PATHOPHYSIOLOGY

PREDISPOSING FACTORS PRECIPITATING FACTORS

AGE VEHICULAR ACCIDENT, ALCOHOLISM AND OCCUPATION (PLUMBER)

Direct, high energy force

(Vehicular accident) Legend:

Predisposing and Precipitating

Factors
Open bone fracture
Mechanism of Action

Signs and Symptoms

Fractures with varying degrees of
commination
Diagnostics and Laboratory Tests

GUSTILO-ANDERSON Admitting Diagnosis

CLASSIFICATION
Medical Management
Nursing Diagnosis

Type II Type IIIB

Wound – 1 to 10 cm Extensive contamination

Possible contamination
Extensive commination

Moderate commination
Extensive periosteal stripping

Open II complete, displaced, M3rd Open IIIB complete. Displaced

Femur, and Right middle Tibia Fibula Right

COMPLICATIONS

Immobilized leg causing decrease

Displaced fracture
in action Bleeding in the injury site Soft tissue damage

Presence of abrasions on right arm

Breakage in the skin X-ray
Limited range of motion due to Blood loss
fractures and 13 kg skeletal Abrasion on both upper extremities
traction on right leg Pain at the fracture site

Decreased fluid volume Hypo perfusion of the kidney

Slight muscle weakness on both Intense inflammatory reaction Pain scale: 8/10
legs. Decreased electrolytes Decreased production of
Erythropoietin

Ranitidine
Tramadol
Muscle grade strength 1/5 on R IV THERAPY RBC: 3.30x10
lower ext. HCT: 0.33
HGB: 10.6 g/dl Maintenance of immobilization to
#1 PLR 1L @30 gtts/min
MCH: 25.40 Acute pain Increase risk for micro bacteria facilitate bone healing
#2 PNSS 1L @30 gtts/min MCHC: 31.3 entry
Impaired physical mobility Sodium: 133.0 mmol/L
#3 D5LR 1L + Amino Acid + Sorbitol
@30 gtts/min Skeletal Traction
Kidneys are unable to filter creatinine Infection
and can cause damage

Neutrophils: 59.50%
Lymphocytes: 2.50
Creatinine: 1.44 mg/dl Monocytes: 9.50
SGOT: 48.14 Eosinophil: 3.80
SGPT: 46.96 Basophils: 0.20

Nephrotoxic drug
Cefuroxime