Background and rationale of the study: One of the leading cases of musculoskeletal trauma is fracture. Fractures are any break in the continuity of the bone. It usually occurs when the stress placed on a bone is greater than the bone can absorb. Muscles, blood vessels, nerves, tendons, joints and other organs may be injured when fracture occurs (Nettina, Sandra B. 2006). It can be caused by metabolic bone diseases such as osteoporosis, or as a result of direct force when a moving object strikes the body area over the bone, or it could result from accidental falls.
Accidental falls is on top of the list when we talk about fracture causes, and it can happen as a result of lack of balance and poor muscle coordination. It can also happen because of underlying neuromuscular disorders like cerebral palsy. Cerebral palsy includes a wide variety of non-progressive brain disorders that occur during intrauterine life, delivery, or early infancy. It is defined as a syndrome of motor disabilities possibly accompanied by mental retardation, seizures, or both.
Causes of cerebral palsy are many and include cerebral developmental disorders uch as microcephaly, intracranial hemorrhage, cerebral anoxia, and toxins such as excessive bilirubin. Prenatal factors include infection with rubella, nutritional deficiency, and blood factor incompatibility (Bullock and Henze, 2000). One of the most common types of cerebral palsy, that accounts for 50% of all CP cases, is the Spastic cerebral palsy.
It has three different subtypes mainly: diplegia, which mostly affects the lower extremities; Quadriplegia, where all four extremities are involved; and lastly Hemiplegia, the most common type of spastic CP and it involves one side of the body. The author of this study chose the above mentioned case because the author would want to make a connection between the two major diseases occurring in one individual, since the occurrence of one would not necessarily mean the presence of the other.
Likewise cerebral palsy patient are thought to be somebody that should be given special attention and care because of the affected individuals inability to perform activities of daily living, and to have a CP patient get injured indicates that there must be some negligence on the part of the direct care giver, who is the mother. Moreover cerebral palsy patients have a high seizure tendency and soft rittle bones due to lack of usage of the extremities contributing to the risk of acquiring injuries such as fracture.
With the given information above, the researcher would like to know more about the disease condition and to provide important information to the parents of the child to avoid future injuries. This study aims to obtain information regarding Cerebral palsy and closed subtrochanteric fracture of the femur. It as well intends to analyze the diagnostic findings of a patient diagnosed with this condition and to identify medical and surgical interventions appropriate for this disease. Lastly this study aims to provide holistic nursing care to patients diagnosed with this disease.
SPECIFIC OBJECTIVES: To know conditions that can possibly lead into cerebral palsy and fracture of the femur. To be able to connect cerebral palsy to the development of fracture and their relationship to each other. To be able to gather information on medical interventions and surgical interventions available to possibly cure this disease condition. As a nurse, to enumerate the responsibilities specific to this kind of disease in order to render compassionate and holistic nursing care. Significance of the study: As we all know Cerebral palsy is not a common condition.
This means that nit too many in society know about the disease, while fracture on the other hand is very common. Like for example, at the Vicente Sotto Memorial Medical Center Orthopedics ward. 70% of the censuses are diagnosed with fracture while cerebral palsy only accounted for 0. 5% of the total census for the whole week of June. This study provides the readers information regarding fracture and cerebral palsy since the presence of the latter predisposes the occurrence of the former. It informs egarding the possible causes, signs and symptoms, and corresponding management to avoid and treat the condition.
People with this condition will benefit from this study through their health care providers who will be educated on the proper interventions to promote their fast recovery of their fractured femur and to prevent the injury from occurring by eliminating risk factors. The health care providers will profit from this study through obtaining past and current interventions to promote fast healing and recovery of fractures. They will also benefit in terms of knowing the right seizure precautions, to avoid such injuries from appening again during the course of the disease or in the future, when fracture recovery is already obtained.
The study will profit the parent of the patient, since the understudy is a seven year old child and can not read or talk, because it will provide them the right information regarding the child’s condition. It will educate them on the proper precaution that has to be observed in order to avoid injuries if ever seizure episodes Methodology: The study was conducted in Vicente Sotto Memorial Medical Center during a week of exposure at Ward VIII (Ortho Ward). A patient with the name of N. F. S. O. was chosen personally by the student nurse under the guidance of his clinical instructor.
She was assisted with her physical, emotional and psychological needs within the next 4 days. Within the allotted time, the patient was rendered with holistic nursing care. The first meeting of the student nurse and patient was devoted to establishing therapeutic relationship in order to gain trust, cooperation and participation from the patient during the course of the treatment. In addition, a physical assessment was also done to obtain baseline data and for the purpose of documentation. This was erformed with the aid of the Orthopedic physical assessment form.
Following the initial observations, nursing problems were identified. To address the problems recognized, nursing care plans were made to guarantee holistic nursing interventions. The implementation of those plans was reserved to the remaining days of the exposure. Likewise, SOAPIE chartings were done to help test the behavioral outcomes or responses of the patient to interventions done. Then with the support from the clinical instructor who also served as the adviser, the student nurse was guided as to her responsibilities to the patient.