Republic of the Philippines

DIVINE WORD COLLEGE OF BANGUED

BANGUED, ABRA

NURSING DEPARTMENT

A case study on

T/C multiple myeloma pathologic fracture distal femur left compression fracture
T12 L5 neurologic

In partial fullfillment of the Recquirements in (Related Learning Experience)

Leading to the Degree of Bachelor of Science in Nursing

PHILIPPINE ORTHOPEDIC CENTER

Prepared by:
HOLLAND B. BATALON
SN3-DWCB
 TABLE OF CONTENTS

I. PATIENT DATA
II. NURSING HISTORY
a. History of present illness
b. Past Medical History
c. Family Medical History
d. Socio Economic History
e. Environmental history
III. PATHOPHYSIOLOGY
IV. NURSING CARE PLAN
a. Assessment
b. Planning
c. Intervention
d. Evaluation
V. MEDICAL MANAGEMENT
a. Diagnostic Problem
b. Drug Study
VI. SURGICAL MANAGEMENT
VII. NURSING CARE MANAGEMENT
I. PATIENT DATA

Name Ofella Apines

Address Laloma Quezon City

Age 59 y/o

Sex Female

Civil status Married

Religion Roman Catholic

Birthdate Feb. 29 1951

Place of birth Laloma Quezon City

Date of admission October 12, 2010

Hospital Philippine Orthopedic Center

Hospital number 609757

Room and Bed number 203 #1

Admitting Diagnosis T/C multiple myeloma pathologic fracture

distal femur left compression fracture T12 L5
neurologic

Final diagnosis T/C multiple myeloma pathologic fracture

distal femur left compression fracture T12 L5
neurologic

Admitting physician Dr. Sindiong

II. NURSING HISTORY
a. History of present illness
-it was October 10, 2010 when mrs. OA experienced back pain and joint
pain and she went to a “manghihilot” after the massage she feel relief and
she continue working in their house
On October 12, 2010 Mrs. OA felt back and joint pain again. She thought
this is because of her tiredness from work so she just took a tablet of alaxan
once, then she went to her bed to take a rest when accidentally she fell on
the floor and when she try to stand she cannot move her left leg and felt
ache on her back her condition bother her and his family and that day they
went to Philippine orthopedic center and admitted there.
b. Past Medical History
-Mrs. OA had experience illnesses during her childhood years like mumps,
measles, and chicken pox. She said she had no allergies, she said that she
cannot recall if she is fully immunized or not. This is her first hospitalization
at the age of 59 y/o.
c. Family Medical History
-According to Mrs. OA, most of the members of their family both paternal
and maternal sides had a medical history of hypertension, diabetes
mellitus. Her father and mother are still alive living in the province.
d. Socio Economic History
-Mrs. OA is a housewife while her husband is a carpenter their monthly
estimated income is around 3000 to 4000 php this depend on the house
that her husband built.
e. Environmental History
-Mrs. OA lives in Laloma Quezon City. They just rent a boarding house with
two rooms, the water that they drinking is mineral water and the water
that they are using in washing clothes and plates are coming from the
faucet, their CR is only one used by many people.
III. PATHOPHYSIOLOGY

From a direct blow, falls with the foot in a flexed position, or a violent
twisting motion

Fracture of the thoracic and lumbar

T/C multiple myeloma pathologic fracture distal femur left

compression fracture T12 L5 neurologic

signs and symptoms include pain, deformity, obvious hematoma, and

considerable edema.

V. MEDICAL MANAGEMENT
 a. Diagnostic Problem
HEMATOLOGY
15.7 11-15seconds
83.3
1.19
31.5 22-45seconds

URINALYSIS
RESULT-NEGATIVE(-)

X-RAY
RESULT-Fracture of the distal femur left compression fracture T 12 L5
neurologic

VI. SURGICAL MANAGEMENT

VII. NURSING CARE MANAGEMENT
1. Promote comfort with proper fit of brace or cast.
2. Provide opportunity for the patient to express fears and ask questions about
deformity and brace wear.
3. Assess skin integrity under and around the brace or cast frequently.
4. Provide good skin care to prevent breakdown around any pressure areas.
5. Instruct the patient to examine brace daily for signs of loosening or
breakage.
6. Instruct patient to wear cotton shirt under brace to avoid rubbing.
7. Instruct about which previous activities can be continued in the brace.
8. Provide a peer support person when possible so the child can associate
positive outcomes and experiences from others.