A femur fracture is a severe injury involving a break in the thigh bone (femur), the longest and strongest bone in the human body. This nursing diagnosis focuses on managing pain, preventing complications, and promoting optimal healing while ensuring patient safety and comfort during recovery.
Causes (Related to)
Femur fractures can occur due to various mechanisms, with several factors influencing their severity and healing potential:
- High-energy trauma (motor vehicle accidents, falls from height)
- Pathological fractures due to:
- Osteoporosis
- Bone tumors
- Metastatic disease
- Sports-related injuries
- Direct blow to the thigh
- Patient Risk Factors including:
- Advanced age
- Osteoporosis
- Poor nutrition
- Chronic conditions
- Medication use (long-term steroids)
Signs and Symptoms (As evidenced by)
Femur fractures present with distinctive signs and symptoms that nurses must recognize for proper assessment and intervention.
Subjective: (Patient reports)
- Severe pain in the thigh area
- Inability to bear weight
- Pain with attempted movement
- Numbness or tingling sensation
- The feeling of instability in the leg
Objective: (Nurse assesses)
- Visible deformity of the thigh
- Swelling and bruising
- Shortened or rotated affected limb
- Limited range of motion
- Crepitus upon examination
- Neurovascular compromise
- Muscle spasms
- Decreased peripheral pulses
Expected Outcomes
The following outcomes indicate successful management of a femur fracture:
- The patient will report adequate pain control
- The patient will maintain proper alignment of the affected limb
- The patient will demonstrate proper use of prescribed mobility aids
- The patient will maintain adequate circulation to the affected limb
- The patient will show no signs of complications
- The patient will achieve optimal bone healing
- The patient will regain functional mobility
- Patient will verbalize understanding of treatment plan
Nursing Assessment
Monitor Pain Status
- Assess pain level using the appropriate scale
- Document pain characteristics
- Evaluate the effectiveness of pain management
- Note non-verbal pain indicators
- Monitor for breakthrough pain
Assess Neurovascular Status
- Check peripheral pulses
- Monitor sensation and movement
- Assess skin color and temperature
- Document capillary refill
- Note any changes in neurological status
Evaluate Mobility Status
- Assess the ability to move safely
- Document range of motion
- Monitor weight-bearing status
- Evaluate transfer abilities
- Check the proper use of mobility aids
Monitor for Complications
- Check for signs of compartment syndrome
- Assess for deep vein thrombosis
- Monitor for fat embolism
- Watch for signs of infection
- Document wound healing progress
Review Risk Factors
- Assess bone health status
- Document medical history
- Review medication profile
- Check nutritional status
- Evaluate fall risk
Nursing Care Plans
Nursing Care Plan 1: Acute Pain
Nursing Diagnosis Statement:
Acute Pain related to tissue trauma and bone fracture as evidenced by verbal reports of severe pain (8/10), guarding behavior, and facial grimacing.
Related Factors:
- Tissue trauma
- Bone fracture
- Muscle spasms
- Movement of fractured bone
- Inflammatory response
Nursing Interventions and Rationales:
- Administer prescribed pain medications on schedule
Rationale: Maintains therapeutic pain control levels - Position the affected limb properly with support
Rationale: Reduces pain and promotes proper alignment - Apply ice packs as ordered
Rationale: Reduces swelling and provides pain relief - Assess pain levels regularly
Rationale: Enables timely intervention and evaluation of treatment effectiveness
Desired Outcomes:
- The patient will report pain level at 3/10 or less
- The patient will demonstrate improved comfort
- The patient will maintain the prescribed position
- The patient will utilize effective pain management strategies
Nursing Care Plan 2: Impaired Physical Mobility
Nursing Diagnosis Statement:
Impaired Physical Mobility related to prescribed immobilization and pain as evidenced by the inability to move purposefully within the physical environment.
Related Factors:
- Prescribed immobilization
- Musculoskeletal injury
- Pain
- Fear of movement
- Muscle weakness
Nursing Interventions and Rationales:
- Assist with prescribed mobility exercises
Rationale: Maintains joint function and prevents complications - Teach proper use of mobility aids
Rationale: Ensures safe movement and prevents falls - Position patient properly q2h
Rationale: Prevents pressure injuries and promotes comfort
Desired Outcomes:
- The patient will demonstrate safe transfer techniques
- The patient will maintain proper body alignment
- The patient will participate in a prescribed exercise program
- The patient will use mobility aids correctly
Nursing Care Plan 3: Risk for Peripheral Neurovascular Dysfunction
Nursing Diagnosis Statement:
Risk for Peripheral Neurovascular Dysfunction related to trauma and immobilization as evidenced by femur fracture and required stabilization.
Related Factors:
- Musculoskeletal trauma
- Edema
- Immobilization
- Vascular compromise
- Compartment syndrome risk
Nursing Interventions and Rationales:
- Assess neurovascular status q4h
Rationale: Enables early detection of complications - Monitor for signs of compartment syndrome
Rationale: Allows prompt intervention for this emergency - Maintain proper positioning
Rationale: Promotes optimal circulation
Desired Outcomes:
- The patient will maintain adequate peripheral circulation.
- The patient will demonstrate intact sensation
- The patient will show no signs of neurovascular compromise
Nursing Care Plan 4: Risk for Falls
Nursing Diagnosis Statement:
Risk for Falls related to altered mobility and balance impairment as evidenced by the use of assistive devices and weakened lower extremity.
Related Factors:
- Altered mobility
- Use of assistive devices
- Muscle weakness
- Pain
- Environmental hazards
Nursing Interventions and Rationales:
- Implement fall precautions
Rationale: Prevents additional injury - Educate about environmental safety
Rationale: Promotes awareness and safe mobility - Ensure proper use of call light
Rationale: Provides timely assistance when needed
Desired Outcomes:
- The patient will remain free from falls
- The patient will demonstrate safe mobility practices
- The patient will utilize the call light appropriately
- The patient will identify fall risk factors
Nursing Care Plan 5: Risk for Infection
Nursing Diagnosis Statement:
Risk for Infection related to surgical intervention and presence of internal fixation devices as evidenced by surgical incision and altered tissue integrity.
Related Factors:
- Surgical procedure
- Internal fixation devices
- Altered tissue integrity
- Decreased mobility
- Invasive procedures
Nursing Interventions and Rationales:
- Monitor surgical site
Rationale: Enables early detection of infection - Maintain sterile technique
Rationale: Prevents contamination - Administer prescribed antibiotics
Rationale: Prevents postoperative infection
Desired Outcomes:
- The patient will remain free from infection
- The patient will demonstrate proper wound care
- The patient will maintain a normal temperature
- The patient will show no signs of systemic infection
References
- Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2023). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.
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