Aklan State University

School of Arts and sciences

Bachelor of Science in Nursing
Banga, Aklan

Hypothetical Case
Scenario
(Transverse Patella Fracture)

Submitted by:
Erika Glen M. Gonzales
BSN 3-1A

Submitted to:
Joan R. Agustin, RN, MAN
 Classroom Instructor

CASE SCENARIO
TRANSVERSE PATELLA FRACTURE IN A TEN-YEAR-OLD BOY
A ten-year-old boy presented at the Rift Valley Provincial General Hospital, Nakuru two months after he fell on his left knee. He
presented with inability to actively extend his left knee. Immediately after the fall, he reported that he had pain and swelling which resolved
after about two weeks. However, the inability to extend his knee had persisted. On examination, there was wasting of the quadriceps
muscles and a palpable gap within the patella. The patient could not extend the affected knee actively. Radiographs revealed a transverse
fracture of the patella as shown in Figure 1. Figure 2 shows the radiographs of the patient’s right (normal) knee.
Reference: Ismail, A., Mahmut, N. A. and Mehmet, K. Non displaced transverse patella fracture in a child: A case report. Sci. Intern. 2013; 1:183-185.
 ASU-INS 01
Series No. 000101
Date: July 30, 2018

Aklan State University

School of Arts and sciences
Bachelor of Science in Nursing
Banga, Aklan

NURSING CARE PLAN

Name of Patient: L.T Attending Physician:

Age: 31 y.o Area/Ward/Bed Number: Medical Ward Impression/Diagnosis: Transverse Patella Fracture
 
Objectives of Care/ Outcome
Nursing Rationale Criteria (Subject + Verb + Rationale
Clustered Cues Nursing Interventions Evaluation
Diagnosis (Scientific basis) Condition + Criteria + Target (Scientific Basis)
Time)
Date & Time: Impaired physical General: Independent: Date & Time:
July 8, 2021
7:00 AM
.
mobility related to
musculoskeletal
disorder as
neck At the end of hospitalization,
the patient will be able to:
1. Monitor the patient's vital
signs
1. To have
baseline data
July 8, 2021
3:00 PM

Subjective:
“My knee hurts
and I can’t extend
evidence by
decreased muscle
strength/control.
Fractur  To facilitate the
maintenance of regulatory
2. Raise side rails of bed 2. To prevent
patient from
Goals are met as
evidenced by:

it.” as verbalized
by the patient. es mechanisms and functions.

3. Assess degree of
possible fall

3. Patient may be
 The patient
was able to
verbalize

occur
Objective: Definition: Specific: immobility produced by restricted by understandin
 Noted NANDA injury or treatment and self-view or g of situation
deformity of The state in which At the end of the 8-hr shift, the note patient’s perception self-perception and individual
thigh due to the individual has a patient will be able to: of immobility. out of treatment


fracture

Limited
limitation in
independent,
purposeful physical 
when  Verbalize understanding of
situation and individual
proportion with
actual physical
limitations,
regimen and
safety
measures
ROM of left
lower extremit
y
movement of the
body or of one or
more extremities.
the treatment regimen and
safety measures
independently.
requiring
information or
interventions to

independently
The patient
was able to
promote perform ROM
progress
  Perform ROM with no toward with no

bone is 
assistance.

Regain/maintain mobility at
wellness.

4. Isometrics

assistance.
The patient
was able to

subject 
the highest possible level.

Increase strength/function
4. Encourage use of
isometric exercises
starting with the
contract
muscles
without
regain/mainta
in mobility at
the highest

ed to 
of affected and
compensatory body parts.
unaffected limb. bending joints
or moving
limbs and help 
possible
level.
Increase

stress
maintain strength/funct
muscle ion of
strength and affected and
mass. compensator

greater 5. Maintain limbs in

functional alignment
(with pillows, sand
5. This prevents
footdrop and
y body parts.

that it bags, etc.). Support

feet in dorsiflexed
position
excessive
plantar flexion

can Collaborative:

absorb.
(Dependent,Interdependent
)

1. Perform passive and 1. Enhances

When active ROM exercises on

extremities and joints,
using slow smooth
circulation
maintains
muscle tone

the movements on the

unaffected body parts.
and joint
mobility and
prevents

bone is disuse
contractures
and muscle

broken
atrophy.
2. Provide and assist with
mobility by means of
wheelchair, walker, 2. Early mobility
reduces

,
crutches, canes as soon
as possible. Instruct in complications
of bed rest
 safe use of mobility aids. (phlebitis) and

adjace promotes
healing and
normalization

nt of organ
function.
Learning the

structu correct way to

use aids is
important to

res
maintain
optimal
mobility and
patient safety.

are
also
affecte
d,
resultin
g in
soft
tissue
edema,
hemorr
hage
into
the
muscle
s and
joints,
joints
disloca
tions,
rupture
d ten-
dons,
severe
d
nerves,
and
damag
ed
blood
vessels
. Body
organs
maybe
injured
by the
force
that
caused
the
fractur
e
fragme
nts.
After a
fractur
e, the
extrem
ities
cannot
functio
n
properl
y
neck
Fractur
es
occur
when
the
bone is
subject
ed to
stress
greater
that it
can
absorb.
When
the
bone is
broken
,
adjace
nt
structu
res
are
also
affecte
d,
resultin
g in
soft
tissue
edema,
hemorr
hage
into
the
muscle
s and
joints,
joints
disloca
tions,
rupture
d ten-
dons,
severe
d
nerves,
and
damag
ed
blood
vessels
. Body
organs
maybe
injured
by the
force
that
caused
the
fractur
e
fragme
nts.
After a
fractur
e, the
extrem
ities
cannot
functio
n
properl
y
neck
Fractur
es
occur
when
the
bone is
subject
ed to
stress
greater
that it
can
absorb.
When
the
bone is
broken
,
adjace
nt
structu
res
are
also
affecte
d,
resultin
g in
soft
tissue
edema,
hemorr
hage
into
the
muscle
s and
joints,
joints
disloca
tions,
rupture
d ten-
dons,
severe
d
nerves,
and
damag
ed
blood
vessels
. Body
organs
maybe
injured
by the
force
that
caused
the
fractur
e
fragme
nts.
After a
fractur
e, the
extrem
ities
cannot
functio
n
properl
y
Fractures occur when
the bone is subjected
to stress greater that
it can absorb. When
the bone is broken,
adjacent structures
are also affected,
resulting in soft tissue
edema, hemorrhage
into the muscles and
joints, joints
dislocations, ruptured
tendons, severed
nerves and damaged
blood vessels. Body
organs maybe injured
by the force that
caused the fracture
fragments. After a
fracture, the
extremities cannot
function properly
because normal
functions of muscle
depend on the
integrity of the bones
which they are
attached.

(Gulanick & Myers:

2007, p. 126)

Students Name: Erika Glen M. Gonzales BSN 3-1A

Clinical Instructor: Joan R. Agustin, RN, MAN