Nursing care of a patient with an open fractured left femur and a closed fractured right femur combined with hypovolemic shock from blood loss: A case study

Abstract

This article aims to study the use of nursing processes in caring for patients with left femur fractures, both with open and closed wounds, along with hypovolemic shock from blood loss, correctly and appropriately according to professional standards. From the first admission until the patient is transferred for treatment in a tertiary hospital. A case study of a Thai female patient, age 52, married, Thai nationality, Buddhist, receiving regular treatment for hypertension at Ban Pho Hospital. The patient had an accident from riding a motorcycle and collided with a truck. Ban Pho Hospital's Advanced Medical Operations Unit Received patients at the scene of the incident, using the concept of holistic nursing theory. Holistic care is included in caring for patients at the scene of the accident by providing care to the patient by all aspects of humanity, including the body, mind, society, and spirit, and maintaining good health and nursing diagnosis according to the North American Nursing Diagnosis Association (NANDA).

It was found that the patient had five important nursing problems; 1) the patient was in hypovolemic shock from blood loss because there is a large open wound in the left thigh and the right thigh was swollen and deformed without wound, 2) risk of fat embolism in the lung from having both thigh bones broken, 3) risk of infection in the left thigh due to torn muscle and fat from open fractures, 4) the patient had severe pains both nociceptive and neuropathic pains due to tissue and nerve injuries in both legs, and 5) the patient and family were concerned about injuries from accidents. The patient received nursing care to treat shock from blood loss since the first admission at the scene of incident. The nursing care was continued until transfer to the emergency room at Ban Pho Hospital. Symptoms of shock from blood loss were improved. Patient was safe and can be refered for further treatment at Phutthasothon Hospital for continuous treatment.