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Nursing Care of Klients with Fractured Distal Femur
VOPÁLKOVÁ, Milena
The name of this Bachelors thesis is "Nursery Care of Patients with Fractured Distal Femur". With view to the lengthening of the populations age, increasing popularity of adrenalin sports and development of traffic we can expect an increasing number of this serious type of injury, and therefore it is time to address the issues of nursery care of the clients with this type of fracture. Fracture of the distal part of femur often happens suddenly and unexpectedly and the client has to deal with a health problem, which brings about a lot of changes as regards his/her health, psychic and social situation. The purpose of this thesis is to map the nursing specifics and nursing problems experienced by clients with a fractured distal femur from the nurses point of view. Through an analysis of a research survey we will summarize the thesis outcomes and determine the specifics of possible complications under the nursery care of such clients. Hence, the thesis contains two fundamental parts: theoretical and empirical. The theoretical part deals with the historical development of nursing and care provided as regards these fractures, the anatomy of lower limbs and causes of such fractures. It also addresses the basic classification of such fractures, principles of an osteosynthesis therapy, education, nursing and rehabilitation care. The empirical part includes a research survey with two predetermined goals mapping the specifics and complications within the nursing care of clients with a distal femur fracture. With view to the fact that various specifics and complications within the nursing care in the period before and after surgery were ascertained, they were categorized as pre-surgery and post-surgery specifics and complications. The research survey found out that one specific is differing pre-surgery nursing care of the clients with a fractured distal femur, mainly provided that stabilisation of the fractured part is executed by means of a skeletal traction or a patch traction or through a knee brace. The ascertained nursing complications are related to such immobilization interventions. According to the interviewed nurses the nursing procedure is even more diverse, mainly as regards the injured clients mobility and the nursing care. Other specifics of the nursing care are monitoring of locomotion and sensitivity of the traumatized lower limb, antidecubitus care, aself-care deficit and a possible risk of the lever action impact on the distal femur when moving on the bed. Specifics of the post-surgery nursing care regarding clients with a knee brace are: monitoring of locomotion and sensitiveness of the lower limb, correct manipulation with the knee brace, care of the locomotion, a risk of the lever action impact on the osteosynthesis area mainly when the client is sitting on the bed with lowered limbs or doing exercise on the motor splint. Nursing complications ascertained during the post-surgery period are mainly an oedema and a haematoma of the surgical wound place, urine and faeces emptying disorders, inadequate relief of acute pain, decubites under the knee brace or on the heels, long-term deficit of the clients self-care due to the traumatic consequences and other possible complications as described in this thesis. Outcomes of this thesis are two simple mind maps, which are a part of this thesis. The first mind map shows the nursing care specifics as regards a client with a fractured distal femur and the second describes the most frequent complications and interventions of a nurse within the nursing care as regards a client with a fractured distal femur. The outcomes of this thesis can serve as an information material for traumatology unit nurses and also for nurses working in other complements.
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