St.

Joseph’s College of Quezon City

Institute of Nursing

295 E. Rodriguez Sr. Blvd, Quezon City

A Case Presentation of 16 years old male Post-Operative closed

Fracture Radius (Right) - ORIF

Submitted to:

Myrna Gianan, RN, MAN

Submitted by:

Garcia, Anjelo Cyrus B.

October 19, 2022

 Table of Contents

I. Objectives
a. General Objectives
b. Specific Objectives
II. Introduction
a. Overview
b. Epidemiology
c. Theoretical Framework
III. Health history
a. Biographical data
b. Reason for seeking of care
c. Present Health History
d. Past Health History
e. Social History
f. Family History
g. Gordon`s Level of Functioning
h. Review of Systems
IV. Physical Assessment
V. Course in the Ward
VI. Diagnostics
VII. Clinical Discussion
VIII. Pathophysiology
IX. Concept Map
X. Drug Study
XI. Discharge Planning

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I. OBJECTIVES

a. General Objective

This study aims to identify and determine the general health problems and basic
needs of the patient with a diagnosis of closed fracture radius (right) as well as the proper
management and treatment for such condition.
b. Specific Objective

 To seek border knowledge regarding Pulmonary Tuberculosis by being able to:

 To identify and understand the disease process of this condition
 To identify client`s data, present and past medical history, family history, and its
contribution to the current condition of the patient
 To consider the environmental and social contributing factors of this case
 To discuss physical condition of the client attributed by the disease through a
thorough physical assessment.
 To discuss the theoretical pathophysiology and the manifesting phatophysiology
of the client with this case.
 To identify laboratory results and its significance to the condition of the client.
 To formulate a Nursing Care Plan which are efficient and beneficial for the
client’s actual needs.
 To identify the prescribed drugs given and understand its action, side effects on
the client condition as well as the nursing responsibilities for this drugs.
 To formulate a detailed discharge plan which could promote client’s comfort if
not to aid in full recovery.

II. INTRODUCTION

a. Overview

Bones are part of the musculoskeletal system, which also includes muscles and the tissues that

connect them (ligaments, tendons, and other connective tissue, called soft tissues). These

structures give the body its form, make it stable, and enable it to move. Fractures (and other

musculoskeletal injuries) vary greatly in severity and in the treatment needed. For example,

fractures can range from a small, easily missed crack in a foot bone to a massive, life-

threatening break in the pelvis. Fractures can break the skin (called open fractures) or not

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(called closed fractures). An injury that breaks a bone may also seriously damage other tissues,

including the skin, nerves, blood vessels, muscles, and organs. These injuries can complicate

treatment of the fracture and/or cause temporary or permanent problems. When most tissues,

such as those of the skin, muscles, and internal organs, are significantly injured, they mend

themselves by producing scar tissue to replace the injured tissue. The scar tissue often looks

different from normal tissue or interferes with function in some way. In contrast, bone heals by

producing actual bone tissue.

When a bone heals itself after a fracture, the fracture often eventually becomes virtually

undetectable. Even bones that have been shattered, when treated appropriately, can often be

repaired and function normally.

b. Epidemiology

No epidemiological data are available for any of the other Asian nations. A paper on pediatric

fractures from India mentions distal radius fractures as the commonest fracture pattern seen in

children, accounting for 22.4% of all fractures. This study from a single center in Mumbai

treated 112 distal radius fractures over a period of one year in 2004–2005 and reported the

highest incidence of distal radius fractures in the 13–16 age group followed by the 7–12 age

group. Similar data were reported from another study on pediatric fractures from Hong Kong.

This study from a single center in Hong Kong saw 617 distal radius fractures over a five year

period (1986–1990). Distal radius fractures were the commonest fracture accounting for nearly

20% of all fractures, and occurred most frequently in the 8–11 followed by the 12–16 age group.

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 c. Theoretical Framework

Dorothea Orem’s Self-Care Deficit Theory defined Nursing as “The act of assisting others in the

provision and management of self-care to maintain or improve human functioning at the home

level of effectiveness.” It focuses on each individual’s ability to perform self-care, defined as

“the practice of activities that individuals initiate and perform on their own behalf in maintaining

life, health, and well-being.”

“The condition that validates the existence of a requirement for nursing in an adult is the absence

of the ability to maintain continuously that amount and quality of self-care which is therapeutic

in sustaining life and health, in recovering from disease or injury, or in coping with their effects.

With children, the condition is the parent’s inability (or guardian) to maintain continuity for the

child the amount and quality of care that is therapeutic.” (Orem, 1991)

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  Self-Care

Self-care is the performance or practice of activities that individuals initiate and perform on their

own behalf to maintain life, health, and well-being.

 Self-Care Agency

Self-Care

Self-care is the performance or practice of activities that individuals initiate and perform on their

own behalf to maintain life, health, and well-being.

 Self-Care Demand

Therapeutic Self-care Demand is the totality of “self-care actions to be performed for some

duration to meet known self-care requisites by using valid methods and related sets of actions

and operations.”

 Self-Care Deficit

Self-care Deficit delineates when nursing is needed. Nursing is required when an adult (or in the

case of a dependent, the parent or guardian) is incapable of or limited in providing continuous

effective self-care.

 Nursing Agency

Nursing Agency is a complex property or attribute of people educated and trained as nurses that

enables them to act, know, and help others meet their therapeutic self-care demands by

exercising or developing their own self-care agency.

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III. HEALTH HISTORY

a. Biographic Data

Name of Patient: AE
Age: 16
Sex: M
Birthdate: 05/05/2006
Birthplace: Pasay City
Address: 2449 mangubat Ext. Tramo St. Pasay City
Civil Status: singe
Occupation: N/A
Religion: Roman Catholic
Spouse’s Name: None
Father’s Name: ECA
Mother’s Name: AB
Admitting Diagnosis: CLOSED FX RADIUS (RIGHT)
Date of Admission: 10/10/2022
Time of Admission: 1:33pm
Attending Physician: ESTHER A. SAGUIL M.D
Source of Information: Patient /Patient’s Mother
Hospital: Pasay City General Hospital, Surgery Ward

b. Reason for Seeking Care

No chief complain

c. Present Health History

Patient is confined due to fall while playing basketball last 9/11/2022. Current condition

was diagnosed as CLOSED FX RADIUS (RIGHT)

d. Past Health History

Patient has no history of hospitalization and no other health problem aside from having

flu and colds.

e. Social History

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 Patient is living with his mother and father with his four siblings. Patient said that his two

other siblings are living with their own family just near their house.

f. Family History

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 g. Gordon’s Level of Functioning

FUNCTIONAL PATTERN BEFORE ADMISSION DURING ADMISSION

Health Perception/Health THE PATIENT THE PATIENT STILL

VERBALIZED THAT HE IS THINK THAT HE HAS AN
Management DRINKING ALCOHOL UNHEALTHY LIFESTYLE
AND SMOKING THAT IS THOUGH IT IS NOT THE
WHY HE THOUGHT THAT REASON WHY HE IS
HIS LIFESTYLE IS HOSPITALIZED BUT HIS
UNHEALTHY. PERCEPTION IN HIS
HEALTH CHANGED
BECAUSE HE DOESN’T
WANT TO BE
HOSPITALIZED AGAIN.
AND IS WILLING TO
CHANGE HIS LIFESTYLE
Nutritional-Metabolic THE PATIENT HAS NO THE PATIENT
ALLERGIES TO FOODS, VERBALIZED THAT HE
Pattern DRUGS AND HE IS CAN`T EAT OR DRINK
EATING 3X A DAY. BUT YET BECAUSE HE IS
ACCORDING TO HIM, HE SCHEDULED FOR
EATS A LOT OF JUNK OPERATION ON HIS ARM.
FOODS BUT HE DRINKS BUT AFTER THE
A LOT OF WATER. AT A OPERATION, HE DRINKS
YOUNG AGE HE START LOTS OF WATER
DRINKING ALCOHOL.
Elimination Pattern THE PATIENT USUALLY AFTER THE OPERATION,
URINATE 5-6 TIMES A THE PATIENT URINATE
DAY DEPENDING ON HIS TWICE, IN THE EVENING
FLUID INTAKE AND AND IN THE MORNING.
DEFECATES ONCE A DAY
AND HE DOESN’T
EXPERIENCE HAVING
DIFFICULTY URINATING
AND DEFECATING.
Activity-Exercise Pattern PATIENT VERBALIZED THE PATIENT IS NOT
THAT HE IS THE ONE PERFORMING ANY
WHO STORES WATER ACTIVITIES YET ASIDE
FOR THEIR DAILY USE. FROM STANDING AND

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Sleep Rest Pattern
Cognitive-Perceptual
Pattern
Self-Perception/Self-concept
Pattern
Roles-Relationship Pattern
Sexuality-Reproductive
Pattern
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HE ALSO LIKE TO PLAY WALKING TO THE
BASKETBALL WITH HIS BATHROOM. HIS
FRIENDS AND ALSO THE MOVEMENT IS ALSO
REASON WHY HE LIMITED BECAUSE OF
FRACTURED HIS RIGHT HIS CURRENT
ARM. CONDITION.
THE PATIENT USUALLY THE PATIENT STILL
SLEEPING FOR 8 TO 9 SLEEPS COMFORTABLY
HOURS AND WAKES UP AND NO DIFFICULTY.
AROUND 6AM IF HE HAS THE PATIENT
A CLASS. THE PATIENT VERBALIZED THAT HE
ALSO VERBALIZED REALLY LIKES TO
THAT HE IS A SLEEPY SLEEP.
PERSON AND LIKES
SLEEPING. HE ALSO
VERBALIZED THAT HE
DOESN’T HAVE ANY
DIFFICULTY IN
SLEEPING.
THE PATIENT IS I ASKED SOME
ORIENTED TO PEOPLE, QUESTIONS TO ASSESS
TIME AND PLACE. HE HIM AND HE IS ABLE TO
CAN ALSO RESPONSE ANSWER MY QUESTIONS
VERBALLY AND CORRECTLY.
PHYSICALLY.
THE PATIENT IS ABLE TO THE PATIENT
EXPRESS HIS FEELIGNS VERBALIZED THAT HE
ABOUT HIS CONDITIONS, FEELS GOOD NOW SINCE
HE VERBALIZED THAT HE IS IN THE HOSPITAL
HIS CONDITION IS TO BE BETTER .
BECAUSE OF HIS OWN
DOINGS. HE LOVES
SEEING HIS FAMILY
ESPECIALLY HIS MOM
AND IT CAN HELP HIM
TO CALM HIMSELF
THE PATIENT IS THE THE PATIENT IS TAKEN
YOUNGEST IN THEIR CARE OF BY HIS FAMILY
FAMILY SO HE FEELS ESPECIALLY HIS
THAT THE ATTENTION MOTHER O IS VERY
OF HIS WHOLE FAMILY SUPPORTIVE TO HIM.
IS WITH HIM.
THE PATIENT IS NOT THE PATIENT IS STILL
SEXUALLY ACTIVE NOT SEXUALLY ACTIVE
Coping-Stress Pattern THE PATIENT COPES UP THE PATIENT USES HIS
WITH STRESS BY GOING CELLPHONE AND
OUT ALONE AND WATCHING RANDOM
PLAYING BASKETBALL. VIDEOS. AND IF HE
SOMETIMES HE IS FEELS TIRED. HE WANTS
SPENDING HIS TIME TO SLEEP OR JUST TAKE
WITH HIS FAMILY. A NAP.
Value-Belief Pattern THE PATIENT IS A THE PATIENT ASK GOD
CATHOLIC AND LIKES FOR FORGIVENESS AND
TO PRAY AND GO TO ASK FOR FAST
CHURCH BUT NOT RECOVERY AND GOOD
CONSISTENTLY HEALTH NOT ONLY FOR
HIM BUT FOR HIS
WHOLE FAMILY.

h. Review of the Systems

GENERAL SYSTEM REVIEW

Patients skin is warm, no edema and no

change in color of the skin.
INTEGUMENTARY SYSTEM

Dizzines after the operation, no other

problems as stated by the patient.
NERVOUS SYSTEM

No problems

ENDOCRINE SYSTEM

Patient is not experiencing any shortness of

breath or difficulty in breathing, patient has
RESPIRATORY SYSTEM cough, no wheezing, no sputum production

Patient is not experiencing any chest pain,

irregular heartbeat.
CARDIOVASCULAR SYSTEM

Patient is not experiencing any abdominal

pain, nausea, vomiting, difficulty swallowing
or heartburn.

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 GASTROINTESTINAL SYSTEM

GENITO-URINARY SYSTEM Patient is not feeling any pain while urinating

MUSCULO-SKELETAL SYSTEM
and he doesn’t have any bladder problems.
THERE IS LIMITATION OF
MOVEMENTS IN UPPER EXTREMITIES
DUE TO FRACTURE. NO OTHER pain in
other joint

IV. PHYSICAL ASSESSMENT

AREAS ASSESSED NORMAL FINDINGS ACTUAL FINDINGS ANALYSIS

Vital Signs:
Temperature 36.2 -37.6 ºC (97-99.6 36,7 C Patient`s vital signs are all
ºF) normal

Pulse Rate 60-100 beats/min 71

Respiratory Rate 12-20 full breath/min 22

Blood Pressure 90/60 to 120/80 120/80

General Appearance:
 Body Built Normal Body Types are:  Ectomorph  Patient is 16 yrs old
1. Endomorph (Shorter male and according to
build with thick arms the patient, his diet is
and legs, solid and more on junk foods
generally soft, gains fat
very easily)
2. Mesomorph(Athletic
physique, with large
bone structures and large
muscles)
3. Ectomorph (Light
build with small joints

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 and lean muscles
 Dressing/Grooming/  Patient is
Hygiene -Appropriate Dress and wearing OR  Patient is scheduled for
Well-groomed gown OR that`s why he
changed his clothes to
OR gown. Then wear
the same shirt after his
operation

 Odor  Patient has no

-No Odor foul odor  Patient`s proper
hygiene is taken care of
by her cousin and
mother
 Obvious Physical  Patient cannot
Mobility -Can Perform Physical perform
Activities  Patient has an IV line
physical on his left arm and his
activities right arm is fractured
with sling.

Mental Status:
 Level of -Conscious and oriented  The patient is  Patient is aware and
Consciousness with time, place and communicating conscious, knows what
persons well and is time is it and where he
aware of the is and whom he is with
present
condition.

 Emotional Status -Calm and Cooperative  Patient is very  The patient verbalized
calm and that he is not afraid of
talkative. his incoming operation.

 The patient is  The patient is not

 Language and -Using simple words
communicating feeling any anxiety or
Communication during communication
well and very anything that can make
responsive to him anxious.
my questions.
Skin Color/Condition/Lesions/  No changes in  No abnormal findings
Temperature/Turgor color

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  Skin is warm,
dry and no
edema

Hair -Color/Texture  Normocephalic  No abnormal findings

in shape, can
rotate head left
and right/up
and down
slowly but with
no obvious
difficulty
 Hair color is
black

Eyes -PERRLA/20-20 vision  Patient can

(pupils are equal, round identify colors  According to the
and reactive to light and  Has black color patient, he can see
accomodation of the eyes things clearly.

Nose Symmetric/No  Nose shape is  No abnormal findings.

discharge/No lesions/Air symmetrical
passes freely and without with the shape
difficulty of face
 No lesions

Mouth -Lips:  Patients lips are

Uniform pink color; soft; not dry
moist; smooth texture;
symmetry of contour;
ability to purse lips

-Teeth
32 adult teeth

-Tongue:
 Tongue is pink
Move freely, no  No abnormal findings
in color
tenderness
Smooth tongue with  Teeth are clean
prominent veins  No lesions
In central position, pink

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 color, moist, slightly
rough; thin whitish
coating’ no lesions
Raised papillae(taste
buds)
Neck Symmetrical, no lesions  Neck is  No abnormal findings
and lymph nodes proportion in
size
Nails Nails in pink color, has  Capillary refill  No abnormal findings
the shape of convex is less than 3
curve. When nails seconds
pressed between the
fingers (Blanch Test), the
nails return to usual color
in less than 4 seconds.
Thorax and Lungs Symmetrical  RR 22  No abnormal findings
-Normal Respiratory rate  Patient has no
: 12-18 breaths/min difficulty
-No tenderness, lesions breathing
and retractions on
intercostal spaces
Abdomen -Symmetrical  No distention  No abnormal findings
-No distention and and any
discoloration discoloration
-No masses and  No tenderness
tenderness
-No unusual vibration
upon percussion
-No pain upon palpation
Lower Extremities -Color: Even  Proportional in  No abnormal findings
-Temperature: warm size/No
-Size: equal swelling
Neurological Level of Consciousness  Patient is aware  No abnormal findings
of his present
condition and
can follow
simple
instructions
from the
attending
physician/nurse
.

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VI. DIAGNOSTICS

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VII. CLINICAL DISCUSSION OF THE DISEASE

A fracture of the distal radius occurs when the radius one of the two long bones in the forearm

breaks close to the wrist. Distal radius fractures are very common. In fact, the radius is the most

commonly broken bone in the arm.

There are two long bones that make up the forearm:

 The radius is on the thumb side of the forearm.

 The ulna is on the small finger (pinky) side.

At the proximal forearm, the part of the forearm closest to the elbow, the ulna is larger. At the

distal forearm, the part of the forearm closest to the wrist, the radius is larger.

A distal radius fracture almost always occurs about 1 inch from the end of the bone. This very

common fracture can occur in many different ways to people of all ages. In young people, such

fractures typically occur in high-energy accidents, such as a fall from a ladder or a car crash. In

older people, especially those with osteoporosis, distal radius fractures can occur from a simple

fall onto

Other ways the distal radius can break include:

 Intra-articular fracture — An intra-articular fracture is one that extends into the wrist

joint. ("Articular" means "joint.")

 Extra-articular fracture — A fracture that does not extend into the joint is called an extra-

articular fracture.

 Open fracture — When a fractured bone breaks the skin, it is called an open fracture.

These types of fractures require immediate medical attention because of the risk for

infection.

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  Comminuted fracture — When a bone is broken into more than two pieces, it is called a

comminuted fracture.

It is important to classify the type of fracture because intra-articular fractures, open fractures,

comminuted fractures, and displaced fractures (when the broken pieces of bone do not line up

straight) are more difficult to treat than other types of fractures.

Sometimes, the other bone of the forearm (the ulna) is also broken. This is called a distal ulna

fracture. Depending on the type of distal ulna fracture, you may or may not require additional

treatment. the wrist.

VIII. PATHOPHYSIOLOGY
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19
IX. CONCEPT MAP

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X. DRUG STUDY

CELECOXIB 1 CAP

ACTION
 is a prescription medicine used to treat the symptoms of acute pain or inflammation.
Celebrex may be used alone or with other medications.
Celebrex belongs to a class of drugs called nonsteroidal anti-inflammatory drugs
(NSAIDs)

ADVERSE REACTIONS
 Increased risk of cardiovascular events,
(MI, CVA), serious, potentially lifethreatening GI bleeding.

INTERACTIONS:
 May decrease antihypertensive effect of ACE inhibitors and angiotensin
 II antagonists. Fluconazole may significantly increase concentration. May increase
lithium concentration. Warfarin
 may increase risk of bleeding. Aspirin
 may increase risk of celecoxib-induced
 GI ulceration, other GI complications.

CONTRAINDICATIONS AND CAUTIONS

 May increase cardiovascular risk when high doses given to prevent
colon cancer
 Hypersensitivity to aspirin, NSAIDs, sulfonamides
 History of GI disease (bleeding/ulcers); concurrent use with aspirin, anticoagulants;
smoking, alcohol, elderly, debilitated pts, asthma, renal/hepatic impairment.

NURSING CONSIDERATIONS
ASSESSMENT
 Assess onset, type, location, duration of pain/inflammation. Inspect appearance of
affected joints for immobility, deformity, skin condition. Assess for allergy to sulfa,
aspirin, or NSAIDs (contraindicated).
 Assess for therapeutic response: pain relief; decreased stiffness, swelling; increased joint
mobility; reduced joint tenderness; improved grip strength. Observe for bleeding,
bruising, weight gain

EVALUATION
 If GI upset occurs, take with food.

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  Avoid aspirin, alcohol (increases risk of GI bleeding).
 Immediately report chest pain, jaw pain, sweating, confusion, difficulty speaking, one
sided weakness (may indicate heart attack or stroke)

PATIENT/ FAMILY TEACHING

 If GI upset occurs, take with food.
 Avoid aspirin, alcohol (increases risk of GI bleeding). • Immediately report chest pain,
jaw pain, sweating, confusion, difficulty speaking, one sided weakness (may indicate
heart attack or stroke).

TRAMADOL + PARACETAMOL (DOLCET) 1 TAB

ACTION
 It is used to treat various allergic conditions such as hay fever, conjunctivitis, some skin
reactions such as eczema, hives, and reactions to bites and stings. It also relieves watery
eyes, runny nose, sneezing, and itching.

ADVERSE REACTIONS
 The most frequently reported events were in the central nervous system and
gastrointestinal system.
 The most common reported events were nausea, dizziness and somnolence.

INTERACTIONS:
 Use Tramadol + Paracetamol (Dolcet) with great caution in patients taking serotonergic
drugs including SSRIs. Concomitant use of tramadol with serotonergic drugs including
SSRI's increases the risk of adverse events, including seizure and serotonin syndrome.

CONTRAINDICATIONS AND CAUTIONS

 Tramadol + Paracetamol (Dolcet) is contraindicated: In all children younger than 12
years of age.
 In post-operative management in children younger than 18 years of age following
tonsillectomy and/or adenoidectomy.
 In patients who have previously demonstrated hypersensitivity to tramadol, paracetamol,
any other component of this product or opioids.
 In cases of acute intoxication with alcohol, hypnotics, narcotics, centrally acting
analgesics, opioids or psychotropic drugs
CAUTIONS: Seizures, Anaphylactic Reactions, Respiratory Depression

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NURSING CONSIDERATIONS
ASSESSMENT
 Assess any incoordination or increased muscle tone. Report any coordination problems or
hypertonia that might impair function or increase the risk of falls.
 Assess dizziness that might affect gait, balance, and other functional activities (See
Appendix C). Report balance problems and functional limitations to the physician and
nursing staff, and caution the patient and family/caregivers to guard against falls and
trauma.

EVALUATION
 Be alert for excessive sedation or somnolence. Notify physician or nurse immediately if
patient is unconscious or extremely difficult to arouse.
 Monitor other changes in mood and behavior, including euphoria, confusion, malaise,
nervousness, and anxiety. Notify physician if these changes become problematic.

PATIENT/ FAMILY TEACHING

 Advise patient that centrally acting analgesics are usually more effective if given before
pain becomes severe; emphasize that adequate pain control will allow better participation
in physical therapy.
 Educate patient about the dangers of overdose; encourage patient to adhere to proper
dosing schedule.
 Emphasize that the risk of physical addiction (tolerance and dependence) is usually
minimal during short-term treatment of pain. Advise patient that addiction is more likely
during excessive or inappropriate use of centrally acting analgesics.

CEFUROXIME 1 TAB PO

ACTION
 Cefuroxime is used to treat bacterial infections in many different parts of the body. It
belongs to the class of medicines known as cephalosporin antibiotics. It works by killing
bacteria or preventing their growth.

ADVERSE REACTIONS
 Severe allergic reaction: itching or hives, swelling in your face or throat, chest tightness,
trouble breathing

INTERACTIONS:
 Probenecid may increase concentration. Antacids, H2-receptor antagonists (e.g,
cimetidine, famotidine) may decrease absorption.
HERBAL: None significant.

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 FOOD: None known.
LAB VALUES: May increase serum BUN, creatinine, alkaline phosphatase, bilirubin,
LDH, ALT, AST. May cause positive direct/indirect Coombs’ test.

CONTRAINDICATIONS AND CAUTIONS

 History of hypersensitivity/anaphylactic reaction to cephalosporins.
 Severe renal impairment, history of penicillin allergy

NURSING CONSIDERATIONS
ASSESSMENT
 Obtain CBC, renal function tests. Question for history of allergies, particularly
cephalosporins, penicillins.
 Assess oral cavity for white patches on mucous membranes, tongue (thrush).
 Monitor daily pattern of bowel activity, stool consistency.
 Mild GI effects may be tolerable (increasing severity may indicate onset of antibiotic-
associated coli tis). Monitor I&O, renal function tests for nephrotoxicity, CBC. Be alert
for superinfection: fever, vomiting, diarrhea, anal/ genital pruritus, oral mucosal changes
(ulceration, pain, erythema).

EVALUATION
 Watch for seizures; notify physician immediately if patient develops or increases seizure
activity.
 Monitor signs of allergic reactions and anaphylaxis, including pulmonary symptoms
(tightness in the throat and chest, wheezing, cough dyspnea) or skin reactions (rash,
pruritus, urticaria). Notify physician or nursing staff immediately if these reactions occur.

PATIENT/ FAMILY TEACHING

 Discomfort may occur with IM injection. • Doses should be evenly spaced.
 Continue antibiotic therapy for full length of treatment.

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XI. DISCHARGE PLANNING

MEDICATION


Take the medication as prescribed. Use the least amount of narcotic pain medication
as possible
 If you are taking narcotic pain medication (Percocet or Vicodin), you may need a
stool softener to prevent constipation. Over-the-counter medication such as
Docusate or Milk of Magnesia is recommended.
EXERCISE

 No lifting, exercise, or weight bearing of the affected extremity.

 Keep the affected extremity elevated when at rest above the level of your heart. This
will help reduce swelling significantly.
 Please use your hand and wrist to perform light daily activities.
 Move your fingers throughout the day to help prevent stiffness. Try to completely
bend and straighten your fingers five to six times a day.

TREATMENT


Keep cast or splint clean and dry. Do not remove or get wet.

Swelling and bruising in the fingertips and forearm is considered normal.

To help with swelling and pain, elevate the affected extremity above the level of your
heart. Apply ice to the splint/cast for 20 minutes on and 20 minutes off.
HEALTH TEACHING

 Move your fingers throughout the day to help prevent stiffness. Try to completely
bend and straighten your fingers five to six times a day.
 Advise patient to increase adequate fluid intake for hydration purposes
 Discourage patient to participate in strenuous activities that might precipitate stress
and trauma to the wound.
 Advice patient to avoid touching the operative wound with hands dirty that may
cause infection.

OPD

 Make a follow-up appointment as advised by your healthcare provider..

DIET

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  Encourage patient to eat foods that lower inflammation (fruits, vegetables, and whole
grains etc.)
 Encourage patient to eat foods with high-quality protein foods (eggs, fish, and Low-fat
cheese etch.).
 Encourage patient to drink lots of water.
 Encourage patient to consume more calcium and Vit D to strengthens bones..

SPIRITUAL

 Encourage patient to put God the center of their lives and always ask for forgiveness
and guidance.
 Encourage patient to talk to God to give them strength and knowledge.
 Encourage patient to have faith and do not lose hope.

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