Nursing care for a child with a fractured left femur and mild head injury focuses on addressing acute pain and ensuring the patient’s safety and well-being. This requires a thorough examination of the child’s whole body to assess for any discomfort, crepitus, deformity, loss of function, and neurovascular status of the affected limb (Haimes & Blankstein, 2019). The priority nursing diagnosis for a patient with a fracture is acute pain. Pain management is essential to promote comfort and facilitate healing.
Following a head injury, the Glasgow Coma Scale (GCS) is performed to assess the patient’s level of consciousness and neurological function. This evaluation is conducted after ensuring the patient’s airway, breathing, and circulation are stable (Haimes & Blankstein, 2019). Identification and management of a head injury is crucial to prevent further complications and promote optimal recovery.
Once the child is transferred from the intensive care unit (ICU), priority nursing interventions include dietary support and physiotherapy. A healthy diet promotes bone repair and ensures the patient’s weight remains within tolerable limits considering the injured limb (Haimes & Blankstein, 2019). Physiotherapy plays a vital role in strengthening the patient’s muscles and promoting mobility. Use of mobility aids and assistive devices should be facilitated to ensure safe ambulation.
Maintaining a clear airway and adequate breathing are also essential nursing priorities. Depending on the severity of the head injury, intracranial pressure (ICP) monitoring may be necessary to prevent further secondary injuries. Monitoring and addressing factors such as hypoxia, hypercapnia, or hypoperfusion can help manage ICP and promote optimal brain function (Haimes & Blankstein, 2019).
However, certain interventions, such as the use of a Foley catheter, may present associated risks. The placement of a urinary catheter, particularly an indwelling Foley catheter, increases the risk of urinary tract infections. Complications such as epididymitis and orchitis can occur in men due to urinary infections (Saifullah et al., 2020). Bladder spasms, obstructions, leaks, and urethral damage are additional potential issues associated with catheter placement.
In the case of this child, an indwelling Foley catheter may not be necessary once they are discharged from the ICU. Instead, the focus should shift towards strengthening and mobilizing the patient’s muscles through physical therapy. It is common for patients to begin ambulating with the assistance of a physical therapist within the first few days following an accident or surgery. By engaging in regular activities and exercises, the child’s chances of a full recovery can be optimized (Haimes & Blankstein, 2019).
In conclusion, nursing care for a child with a fractured left femur and mild head injury involves addressing acute pain and ensuring the patient’s safety and well-being. This includes a thorough examination of the whole body, pain management, GCS assessment, dietary support, physiotherapy, maintaining a clear airway and adequate breathing, and monitoring and managing intracranial pressure if necessary. Care should be taken when considering interventions like the placement of a Foley catheter, as they carry associated risks. It is crucial to individualize nursing care and prioritize interventions that promote healing and optimal recovery.