1. The client/caregiver can define fracture.
   1. It is a break in the bone.
   2. Surrounding soft-tissue injury can also occur.
   3. Fractures can be caused by trauma or disease.
2. The client/caregiver can state type of fracture that occurred.
   1. Open (skin pierced over the fracture)
   2. Closed (skin intact over the fracture)
   3. Complete (break across entire bone)
   4. Incomplete (fracture extends only part way through the bone), also called greenstick fracture
   5. Impacted (one bone fragment forcibly driven into another bone fragment)
   6. Comminuted (bone broken in several places)
   7. Displaced (bone fragments are separated at the fracture line)
   8. Complicated (a body organ or other body tissues injured at the time of the fracture)
3. The client/caregiver can recognize signs and symptoms.
   1. Deformity
   2. Pain and tenderness
   3. Restricted or limited mobility
   4. Swelling
   5. Bruising
   6. Muscle spasm
   7. Pallor
   8. Numbness and tingling
   9. Shortening of a limb
4. The caregiver can administer first aid to a fracture victim.
   1. Move the victim no more than absolutely necessary to prevent further tissue damage.
   2. Assess client’s total condition.
   3. Remove constricting clothing or jewelry.
   4. Cover open wounds with sterile dressing before splinting.
   5. Splint injured site before moving to immobilize the joints above and below the fracture.
   6. Apply well-padded splints and bandage splints over clothing.
5. The client/caregiver understands possible medical/surgical treatment of fractures.
   1. Closed reduction (manual realignment of bones)
   2. Immobilization of bone
   3. Electrical bone stimulation
   4. Cast, splint, traction, sling, or external fixator
   5. Total joint replacement
6. The client/caregiver can list measures to promote healing and prevent complications of a fracture.
   1. Report to physician any signs of coolness, pallor, redness, blueness, numbness, or signs of infection.
   2. Eat a well-balanced diet that is high in carbohydrates and proteins. Eat foods that are high in calcium.
   3. Take vitamin (A, B, C, and D) and mineral (calcium and zinc) supplements as recommended.
   4. Increase fluids to 8 to 10 glasses per day unless contraindicated.
   5. Use medications (analgesics, antibiotics, muscle relaxants, etc.) as ordered.
   6. Follow activity and weight-bearing instructions as ordered.
   7. Use ambulatory aids (cane, walker, and crutches) as ordered.
   8. Follow an exercise program as ordered.
   9. Follow referral to physical or occupational therapy.
   10. Use safety precautions in environment to prevent falls or injury.
   11. Keep follow-up appointments with physician.
7. The client/caregiver is aware of possible complications.
   1. Infection
   2. Peripheral nerve damage
   3. Fat embolism
   4. Shock
   5. Compartment syndrome
   6. Venous thrombus

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. Philadelphia: Mosby Inc.
Cohen, B. J., & Wood, D. L. (2000). Memmler’s the Human Body in Health and Disease (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
Nutrition made incredibly easy. (2003). Springhouse: Lippincott, Williams & Wilkins.
Portable RN: The all-in-one nursing reference. (2002). Springhouse: Lippincott, Williams & Wilkins.
Taylor, C., Lillis, D., & LeMone, P. (2005). Fundamentals of nursing. Philadelphia: Lippincott Williams & Wilkins. Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott
Williams & Wilkins.

Credits

Client Teaching Guides for Home Health Care, 2nd ed.
© 2008 Jones and Bartlett Publishers, Inc.
www.jbpub.com