Saint Paul University Dumaguete College of Nursing: Dumaguete City 2 Semester, Academic Year 2022-2023

SAINT PAUL UNIVERSITY DUMAGUETE
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
Academic Year 2022-2023
DOCUMENTATION
FIRST ROTATION- SECTION 3 - E
DISCLAIMER: This document is a strictly confidential

communication to and solely for the purpose of making and
creating a case study (under Mr Villo) only. The goal of this
assignment is for the students to come up with output based on
the individual case of the patient, with this, do not reproduce
or share with others for the purpose of keeping the patient's
name to be safe and private.
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COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
IN PARTIAL FULFILLMENT OF THE REQUIREMENT IN

NCM 116 MEDICAL SURGICAL NURSING(RELATED LEARNING EXPERIECNCE) -
SURGICAL WARD
A case study on Fracture closed, complete, displaced, middle 3rd

Radio-Ulna
Submitted to:
Mr. Miller Villo, RN.
Submitted by:
Crystal Fate Valdez
Date:
May 10,2023
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COLLEGE OF NURSING
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2nd Semester,
TABLE OF CONTENTS
Acknoweldgement.................................................4
Abstract........................................................5
CHAPTER I CASE OVERVIEW

Introduction...............................................6-7
Objectives.................................................8-9
Scope and Limitation.......................................10
CHAPTER II CASE DATA AND INFORMATION
Biographical Data..........................................11
Health History.............................................11
Chief Complaint............................................12
History of present Illness.................................12
Past Health History........................................12
Family History.............................................12
Functional Health Patterns.................................14-18
General Condition..........................................19
Physical Assessment........................................19-22
Laboratory Examination.....................................23-24
CHAPTER III LITERATURE REVIEW
Normal Anatomy and Physiology..............................25-33
Theoretical Background.....................................34
CHAPTER IV CASE ANALYSIS AND INTERVENTIONS
Pathophysiology............................................35
Medical Management.........................................36
Pharmacological Management.................................37
Nursing Care Management....................................38-45
Discharge Plan.............................................48-50
CHAPTER V CONCLUSIONS AND RECOMMENDATIONS
Conclusion.................................................51
Recommendation.............................................51-52
References...................................................… 52
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2nd Semester,
Acknowledgement
First, I would like to thank our Almighty God for keeping us

safe, for the strength He has bestowed upon us and for lighting
the path of every endeavour we have encountered.
Secondly, to our clinical instructor for the Surgical ward,

Mr. Miller Villo, RN for the never-ending support and guidance
during our clinical duty. Thank you for sharing your expertise
with us and for honing our characters in becoming one with the
Paulinian registered nurses in the future.
To my family, I am very grateful for providing me with my

needs during the clinical duty and for the unending love and
financial support.
To St Paul University Dumaguete- College of Nursing, I would

like to express my overwhelming gratitude for molding me as a
student nurse with respect and putting a heart in every work I’m
working.
Finally, to Negros Oriental Provincial Hospital, I would

like to express my gratitude for opening your door to us
practitioner to mold us to become what we really want in the
future. Also, for letting us used your facilities to let us
experience what a clinical real scenario looks like.
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ABSTRACT
This Case study emphasis on a bone fracture, close, complete

displacement in the middle 3rd radio-ulna on the right upper
extremities to a eleven years old child who was brought by the
significant other with a complaint of swelling on his throw out
his right arm to catch himself. Prior to admission, the patient a
eleven years old child was playing basketball with his friend
when suddenly stumbled and right arm, the patient’s forearm
swell and experiencing severe pain in the affected area the
reason why his parents got alarmed and brought him to Negros
Oriental Provincial Hospital. X ray were done to the patient and
it shows that there is a bone deformities on his middle 3rd
radio-ulna on the right, a couple of intervention were also given
during the assessment. Some important data were taken which
includes the patient’s health history, functional health pattern
and general condition. Head to toe assessment and laboratory
examination (hematology) were also taken. The patient was being
diagnose with fracture close, complete displaced, middle 3rd
Radio-Ulna on the right upper extremities. The patient was give
several intervention and medication which include PLR 1L at
70cc/hr inserted at the Left metacarpal vein. There is no
specific diet was given to patient but the patient was undergone
NPO(nothing by mouth) for 8 hours in preparation for his surgery
closed reduction with a long circular cast. Patient was
awake ,alert and responsive during the interview on our first
encounter, physical assessment was taken on the second day and
the patient let me touch and assessed him with ease.
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2nd Semester,
CHAPTER I
CASE OVERVIEW
Introduction
Bone fracture are classified in several ways. The most

commonly used classification involves the severity of the injury
to the soft tissues surrounding the bone. An open fracture
occurs when an open wound extends to the site of the fracture or
when a fragment of bone protrudes through the skin. If the skin
is not perforated,the fracture is called a closed fracture. If
the soft tissues around a closed fracture are damaged, it is
called a Complicated fracture.(VanPutte, C. L., Regan, J. L., &
Russo, A. F. (2022). Seeley's Essentials of Anatomy & Physiology.
McGraw-Hill. )
According to Bittany Mikuluk, M.Ed., CCLS a pediatrician

expert, fracture rate peak from 11-15 years of age, the time when
children have pubertal growth spunt and the amount of mineral
needed to keep bones strong often can’t keep up with how fast the
bones are are growing. Forearm fracture are the most common
fractures in children, responsible for up to 50 percent of all
fracture and much more common than leg fracture. This is because
it is a common reflex to throw out your arms to catch yourself
when you fall.
There is usually no cause for concern in a vast majorities

of childhood fracture as they heal quickly after a cast. Some
fractures may need to be fixed by an orthopedic specialist to
improve the alignment of the bones. However, children who
experience certain type of fractures, particularly those
seemingly mild injuries, or have multiple fractures , may need to
be evaluated by a pediatric metabolic bone specialist.
Patient J.B., a 11 years old child from Abis, Mabinay Negros

Oriental was brought by the significant other to Negros Oriental
Provincial Hospital with a complaint of swelling and severe pain
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DUMAGUETE CITY
2nd Semester,
on his right forearm. Prior to admission, the patient was playing
basketball when he suddenly stumbled and catch himself using his
right arm.
I was tasked to make a clinical paper about bone fracture,

closed complete displacement,I find it interesting at the same
time implementing awareness especially for young children who are
known to be energetic and active.
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OBJECTIVES
General Aim of this Study:
The researcher aim to formulate a comprehensive case analysis

that would provide essential knowledge in delivering quality
health care for patients with bone fracture.
SPECIFIC LEARNING OBJECTIVES:
Knowledge
To formulate a comprehensive study on the patient’s current

health status.
To present interpretation of the laboratory exams.
Come up with three (3) Prioritized Nursing Care Plan based on the
subjective and objective data manifested by the patient.
To create Specific, Measurable, Attainable, Realistic, and Time-

bound plan of care designed for patient.
Skills:
To implement thoroughly Nursing Care Plan.
To gather pertinent data regarding the health background of the

patient including the past and present health history.
To attend the general and specific needs of the patient.
To conduct a thorough Physical Assessment of the client’s

condition in a daily basis in order to see progress or changes
towards patient’s health.
Prepare an adequate Discharge Summary and Plan.
Attitude:
To express genuine compassionate care for the patient’s overall

welfare.
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To value time and efforts exhibited, as well as the learning
gained from the duration of clinical duty up to the making and
processing of clinical paper.
To initiate conversation following the several techniques used in

therapeutic communication.
Ensure and facilitate maintenance in regards with patient’s

privacy and confidentiality.
Communicate accurately and completely as well as document

patient’s responses to prescribed medications, treatments, and
procedures to other health care professionals clearly and in
timely manner.
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Scope and Limitations
Scope
Student nurses Focusing on Obtaining data form a patient that was

admitted last March 07, 2023 at Negros Oriental Provincial Hospital,
4th Floor South Wing, Room 223, under the supervision of Dr. Chloe
Marie Samarita. The information gathered was given 30% father,30 %
mother, 20% patient’s chart, 10% patient and 10% uncle.
The receive patient handled during clinical exposure. The

interventions done include obtaining patient’s health history,
functional health patterns, general condition and head-to-toe
assessment. To completely understand patient’s condition, laboratory
examination like CBC , the anatomy and physiology, the pathophysiology
of bone fracture were conducted. During admission, the patient is
given medical, nursing, and pharmacologic management, as well as the
discharge plan.
Limitation
The possible problems that the researchers could encounter while

obtaining this case study would be (1) The student nurses are nit
present during the admission and any prior treatment are not observed
by the student. (2) Young patient are sometimes may not be able
cooperate and not able to understand what were you saying and lastly,
because of time constraints, the student is not able to take care and
monitor patient from time to time.
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2nd Semester,
CHAPTER II
CASE DATA AND INFORMATION
Patient’s Biographical Data
A. Child’s Name: J.J.B
B. Parent’s Name: Rosemalyn J. Baldado (mother)
Junard B. Baldado (father)
C. Address: Abis, Mabinay, Negros Oriental
D. Contact Number: None
E. Age of Children: 11 Years Old
F. Sex: Male
G. Culture: Asian
H. Ethnicity: Filipino
I. Date of Birth: September 14, 2011
J. Place of Birth: Abis, Mabinay, Negros Oriental
K. Religion: March of Faith
L. Medical Diagnosis: Fracture, complete, displaced, Middle 3rd Radio-

Ulna Right.
M. Physician: Dr. Chloe Marie Samarita
N. Source of Referral: O. Source of Information: 30% father,30 %

mother, 20% patient’s chart, 10% patient and 10% uncle
Date of Admission: March 07 , 2023
Health History
Chief Complaint
“ gadula siya dayon na dugmo nauna iya too nga kamot” as

verbalized by the s/o.
Interpretation:
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As Verbalized by the significant other, the patient is
playing when suddenly stumbled and landed his right arm first.
History of Present Illness
Prior to admission, The patient is playing basketball when

he suddenly stumbled and uses the right arm to catch himself, the
patient arm swell and experiencing severe pain with a pain scale
of 9 out of 10 then his father brought him to Negros Oriental
Provincial Hospital.
Past Health History
Upon assessment, the patient has no past illnesses, no past

hospitalizations, this is his first time being hospitalized and
has no allergies, as verbalized by the S/O. Patient had complete
immunization but was not able to recall the age it was administer
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Immunization
The following table illustrates all the immunizations the patient

was given from birth up to current age.
The patient had completed her immunization from birth up to

current age and had no allergic reactions or complications and
has no previous history of hospitalizations. This is her first
time being hospitalized. However, S/O was unable to recall the
age when the immunization was administered
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Genenogram
Interpretation
On the paternal side, the grand mother 61 years old is already

deceased and the cause of death is peptic ulcer disease.On the other
hand,the grandfather was still alive. On the maternal side, both
grandparent is still alive without any common family disease.
The etiology of all of this is unknown and the family genogram has no
relationship with the condition of the patient. however this may be
caused by a lack of supervision by the parents during the said
basketball game resulting to an accident.
Functional Health Patterns
Functional Prior to Admission During

Hospitalization
Health pattern
Health perception- The patient is Upon entering the

Health Management active, energetic room, the patient is
Pattern and playful. He alert and responsive
loves playing with when ever he was
his friend and love ask. He feel pain on
to play basketball. arm but able to move
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As stated by the it slowly.
S/O, the patient
didn’t experience
any cough, fever and
don’t have any
travel history
outside the country.
Also,the child live
in Abis, Mabinay,
negros Oriental
wherein he live with
full of trees and
plants.
Nutritional and As stated by the The patient is on

metabolic pattern. father, the usual NPO diet in his
meal that his wife preparation for his
prepared for them surgery.
are composed of
rice, vegetables,
fish and sometime
chicken and pork.
The patient usual
snack are sometime
biscuits and junk
food during his
recess at school. He
consume 8 glasses
per day including
juice and milk. The
patient didn't take
any vitamins as well
as any medication.
Elimination Pattern Prior to admission, During admission,

the patient stated the patient stated
that he defecate that he wasnt
twice everyday, defecate since the
usually at morning admission but he
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and evening. The able to urinate
usual color of his everyday with a
stool is brown and measurement of 250
without any usual ml.
odor. The also
stated that he
urinate 4 times a
day, the color of
his urine is yellow
without any unusual
odor.
Sleep-Rest Pattern Prior to admission, During the

as stated by the admission, the
father the patient patient usually
sleeps at 10*clock sleep whenever he
in the evening and feels bored, he also
usually woke up 5 o stated he usually
clock in the morning woke up due to the
this consume 7 hours pain experience on
a day. The patient his left arm.
sleep together with
siblings. The
patient dont have
any sleep
disturbances.
Activity- Exercise Prior to admission, During admission,

Pattern the patient usually the patient is at
plays basketball rest and sometime
with his friends. Hi sit down. He able go
is a grade 5 student to the restroom
and go to school at without any
7 am and go home at assistance. He is
5 pm. Whenever his hesitate to go home
at school and have because he feels
free time, he bored and hangout
usually plays with
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his classmate and with his friends.
usual roams around.
Cognitive - the patient dont The patient is still

perception pattern have any hearing a dont have any
and visual hearing and visual
difficulties during difficulties upon
physical assessment. assessment. The
The patient can able patient also alert
to response, recall and coherent
and answer when
being asked
Self Perception- As stated by the During admission,

Self-concept father, the patient the patient is
is playful, friendly talkative and
and always making friendly. He usually
jokes at home. He minggle whenever he
doensnt like to be ask and sometime
interupted whenever jokes.
he is watching
movies and playing
with his friends.
Role Relationship In the house, the The patient is being

Pattern patient is having a accompanied by his
Nuclear family that father, since his
only composes of his mother is at home
mother, father and taking care of his 7
children. The years old child. The
patient has a 3 patient is at sleep
siblings and he is and and sometimes
the second among the uses phone from his
three. He usually uncle to watch
plays around with 7 movies
years old child. His
mother usually the
one who prepares the
meal and prepares
them to go to
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school.
Sexuality- None because the None because the

reproductive Pattern child has not child has not
reached the reached the
pubescent stage pubescent stage
Coping Stress The patient stated the patient stated

Tolerance that whenever he was that, whenever his
being scolded by his bored, we will watch
parents he would movies and sometime
like hang out with sleep.
his friend and play
game or basketball.
Value-belief Pattern Patient’s religion At the time of

is roman catholic. hospitalization,
Before patient wasn’t able
hospitalization, to attend masses but
they always attend continued religious
mass every Sunday. practices in the
They eat meals hospital such as
together and does prayers before meals
not forget to pray and bedtime.
before eating.
Physical assessment
Vital signs:
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On March march 8, 2023, the patient’s vital signs are: T: 36.2
degree celcius, RR: 18 cycle per minute, P: 83 beat per minute, BP:
110/90 mmhg, 02 stat: 97%
On march 9, 2023, the patient’s vital sign are : T:36.8 degree

celcius RR: 17 cycle per minute P: BP:110/70 mmhg , 02 stat:97%
On March 10,2013, the patient’s vital sign are : T:36.5 degree

celcius RR:17 cycleper minute P: BP:110/70 mmhg, 02 stat:98%
General Condition
Upon entering the room, the child is alert, responds

appropriately to stress of the situation, he able to maintain eye
contact. The child is appropriately interactive for age, that usually
seek comfort from his parents, appear to be happy and partially
anxious because of some examination. The child is attentive and the
way he speech is appropriate to his age. The patient is also can stand
with ease and able to move his fractured arm slowly but experiencing
pain with a pain scale of 7 out of 10.
Mental status
The patient is sometimes sleep whenever he feel bored. Appears to

be happy and partially anxious because of some examination. He able to
recognize nurses and family members.
REVIEW OF SYSTEMS
Integumentary system
Skin- skin color is light brown; no signs of hyperpigmentation or

hypo pigmentation. There is no lesion but there is scar on his left
knee due to a stumble as stated by the s/o. no edema present and skin
turgor is prompt within 2 second. Skin appears to be dry.
Hair- hair color is black it appears to oily. No infestation noted

and hair is evenly distributed.
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Nails- nail bed appears pink, capillary refill is within 2 second.
Nails are catted.
Head and face:
Head is normocephalic and symmetric, head can do full ROM from

left to right and up to down. The face of the patient is proportionate
and symmetrical.
EYES
Eyelids close completely. No lesions or redness present on both

eyes. Conjunctiva moist and pink. Sclera is color white. Iris color
brown. No purulent or clear discharges noted.
Ears
The top pinna is in line with the cantus of both eye. No excessive
cerumen, discharge, lesions, excortiation or foreign body seen in the
external canal. The patient also, hears clearly whenever I ask a
questions.
Nose and sinuses
Nose in midline in face, septum is straight and nares are

patent. No discharge or tenderness is present. No tenderness palpate
in the sinuses of the patient.
Mouth and throat (examine last in young children)
lips, tongue and buccal mucosa appears pink and moist. There is
no lesion present. Gingiva is red in color; moist. No swollen and/or
bleeding gingiva noted. Tongue normal in appearance without lesions
and with good symmetrical movement. Has 20 erupted pearly-white teeth.
Teeth are aligned.
Neck
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Small lymph nodes can be palpated and no tenderness and no swelling
are noted. Upon palpating submaxillary, sublingual, and parotid glands
are non-palpable, not swelling, and no tenderness noted and no
presence of masses.
Respiratory
The chest wall is symmetric and without deformity. No signs of trauma.

Chest wall is non-tender. No signs of respiratory distress.
Inspirations are shallow, effortless, and regular. No presence of
nasal flaring during inspiration. Lung sounds are clear in all lobes
bilaterally without rales, ronchi, or wheezes. Normal respiratory
movement and fremitus. Resonance is normal upon percussion of all lung
fields. No adventitious sounds auscultated.
Cardiovascular
The external chest is normal in appearance without lifts, heaves, or

thrills. No heaves noted and pulse rate is 84 bpm. Presence of
bilateral symmetry is noted. Amplitude is grade 2 (normal, detected
easily, and obliterated by strong force). Heart rate and rhythm are
normal. No murmurs, gallops, or rubs are auscultated. S1 and S2 are
heard and are of normal intensity.
Breast
-Upon inspection, breasts are flat and symmetrical. No tenderness, no

discharges, no lesions, and no masses noted.
Gastrointestinal
abdomen is globular in shape. Symmetrical rise and fall of the abdomen

noted upon respirations. No lesions or redness noted. Bowel sounds
present. No bulges or masses present. No tenderness noted upon
palpation. Umbilicus is free of any purulent or bloody discharges.
Bruits not noted upon auscultation.
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Genitourinary (MALE)
The patient don’t have any dwelling catheter inserted. As stated by

the s/o the patient was uncircumcised and without any difficulty
urinating.
Musculoskeletal
The patient right forearm has deformities and being scheduled for long
circular cast, there is swelling around the affected area. The patient
can move it slowly but experiencing pain with a pain scale of 8 out of
10.
Feet and legs are symmetric in term of size, shape, movement and
positioning. Both extremities are warm to touch.he patient can stand
with ease, sits in upright position and able to run.
Neurologic
The patient can stand straight and able to stand with one foot.
Whenever I touch his hand and back he able to recognize it.
Diagnostic Imaging
X ray-
Definition: Determines location and extent of fractures/trauma, may

reveal preexisting and yet undiagnosed fracture(s).
Result
Result show that there is a bone deformities on the right

forearm.
Laboratory Examinations
HEMATOLOGY
This perform a suites of tests including Complete Blood count, blood

differential, smear morphology and bone marrow staining. This test can
evaluate the overall health and detect variety of diseases conditions
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such as anemia, certain cancers of the blood, inflammatory diseases,
certain bleeding and clotting disorder.
Complete Blood Count:
Component NORMAL VALUES RESULT REMARKS
Hemoglobin 12.4-15.7 g/dL 12.9 d/dl Normal
(Male)
Hematocrit 35-43% (Male) 37.8 % Normal
WBC count 3.8-10.4 x 8.2 X 10(9)/L Normal

10(9)/L
Red Blood Cell:
MCV 79.1 Normal
MCH 27.0 Normal
MCHC 34.1 Normal
Protime:
Bleeding Time 1-4 min 1-3 min Normal
Clotting Time 3-5 min 3-5 min Normal
Differential Count
Neutrophils 1.40-6.10 x 68 Normal

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10(9)/L
Lymphocyte 26 25-57 Normal
monocyte 5 Normal
eosinophil 1 Normal
Platelet 177-381 x 150,000 - 45000 Normal

10(9)/L
RBC count 4.7% 3.8-5.2% Normal
Interpretation:
The test results show that all result appears within normal range.
This means that there is no other underlying disease that may
alter to his condition.
CHAPTER III
LITERATURE REVIEW
Normal Anatomy and Physiology
The Hematologic System
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The hematologic system is made up of the Blood, the Spleen, Bone
Marrow, and the Liver. This is the principal system by which
nutrients, elements, and more are carried to tissues.
Blood
Blood is made up of liquid (plasma) and solid cells. Blood cells

are made in the bone marrow. Bone marrow is the soft, spongy substance
in the center of bones.
All of our blood cells develop from stem cells. The process
of blood cell development is called hematopoiesis. In the earliest
stage of blood cell development, stem cells begin to develop either
along the lymphoid cell line or the myeloid cell line. In both cell
lines, the stem cells become blasts, which are still immature cells.
Lymphoid Cell Line
Lymphoid stem cells develop into lymphocytes (lymphoblasts).

Lymphocytes are another type of white blood cell (leukocytes).
Lymphocytes help fight infection and destroy abnormal cells.
Myeloid Cell Line
Myeloid stem cells develop into red blood cells, platelets and
some types of white blood cells. Red blood cells carry oxygen to all
tissues of the body. Platelets form clots in damage blood vessels to
stop bleeding. Myeloid stem cells develop into 2 different types of
white blood cells, called granulocytes and monocytes. These white
blood cells destroy bacteria and other foreign invaders and help to
fight infection.
The main function of blood is to carry nutrients, gases, waste

products, cells and hormones and each type of blood cell has a
specific job.
Red Blood Cells carry oxygen from the lungs to the rest of the body.
They also carry carbon dioxide from the body to the lungs so it be
breathed out.
Platelets form blood clots in damaged vessels to stop bleeding.
White blood cells help prevent and fight infection by destroying

bacteria, viruses and other foreign cells or substances.
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Bone Marrow
The bone marrow is the spongy tissue inside some of the bones,
such as in hip and thigh bones. It contains stem cells in which it can
develop into the red blood cells that carry oxygen through the body,
the white blood cells that fight infections, and the platelets that
help in blood clotting.
Bone marrow manufactures bone marrow stem cells and other substances,
which in turn produce blood cells. Each type of blood cell made by the
bone marrow has an important job. The red blood cells carry oxygen to
the tissues in the body
Musculoskeletal System
The musculoskeletal system (locomotor system) is a human body

system that provides our body with movement, stability, shape, and
support. It is subdivided into two broad systems:
Muscular system, which includes all types of muscles in

the body. Skeletal muscles, in particular, are the ones
that act on the body joints to produce movements.
Besides muscles, the muscular system contains the
tendons which attach the muscles to the bones.
Skeletal system, whose main component is the bone. Bones

articulate with each other and form the joints, providing
our bodies with a hard-core, yet mobile, skeleton. The
integrity and function of the bones and joints is
supported by the accessory structures of the skeletal
system; articular cartilage, ligaments, and bursae.
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Besides its main function to provide the body with stability and

mobility, the musculoskeletal system has many other functions; the
skeletal part plays an important role in other homeostatic functions
such as storage of minerals (e.g., calcium) and hematopoiesis, while
the muscular system stores the majority of the body's carbohydrates in
the form of glycogen
Muscular system
The muscular system is an organ system composed of specialized

contractile tissue called the muscle tissue. There are three types of
muscle tissue, based on which all the muscles are classified into
three groups:
Cardiac muscle, which forms the muscular layer of

the heart (myocardium)
Smooth muscle, which comprises the walls of blood vessels and hollow
organs
Skeletal muscle, which attaches to the bones and provides voluntary

movement.
Based on their histological appearance, these types are classified

into striated and non-striated muscles; with the skeletal and cardiac
muscles being grouped as striated, while the smooth muscle is non-
striated. The skeletal muscles are the only ones that we can control
by the power of our will, as they are innervated by the somatic part
of the nervous system. In contrast to this, the cardiac and smooth
muscles are innervated by the autonomic nervous system, thus being
controlled involuntarily by the autonomic centers in our brain.
Skeletal System
The skeletal muscles are the main functional units of the muscular
system. There are more than 600 muscles in the human body. They vary
greatly in shape in size, with the smallest one being the stapedius
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muscle in the inner ear, and the largest one being the quadriceps
femoris muscle in the thigh.
The skeletal muscles of the human body are organized into four groups
for every region of the body:
Muscles of the head and neck, which include the muscles of the facial
expression, muscles of mastication, muscles of the orbit, muscles of
the tongue, muscles of the pharynx, muscles of the larynx, and muscles
of the neck
Muscles of the trunk, which include the muscles of the back, anterior

and lateral abdominal muscles, and muscles of the pelvic floor
Muscles of the upper limbs, which include muscles of the

shoulder, muscles of the arm, muscles of the forearm and muscles of
the hand
Muscles of the lower limbs, which include hip and thigh muscles, leg

muscles and foot muscles
Structurally, the skeletal muscles are composed of the skeletal muscle

cells which are called the myocytes (muscle fibres, or myofibrils).
Muscle fibers are specialized cells whose main feature is the ability
to contract. They are elongated, cylindrical, multinucleated cells
bounded by a cell membrane called sarcolemma. The cytoplasm of
skeletal muscle fibers (sarcoplasm), contains contractile proteins
called actin and myosin. These proteins are arranged into patterns,
forming the units of contractile micro-apparatus called sarcomeres.
Each muscle fiber is enclosed with a loose connective tissue sheath

called endomysium. Multiple muscle fibers are grouped into muscle
fascicles or muscle bundles, which are encompassed by their own
connective tissue sheath called the perimysium. Ultimately, a group of
muscle fascicles comprises a whole muscle belly which is externally
enclosed by another connective tissue layer called the epimysium. This
layer is continuous with yet another layer of connective tissue called
the deep fascia of skeletal muscle, that separates the muscles from
other tissues and organs.
This structure gives the skeletal muscle tissue four main

physiological properties:
28
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
Excitability - the ability to detect the neural stimuli (action
potential);
Contractibility - the ability to contract in response to a neural

stimulus;
Extensibility - the ability of a muscle to be stretched without

tearing;
Elasticity - the ability to return to its normal shape after being

extended.
Muscle contraction
The most important property of skeletal muscles is its ability

to contract. Muscle contraction occurs as a result of the interaction
of myofibrils inside the muscle cells. This process either shortens
the muscle or increases its tension, generating a force that either
facilitates or slows down a movement.
There are two types of muscle contraction; isometric and isotonic. A

muscle contraction is deemed as isometric if the length of the muscle
does not change during the contraction, and isotonic if the tension
remains unchanged while the length of the muscle changes. There are
two types of isotonic contractions:
Concentric contraction, in which the muscle shortens due to generating

enough force to overcome the imposed resistance. This type of
contraction serves to facilitate any noticeable movement (e.g. lifting
a barbell or walking on an incline).
Eccentric contraction, in which the muscle stretches due to the

resistance being greater than the force the muscle generates. During
an eccentric contraction, the muscle maintains high tension. This type
of contraction usually serves to slow down a movement (e.g. lowering a
barbell or walking downhill).
29
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
The sequence of events that results in the contraction of a muscle

cell begins as the nervous system generates a signal called the action
potential. This signal travels through motor neurons to reach
the neuromuscular junction, the site of contact between the motor nerve
and the muscle. A group of muscle cells innervated by the branches of
a single motor nerve is called the motor unit.
The incoming action potential from the motor nerve initiates the
release of acetylcholine (ACh) from the nerve into the synaptic cleft,
which is the space between the nerve ending and the sarcolemma. The
ACh binds to the receptors on the sarcolemma and triggers a chemical
reaction in the muscle cell. This involves the release of calcium ions
from the sarcoplasmic reticulum, which in turn causes a rearrangement
of contractile proteins within the muscle cell. The main proteins
involved are actin and myosin, which in the presence of ATP, slide
over each other and pull on the ends of each muscle cell together,
causing a contraction. As the nerve signal diminishes,
The main function of the muscular system is to produce movement of the

body. Depending on the axis and plane, there are several different
types of movements that can be performed by the musculoskeletal
system. Some of the most important ones include:
30
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
Flexion and extension: movement of decreasing or increasing the angle

between the bones involved in the movement, respectively. This motion
takes place in the sagittal plane around a frontal axis. An example of
flexion is bending the leg at the knee joint, whereas extension would
be straightening knee from a flexed position.
Adduction and abduction: movements of bringing the parts of the body

towards or away from the midline, respectively. These movements are
carried out in the frontal plane around a sagittal axis. For example,
abduction of the arm at the shoulder joint involves moving the arm away
from the side of the body, while adduction involves bringing it back
towards the body.
Rotation is the movement in which a part of the body rotates around

its vertical (longitudinal) axis in the transverse plane. This
movement is defined relative to the midline, where internal
rotation involves rotating the segment towards to the midline,
while external rotation involves moving it away from the midline.
Examples include lateral or medial rotation of the thigh.
Supination and pronation are special types of rotatory movements

usually used to describe the movements of the forearm. Supination is
essentially a lateral rotation of the forearm which turns the palms
anteriorly (if the arm is anatomical position) or superiorly, when the
elbow is flexed. These movements are also sometimes used to describe
movements in the ankle and foot, in which supination means rolling the
foot outwards, while pronation means rolling the foot inwards. the
chemical process reverses and the muscle relaxes.
Types of bones
Bones can be classified according to their shapes as follows:
Long bones have a tubular shape, with a longer longitudinal and a

shorter transverse diameter. They are composed mostly of compact bone,
while the spongy bone and bony marrow fill the ends of the bones.
Examples of long bones include the humerus, ulna, tibia and clavicle.
31
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
Short bones have a roughly cuboid or round shape, and only contain a
thin layer of compact bone surrounding the spongy bone. Examples
include the tarsal and carpal bones.
Flat bones are mostly thin, flattened and usually curved. They contain
two parallel layers of compact bones surrounding a layer of spongy
bone. Examples include most of the skull
bones, scapula, sternum and sacrum.
Sesamoid bones are small, rounded unique types of bones that are

embedded in muscle tendons where the tendon passes over a joint. The
largest sesamoid bone in the body is the patella, but several other
smaller sesamoid bones can be found in the hand and foot, usually in
close proximity to the joints.
Irregular bones do not fit into any of the other categories.

Generally, irregular bones contain foramina through which soft tissue
and neurovascular structures pass. Examples include the vertebrae, hip
bone and some bones of the skull.
Functions of the skeletal system
The skeletal system serves a variety of functions. The bones give the
shape to the body and provide the site of attachment to muscles,
tendons, ligaments and cartilage. These tissues function together as a
whole to generate a force that provides the biomechanical basis of
movement.
Due to its structural integrity, the skeletal system protects the

internal organs, most importantly the brain, which is surrounded by
the skull, as well as the heart and lungs, which are protected by the
rib cage.
Moreover, the skeletal system serves several metabolic functions. The

bones are the storage site of important minerals, most notably calcium
and phosphorus. This makes the bones essential for balancing calcium
levels in the blood, which is regulated by adjusting the rate of bone
resorption.
Lastly, the bone marrow found in spongy bone is the site

of hematopoiesis, which is a process of production of new blood cells.
Cells that are produced in the bone marrow are red blood cells,
32
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
platelets and white blood cells, such as monocytes, granulocytes
and lymphocytes.
Theoretical Background
Fracture is a partial or complete break in the bones. When a

fracture happens, it is classified as either open or close fracture.
Open fracture is a bone that pokes through the skin and can be seen,
or deep wound exposes the bone through he skin. In the other hand
close fracture is a broken bone but the skin is intact.
33
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
Forearm fractures are a group of fractures that occur in the forearm
following trauma. The radius and ulna are bound together at the
proximal and distal radio-ulnar joints and act as a ring. Like
elsewhere in the body, it is difficult to only fracture one bone if
there is a bony ring. If the radius or ulna is fractured, it is likely
there is another fracture or one of the radio-ulnar joints has been
damaged.
Ulnar and radial shaft fracture frequently result from direct

trauma to the radius or ulna.
CHAPTER IV
CASE ANALYSIS AND INTERVENTIONS
Pathophyisology:
34
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
Medical Management ORDERED BY DOCTOR:-BASED ON PATIENT’S CONDITION
PLR @70cc/hr inserted @Left metacarpal vein
Definition:
35
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
- sodium lactate solution is mixture of sodium chloride, sodium
lactate, potassium chloride and calcium chloride in the water.
Nursing responsibilities:
1. To observe patient for at least 30 minutes after installation

procedure. Be available for complaints and to check vital sign,
temperature, pulse rate, BP.
2. Suspecte accidental interaperitoneal , intravascular, or

myometrial injection. If the patient begins vomiting .
cardiovascular collapse, seizures , and death may follow.
3. Iv monitoring every hour to check the measurement of the IV

level to ensure accurate delivery of medication and reduce drug
dosing errors.
Close reduction
Definition:
- closed reduction is procedure to set (reduce) a broken bone without

cutting the skin open.
Nursing responsibilities:
1. Maintain bed rest as indicated.
Rationale: provide stability, reducing the possibility of disturbing

alignment and muscle spasm which enhance healing.
2. support fracture site with pillow or folded blankets. Maintaining a

neutral position of the affected part with splints
Rationale: Prevent unnecessary movement and disruption of alignment.

Proper placement of pillow also can prevent pressure deformities in
the drying cast.
Pharmacologic Management [Alphabetical Arrangement]
Drug Studies
Generic Name: Ketorolac
Brand Name: Toradol, Acular, Acular LS

36
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
Drug Classification: Pain Reliever
Indication: Short-term Management of pain
Dosage: 15 mg IVTT/min every 8 hrs as needed.
Drug Action:
It inhibits synthesis of prostaglandins and is a peripherally

acting analgesic.
Side effect and adverse effect:
CNS: drowsiness, dizziness, headache
GI: nausea, dypepsia, GI pain, hemorrhage
Other: edema, sweating , pain at injection site
Nursing Responsibilities:
 Monitor for S&S of GI distress or bleeding including nausea, GI

pain, diarrhea, melena, or hematemesis. GI ulceration with
perforation can occur anytime during treatment. Drug decreases
platelet aggregation and thus may prolong bleeding time.
 Monitor for fluid retention and edema in patients with a history of

CHF.
37
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
COLLEGE OF NURSING
NURSING CARE PLAN FORM
Patient’s Name (Initials): J .B Admitting Medical Diagnosis/CC: fracture, close, complete, displace,
middle 3rd Radio-ulnar Right
Age:11 years old Sex: Male Physician (Initials): Dr. C.M.S
Room No:__423__ Diet: DIET AS TOLERATED
SUBJECTI OBJECTIV NURSING SCIENTIFIC ANALYSIS PLANNING INTERVENTIONS RATIONALE EXPECTED

VE E DIAGNOSIS OUTCOME
“ sakit  Pain Short term: Independent: After 8 hours
akong scale Acute Pain Acute pain is of nursing
kamot related to short-term pain After 8 hours of  Assess and  take note intervention
of 8
iisa” physical that comes on nursing record the of the
out the S/O can
injury as suddenly and has a intervention the patient’s relieving
prior to of manifested specific cause, able to
S/O will be able level of
10. and
admissio by swelling usually tissue pain
to: aggravating  Demonstrate
n on the injury
patient  Facia right factors and different
 Demonstrate ways non-
is l forearm. nonverbal
different pharmacologic
playing glimp References: pain cues
basketba ways non- al management
ses such as
ll when pharmacologic to pain such
Santos-Longhurst, changes in
suddenly Definition: A. (2018, al management as deep
vital
stumble November 29). to pain such
signs, breathing
resultin Unpleasent Types of pain: as deep
g to sensory and emotions, exercise.
Classifications breathing
outstret emotional and examples to and
ch his experience exercise.  Verbalize
help describe behavior
right associated understanding
your pain.  Verbalize
forearm. with actual  To develop of condition
38
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
or Healthline. understanding a baseline and
potential Retrieved March of condition  Monitor data for importance of
tissue 11, 2023, from and vital signs any treatment
damage or https://www.hea q4h and O2
importance of alterations regimen.
described lthline.com/hea saturation
in terms of treatment in body
lth/types-of- every shift
such damage regimen. function.
pain#acute-pain
Reference: After 12 hours

 To evaluate
of nursing
Aprn Bc, M. distributio intervention
D. E., n and the patient
Crrn, M. M.  Determine quality of will be able to
R. M. F., & pulse blood flow display clear
Bsn Rn, A. equality as facial
M. C. wells as  To expression,
(2019). Long term: intensity determine with a pain
Nurse’s pain from scale of 5 out
Pocket After 12 hours of 10.
of nursing specific
Guide:  Evaluate
Diagnoses, intervention the areas,
extremity
Prioritized patient will be pain whether
Interventio able to: reports pain is
ns and  Clear facial increasing
Rationales glimpses and/or
(Fifteenth  Pain scale of localized
ed.). F.A. 4 out of 10
Davis  For
Company.
compliance
39
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
of
medications
 Instruct
and provide
teaching
S/O of the
patient
about the
drugs given
 Helps
improve
Dependent: tissue
perfusion
 Administer and organ
medications function
prescribed
by the  For
doctor hydration
and
elimination
 Administer of toxins
and
regulate
IVF as
ordered
40
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
Patient’s Name (Initials): J .J.B Admitting Medical Diagnosis/CC: fracture, close, complete,
displace, middle 3rd Radio-ulnar Right
Room No:______423____ Diet:_
SUBJECTIV OBJECTIV NURSING SCIENTIFIC ANALYSIS PLANNING INTERVENTIONS RATIONALE EXPECTED
E E DIAGNOSIS OUTCOME
“Akong  Long Feeding Self Self deficit refers After 2 hours of Independent: after of
papa moy circu care deficit to those activities nursing intervention nursing
ga pakaon lar related to an individual the s/o will be able intervention
nako” mechanical performs  Place the  Proper
cast to: the S/O can
restriction independently patient in a positioning able to:
on as evidence throughout life comfortable
 Understand the can make
his by long promote and maintain position for
importance of the task  Understand
right circular personal well- being. feeding
cast on the The deficit may be te securing the easier the
arm.
right effect of temporary safety of the while also importance
limitation, such as patient reducing of
Definition: recovering from the risk securing
surgery,pt sufferes  Verbalized the for the safety
Inability to depression. what are feeding aspiration of the
independentl methods.
y perform or patient
 Assure that  Thickened
complete the semisoli  Verbalized
claensing consistency
activities; of diet is foods such the what
After 3 week of
to put on or suitable for as pudding are
nursing intervention
remove the patient’s and hot feeding
cloting; to the patient will be
ability to cereal are methods.
eat or able to: chew and most easily
perform rask swallow, as
 Eat on his own swallowed
associated assessed by
with bowel and less
the speech
and bladder therapies. likely to
41
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
eliminition. aspirated. After 3 week
of nursing
Reference:  Encourgae  To intervention
food and maximize the patient
Aprn Bc, M. fluid choices food
D. E., Crrn, will be able
reflecting intake.
M. M. R. M. individual to eat on his
F., & Bsn like and own.
Rn, A. M. C. abilities and
(2019). that meet
Nurse’s nutritional
Pocket need.
Guide:
Diagnoses,  To increase
Prioritized  Assist client dependence
Intervention to handle or
s and utensils and
Rationales assistance
or in guiding
(Fifteenth utensil in with
ed.). F.A. mouth movement of
Davis arms and
Company. hands.
Dependent:
 To provide
 Collaborate
with adequate
nutritionist nutrition.
for special
diet or
feeding
methods
necessary.
42
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
Patient’s Name (Initials): J .J.B Admitting Medical Diagnosis/CC: fracture, close, complete,
displace, middle 3rd Radio-ulnar Right
43
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
Room No:______423____ Diet:_
SUBJECTIV OBJECTIV NURSING SCIENTIFIC ANALYSIS PLANNING INTERVENTIONS RATIONALE EXPECTED
E E DIAGNOSIS OUTCOME
 Disturbed Body image After 2 hours of Independent: after of
body Image disturbance is nursing intervention nursing
Related to defined by the s/o will be able  Listen to intervention
long maladaptive attitudes client’s  Different
to: the S/O can
circular and behavior directed comment an situation
cast. towards a disliked able to:
 Verbalized responses to are
aspect of one’s own the
understanding of upsetting  Verbalized
Definition: body. situation.
Confusion the client to understand
(and/or condition and differenr ing of the
dissatisfact safety people. client
ion) in precautions. Depending condition
mental on and safety
picture of  Know the individual precaution
one’s importance of coping s.
physical
providing support skills and
self.
to the patient past  Know the
Aprn Bc, M. experiences importance
D. E., Crrn,  Establish  Provide of
M. M. R. M. therapeutic opportuniti providing
F., & Bsn nurse-client support to
es for
Rn, A. M. C. relationship. the
After 4 weeks of listening
(2019).
nursing intervention concern and patient
Nurse’s
Pocket the patient will be question.
Guide: able to:  Assisting in  Promote
Diagnoses, correcting optimal After 4 weeks
Prioritized  Accept the underlying healing and of nursing
Intervention problem
44
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
s and condition adaptation. intervention
Rationales  Encourage the patient
(Fifteenth  Verbalize learning family member will be able
ed.). F.A. of the situation to treat to:
Davis client
Company. normally and  Accept
not as an
the
invalid.
condition
Verbalize
learning of
the situation
45
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
Nursing Progress Note
Date Problem Medical/Surigical Nursing Outcome

intervention
Intervention
March 8, Swelling at Ketorolac 15 mg  IV Reduce

2023 right IVTT/min RTC monitorin stranger
forearm g every 1 anxiety of
PLR 1 L 70cc/hr.
hr. patient
Patient
related to
experience  Taking of
the upcoming
ain with a vital
surgery
pain scale sign
of 7 out 10. every Decrease pain
4hrs as evidence
The pt is on
by pain scale
NPO diet as
of 5 out of
this time.
10.
The patient
is anxious
about his
surgery
March Anxiety PLR 1 L 70cc/hr. Perform able to

9,2023 related to morning care reduce
his post anxiety.
 follow up
operation
IV. Able to
Pain develop
 Vital
patient-
signs
nurses
taking
relationship
 do with the
physical patient.
examinati
46
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
on
 Gather
Gordon’s
health
pattern
 Encourage
family
interacti
on with
each
other.
 Provide
support
to the
patient
March 10,  Do health Verbalized

2023 teaching understanding
on the
 Vital
different
signs
cast care.
 Making of
discharge
summary
47
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
DISCHARGE PLAN
Medication:
Instruct S/O to give ibupropen 200 mg twice a day as needed.

Next, remind S/O to give prescribed medications, following the
doctor’s order and prescription. Then, educate S/O to NOT give
NSAID’s since these medications will increase the risk overdosing
of medication. Lastly, inform significant other to seek for
medical help immediately if there are manifestations of adverse
effects and allergic reactions.
Exercise:
Instruct the S/O to keep an eye on the child and avoid strenuous
activities that may result to injury.Then, advise S/O to let the
child do low-intensity lower body exercise for cardiovascular
activities like walking
Treatment:
Inform S/O to minimizing from letting the patient play outside to

prevent further injury . Then encourage the S/O to let the child
maintain bed rest until recovery.
Health Teaching:
48
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
Teach the patient with a supervision of the S/O the
importance of Cast care.
For Swelling, advise the S/O to elevate his arm and uses
pillow to raise the cast above the level the heart of the
patient. Apply ice, wrap the ice pack with a thin cloth this is
important to maintain the dryness of the cast.
When scratch felt, advise the patient and S/O to “DO NOT”
use ay harm object to insert inside the cast this can cause
infection. If itchiness is felt, you can grab a blower to relieve
the itch.
Advise the s/o to do not remove the cast as well as prevent

the cast from getting wet this may cause irritation.
Out-patient Department:
Instruct the S/O about the follow up check this coming

April 20, 2023 with repeat X-Ray in the LCC.
Diet:
Instruct S/O to have diet according to age. Encourage the family

to give the child protein-rich foods like chicken, meat, fish,
eggs, nuts, vitamin K-rich foods such as green, leafy vegetables,
and vitamin C-rich fruits foods like citrus fruits.
Spiritual:
49
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
Encourage the family and child that the situation will soon pass
and to never lose hope despite the circumstances in life. Advise
the family to maintain spiritual needs together with the child.
50
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
CHAPTER V
CONCLUSIONS AND RECOMMENDATIONS
Conclusions
As a result of the ordered laboratory and diagnostics tests, it

shows that there is a deformities on the right forearm confirm by
Dr. C.M.S.
Overall, the patient’s condition has gradually improved as early

ambulation and positive response to student nurses took place.
Recommendations
To our co-students
The study will help you in further to knowledge about radio-

ulna fracture including its clinical manifestations,
pathophysiology, and its various management. The group recommends
to analyze the case scenario given and if given the chance,
conduct a limited face-to-face interaction if time permits.
To faculty members
The study serves as a refresher course about fracture and

enabling members to recall knowledge of the condition being
51
COLLEGE OF NURSING
DUMAGUETE CITY
2nd Semester,
discussed. The group recommends to conduct community programs for
the people to be well-informed of awareness child injuries.
To the readers
The group recommends to do analysis of the pathophysiology

with reference to the case study presented. Also, it aims to
address the lack of information regarding prevention and
management to injuries and for the readers to always provide
necessary measures in the occurence of such.
REFERENCES
Availability. KETOROLAC TROMETHAMINE. (n.d.). Retrieved March 10, 2023, from

http://robholland.com/Nursing/Drug_Guide/data/monographframes/K005.html
VanPutte, C. L., Regan, J. L., & Russo, A. F. (2022). Seeley's Essentials of Anatomy &
Physiology. McGraw-Hill.
Availability. KETOROLAC TROMETHAMINE. (n.d.). Retrieved March 10, 2023, from
http://robholland.com/Nursing/Drug_Guide/data/monographframes/K005.html
Wikimedia Foundation. (2023, January 18). Ringer's lactate solution. Wikipedia. Retrieved
March 11, 2023, from https://en.wikipedia.org/wiki/Ringer
%27s_lactate_solution#:~:text=Ringer%27s%20lactate%20solution%20%28RL%29%2C
%20also%20known%20as%20sodium,low%20blood%20volume%20or%20low%20blood
%20pressure.%20
52

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Saint Paul University Dumaguete College of Nursing: Dumaguete City 2 Semester, Academic Year 2022-2023

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SAINT PAUL UNIVERSITY DUMAGUETE

DISCLAIMER: This document is a strictly confidential

IN PARTIAL FULFILLMENT OF THE REQUIREMENT IN

A case study on Fracture closed, complete, displaced, middle 3rd

CHAPTER I CASE OVERVIEW

First, I would like to thank our Almighty God for keeping us

Secondly, to our clinical instructor for the Surgical ward,

To my family, I am very grateful for providing me with my

To St Paul University Dumaguete- College of Nursing, I would

Finally, to Negros Oriental Provincial Hospital, I would

This Case study emphasis on a bone fracture, close, complete

Bone fracture are classified in several ways. The most

According to Bittany Mikuluk, M.Ed., CCLS a pediatrician

There is usually no cause for concern in a vast majorities

Patient J.B., a 11 years old child from Abis, Mabinay Negros

I was tasked to make a clinical paper about bone fracture,

General Aim of this Study:

The researcher aim to formulate a comprehensive case analysis

SPECIFIC LEARNING OBJECTIVES:

To formulate a comprehensive study on the patient’s current

To present interpretation of the laboratory exams.

To create Specific, Measurable, Attainable, Realistic, and Time-

To implement thoroughly Nursing Care Plan.

To gather pertinent data regarding the health background of the

To attend the general and specific needs of the patient.

To conduct a thorough Physical Assessment of the client’s

Prepare an adequate Discharge Summary and Plan.

To express genuine compassionate care for the patient’s overall

To initiate conversation following the several techniques used in

Ensure and facilitate maintenance in regards with patient’s

Communicate accurately and completely as well as document

Scope and Limitations

Student nurses Focusing on Obtaining data form a patient that was

The receive patient handled during clinical exposure. The

The possible problems that the researchers could encounter while

CASE DATA AND INFORMATION

Patient’s Biographical Data

A. Child’s Name: J.J.B

B. Parent’s Name: Rosemalyn J. Baldado (mother)

Junard B. Baldado (father)

C. Address: Abis, Mabinay, Negros Oriental

D. Contact Number: None

E. Age of Children: 11 Years Old

I. Date of Birth: September 14, 2011

J. Place of Birth: Abis, Mabinay, Negros Oriental

K. Religion: March of Faith

L. Medical Diagnosis: Fracture, complete, displaced, Middle 3rd Radio-

M. Physician: Dr. Chloe Marie Samarita

N. Source of Referral: O. Source of Information: 30% father,30 %

Date of Admission: March 07 , 2023

“ gadula siya dayon na dugmo nauna iya too nga kamot” as

History of Present Illness

Prior to admission, The patient is playing basketball when

Past Health History

Upon assessment, the patient has no past illnesses, no past

The following table illustrates all the immunizations the patient

The patient had completed her immunization from birth up to