6 weeks

  
  

• smokes 20 cigarettes a day [how's he going to get cigarettes when he runs out?]

  
  

• drinks alcohol on a regular basis [how regular and how much?]

  
  

• depends on takeaway food for meals [any food in the house? does he cook? how will he get groceries?]

  
  

• will need to be goes up stairs in his house to get to his bedroom

  
  

• the bedroom floor is carpeted [crutches and carpet don't do well together; is it possible the patient can sleep downstairs somewhere?]

  
  

• the shower and bathroom are upstairs attached to the bedroom [question: is there a bathroom downstairs?]

  
  

• steep driveway which will make getting in and out of a vehicle a potential problem [was the motorbike ruined? is there another vehicle? is the patient even going to be able to drive? how will be get to doctor appointments, the store?]

  
  

• eating and drinking
  
• toileting
  
• bathing
  
• dressing
  
• ability to move and get where they need to go
  
• communicate
  
• sleep and rest
  

• diversional activity

  
  

• https://allnurses.com/forums/f205/desperately-need-help-careplans-170689.html - desperately need help with careplans (in nursing student assistance forum)
  
• https://allnurses.com/forums/f50/careplans-help-please-r-t-aeb-121128-7.html - careplans help please! (with the r\t and aeb) (in general nursing student discussion forum)
  

one of the things you need to do in working on this assignment is to read about the medical treatment of fractures and the complications that can occur as a result of fractured bones. you must be aware of what the doctor is likely to have ordered when you are planning nursing care. you already know he wants the patient up and moving with crutches. luke would have been instructed in how to use them by a physical therapist. if he needed a wheelchair, the physical therapist would have informed the doctor of this before his discharge. this is a 27-year old healthy man. the scenario hasn't told you exactly where on the femur his fracture was: the hip or the shaft of the bone. you don't know if the fracture was repaired by surgery (screws, plates, hip replacement, or plain old manipulation). each carries different potential complications. most orthopedic doctors don't want a patient, particularly a young patient like this, immobilized in a wheelchair. you want him up and about and as active as possible to prevent complications of immobility such as fat embolism, thrombophlebitis and pneumonia. you need to be doing some reading and studying about fractures, how they heal and mobility to complete this assignment.

there are plenty of rationale decisions you can make here based upon the information you were given, the pathophysiology of the patient's condition and your nursing knowledge of adls. that is the critical thinking aspect of being a nurse that this assignment is introducing you to. as a nurse you know every human must eat to sustain life and, in this case, to assist in the healing process. however, the patient is going to have a problem getting access to food, may need teaching regarding a good balanced diet that will help promote his healing, and may need some assistance with the actual act of preparing the food. those are logical assumptions that you can make based on the information you were given. you've still got a whole bunch of other adls to address. this could turn out to be one long and complicated care plan.