Responses to

Altered
Coordination
1. Injuries
- Fracture
- Motor Vehicle Collision
- Sports Injury
2. Joint Disorders
- osteoarthritis
- gout
- carpal tunnel syndrome
- low back pain
3. Degenerative
- osteoporosis
 BONE FRACTURE

• A fracture is a partial or complete

break in the bone.
BONE FRACTURE – Types depending
on criteria
• Pattern: A fracture pattern is the medical
term for the shape of a break or what it
looks like.
• Cause: Some fractures are classified by
how they happen.
• Body part: Where in your body your
broke a bone.
BONE FRACTURE – Types depending
on criteria
Fractures that have a single straight-line
break include:
• Oblique fractures.
• Transverse fractures.
• Longitudinal fractures (breaks that happen
along the length of the bone).
• Fracture patterns that don’t break your
bone in a single straight line include:
BONE FRACTURE – Types depending
on criteria
Fracture patterns that don’t break your
bone in a single straight line include:
• Greenstick fractures.
• Comminuted fractures.
• Segmental fractures.
• Spiral fractures.
BONE FRACTURE – Types depending
on criteria
Fractures diagnosed by cause:
• Stress fractures (a fatigue-induced bone
fracture caused by repeated stress over
time).
• often occur in the foot after training for
basketball, running, and other sports.
BONE FRACTURE – Types depending
on criteria
Fractures diagnosed by cause:
• Avulsion fractures.(A piece of bone
attached to a ligament or tendon breaks
away from the main part of the bone)
bones that are most at-risk of an
avulsion fracture include:
BONE FRACTURE – Types depending
on criteria
Bones that are most at-risk of an avulsion
fracture include:
 Elbow bones.
 Ankle and foot bones.
 Knee bones.
 Finger and wrist bones.
 Pelvis and hip bones.
 Spine bones.
avulsion
BONE FRACTURE – Types depending
on criteria
Fractures diagnosed by cause:
• Buckle fractures (sometimes referred to
as torus or impacted fractures).
BONE FRACTURE – Types depending
on criteria
Fractures that affect people’s chest, arms, and upper
body include:
Clavicle fractures (broken collarbones).
Shoulder fractures.
Humerus (upper arm bone) fractures.
Elbow fractures.
Rib fractures.
Compression fractures.
Facial fractures.
BONE FRACTURE – Types depending
on criteria
Fractures that damage the bones in your lower body and
legs include:
Pelvic fractures.
Acetabular fractures.
Hip fractures.
Femur fractures.
Patella fractures.
Growth plate fractures.
Tibia (your shin bone) and fibula (your calf bone)
fractures.
BONE FRACTURE – Types depending
on criteria
Fractures that affect your feet and ankles are more
likely to have complications like nonunion. They include:
Calcaneal stress fractures.
Fifth metatarsal fractures.
Jones fractures.
Lisfranc fractures.
Talus fractures.
Trimalleolar fractures.
Pilon fractures.
Open vs. closed fractures
 BONE FRACTURE - CAUSES
• falls
• Injuries like sports injuries and accidents
• because of a direct hit or kick to the body.
• Overuse or repetitive motions that cause
stress fractures
• diseases that weaken the bone
(osteoporosis)
 BONE FRACTURE - symptoms
• Pain.
• Swelling.
• Tenderness.
• Inability to move a part of your body like you
usually can.
• Bruising or discoloration.
• A deformity or bump that’s not usually on your
body.
 BONE FRACTURE - complications
1. Infection:
• Monitor for signs and symptoms of
infection (fever, redness, swelling, pain,
purulent drainage) and administer
antibiotics as prescribed.
 BONE FRACTURE - complications
2. Neurovascular Compromise:
• Regularly assess circulation and
sensation in the affected limb to detect
any signs of nerve or blood vessel
damage.
 BONE FRACTURE - complications
3. Deep Vein Thrombosis (DVT):
• Encourage early mobilization and
administer anti-coagulants as prescribed
to prevent DVTs.
 BONE FRACTURE - complications
3. Deep Vein Thrombosis (DVT):
• Encourage early mobilization and
administer anti-coagulants as prescribed
to prevent DVTs.
 BONE FRACTURE – diagnostic test
• X-rays: An X-ray will confirm any fractures and
show how damaged your bones are.
• Magnetic Resonance Imaging (MRI): to get a
complete picture of the damage to the bones
and the area around them. An MRI will show
tissue like cartilage and ligaments around the
bones, too.
• CT scan: gives a more detailed picture of the
bones and the surrounding tissue than an X-ray.
 BONE FRACTURE – management and
treatment
1. Immobilization with
 splint,
cast,
For 3-8 weeks
 BONE FRACTURE – management and
treatment
2. Closed reduction
For more severe breaks to set (realign)
your bones.
During this non-surgical procedure, the
surgeon will physically push and pull the
body on the outside to line up your broken
bones inside.
 BONE FRACTURE – management and
treatment
2. Closed reduction
Management during the procedure:
a. Local anesthetic to numb the area around the
fracture.
b. Sedatives to relax your whole body.
c. General anesthesia to make you sleep through the
procedure.
d. Post-care: splint & cast
 BONE FRACTURE – management and
treatment
3. Bone fracture surgery
a. Internal fixation – (the surgeon inserts pieces of metal
into the bone to hold it in place while it heals).
 The technique includes:ORIF (Open Reduction and Internal Fixation)
Rods: A rod inserted through the center of the bone
that runs from top-to-bottom.
 Plates and screws: Metal plates screwed into your bone to hold the
pieces together in place.
 Pins and wires: Pins and wires hold pieces of bone in place that are
too small for other fasteners. They’re typically used at the same
time as either rods or plates.
 BONE FRACTURE – management and
treatment
3. Bone fracture surgery
b. External fixation – the surgeon will put
screws in the bone on either side of the fracture
inside the body then connect them to a brace
or bracket around the bone outside the body.
This is usually a temporary way to stabilize the
fracture and give it time to begin healing before
the internal fixation.
 BONE FRACTURE – management and
treatment
3. Bone fracture surgery
c. Arthroplasty– the surgeon will remove the
damaged joint and replace it with an artificial
joint.
The artificial joint (prosthesis) can be metal,
ceramic, or heavy-duty plastic.
The new joint will look like the natural joint
and move similarly.
 BONE FRACTURE – management and
treatment
3. Bone fracture surgery
d. Bone grafting– the surgeon will insert
additional bone tissue to rejoin the
fractured bone. Done in severely
displaced bone or when sn’t healing back
together as well as it should.
 BONE FRACTURE – management and
treatment
3. Bone fracture surgery
d. Bone graft sources:
Internally from somewhere else in the
body — usually the top of the hip bone.
An external donor.
An artificial replacement piece.
 BONE FRACTURE – management and
treatment
4. pharmacological
NSAIDs
 Side effects:
Bleeding.
Ulcers.
Stomach pain
Bowel complications.
 Complications of bone fracture treatment
Acute compartment syndrome (ACS): A
build-up of pressure in the muscles may stop
blood from getting to tissue, which can
cause permanent muscle and nerve damage.
Malunion: This happens when your broken
bones don’t line up correctly while they heal.
Nonunion: Your bones may not grow back
together fully or at all.
 Complications of bone fracture treatment
Bone infection (osteomyelitis): open
fracture (the bone breaks through the
skin) causes an increased risk of
bacterial infection.
Other internal damage: Fractures can
damage the area around the injury
including the muscles, nerves, blood
vessels, tendons, and ligaments.
 BONE FRACTURE - main goal of
treatment
• to put the pieces of bone back in place so the
bone can heal.
• This can be done with:
 splint,
cast,
surgery, or
traction.
 BONE FRACTURE – nursing assessment
Pain Assessment:
1. Regularly assess the patient's pain level
and administer pain medication as
prescribed.
2. "5 P's" (pain, pulse, pallor, paresthesia,
and paralysis), check level of
consciousness and temperature, and
ensure proper fit and function of casts,
 BONE FRACTURE – nursing assessment
2. Neurovascular Assessment:
Monitor for signs of neurovascular
compromise, such as:
 decreased pulses,
numbness,
tingling,
coolness, especially distal to the
BONE FRACTURE – nursing assessment
3. Fracture Assessment: Check the
immobilization device (cast, splint,
traction) for proper placement and
alignment, and monitor for signs of
pressure or irritation.
4. Infection Assessment: Monitor for signs
of infection, such as redness, swelling,
warmth, pain, or drainage, especially with
BONE FRACTURE – nursing assessment

5. Psychosocial Assessment: Assess the

patient's anxiety, fear, and coping
mechanisms, and provide support and
education.
BONE FRACTURE – nursing interventions
2. Immobilization:
Maintain the fracture immobilization
device as prescribed, and educate the
patient on proper care. ,
BONE FRACTURE – nursing interventions
3. Prevent Complications:
a. Infection:
Monitor for signs of infection.
Provide wound care as needed for open
fractures.
administer antibiotics as prescribed.
BONE FRACTURE – nursing interventions
3. Prevent Complications:
b. Thromboembolism:
Encourage early ambulation and
movement
administer anticoagulants as prescribed
to prevent blood clots.
BONE FRACTURE – nursing interventions
3. Prevent Complications:
c. Pressure Ulcers: Monitor skin integrity
and perform skin care, especially in
immobilized patients.
d. Muscle Atrophy: Encourage isometric
exercises and physical therapy as
prescribed to prevent muscle weakness.
BONE FRACTURE – nursing interventions
4. Promote Healing:
a. Nutrition: Provide a high-protein diet to
support bone healing.
b. Hydration: Encourage adequate fluid
intake to prevent constipation.
c. Rest and Activity: Balance rest with
appropriate activity to promote healing and
prevent complications.
BONE FRACTURE – nursing interventions
5. Psychosocial Support: Provide emotional
support, education, and referrals as needed to
address anxiety, fear, and coping mechanisms.
6. Patient Education:
Fracture Care: Educate the patient on proper
care of the fracture immobilization device,
wound care (if applicable), and signs of
complications.
nursing interventions: Fracture Care:
a. Medications: Explain the purpose, dosage,
and potential side effects of medications.
b. Activity Restrictions: Explain activity
restrictions and the importance of avoiding
activities that could cause further injury.
c. Rehabilitation: Educate the patient on the
importance of physical therapy and
rehabilitation exercises to regain function and
mobility.
nursing interventions: Fracture Care:
Rib Fractures:
Monitor respiratory status, encourage
coughing and deep breathing exercises,
and provide pain management to prevent
complications like pneumonia.
nursing interventions: Fracture Care:
Ankle Fractures:
Provide education on proper fitting of
casts or splints, and monitor for signs of
compartment syndrome.
nursing interventions: Fracture Care:
Hip Fractures:
Address potential complications such as
DVT, infection, and pneumonia, and
provide education on mobility and
assistive devices.
nursing interventions: Fracture Care:
Pediatric Fractures:
Use age-appropriate explanations and
techniques, and involve parents or
caregivers in the care plan.
 BONE FRACTURE – nursing interventions to prevent
fracures

1. EDUCATION:
• Always wear a seatbelt.
• Wear the right protective equipment for all
activities and sports.
• Make sure the home and workspace are free
from clutter that could trip you or others.
• Use a cane or walker for difficulty in walking
or have an increased risk for falls.
BONE FRACTURE – nursing management
1. EDUCATION:

• Always use the proper tools or equipment at

home to reach things. Never stand on chairs,
tables, or countertops.
• Follow a diet and exercise plan that will help you
maintain good bone health.
• Submit for a bone density test for ages 50 and
above or if you have a family history of
osteoporosis.
BONE FRACTURE – nursing management
2. Focus on pain relief,
3. Ensure proper immobilization,
4. Prevent complications like infection,
and
5. promote healing through adequate
nutrition and rehabilitation.
 ASSISTIVE DEVICES
• Assistive devices for fractures primarily
focus on weight-bearing support, balance,
and stability to aid in mobility during
recovery.
• Common devices include crutches, canes,
and walkers. These devices help reduce
stress on the injured limb and assist with
activities of daily living
 Types of Assistive Devices for Fractures:
Crutches:
• Provide support and weight-bearing
assistance, especially for lower limb
fractures
Canes:
• Offer a smaller level of support than
crutches, primarily for balance and stability
 Types of Assistive Devices for Fractures:
Walkers:
 Provide more stability than canes and are often
recommended for individuals with significant
balance issues or lower limb weakness.
Wheelchairs:
 Used for individuals with limited mobility or
inability to walk, especially for extended
recovery periods.
 Types of Assistive Devices for Fractures:
Forearm Crutches:
 Offer increased freedom of movement
compared to traditional crutches, often
preferred for long-term use.
 Purpose of Assistive Devices:
Weight Bearing: - Reduce stress on the
injured limb during weight-bearing activities.
Balance and Stability: - Improve balance and
reduce the risk of falls.
Mobility and Independence: - Enable
individuals to perform daily activities more
safely and independently.
Assistive Devices: