Nursing Care of Distal Left Leg Fracture and Amputation with Renal Failure : Case study

Abstract

A 28 years old. Hospitalization in King Naria Hospital on 12 January 2017. Nearly amputation distal left leg after motorcycle accident was presented 10 minuted prior to admission. Hypovolemic shock was showed. Scrub and debridement with multiple pinning were done. Nursing care plan to improved hypovolemic shock. Then limb ischemia, bleeding and distal pulselessness were occur. Below knee amputation was done.

Tissue  hypoxia  was  showed  in  post-operative period. Nursing care plan to improved oxygenation by endotracheal tube and ventrilator support. Then tissue hypoxia was improved ; weaning protocol was done and extubation was successed.

Within 2 days post operatively; wound infection, acute renal failure and fluid overload were presented. Respiratory support and hemodialysis were done. Patient was transfered-in ICU Surgery. When renal function was improved ; patient was transfered-out to Orthopedic Department. Wound infection was performed by scrub and debridement, wound care management. Then closed strump was done.

Discharge planning were performed during rehabilitation under multidisplinary care team and care giver empowerment for  adaptation and new body image accepted. Length of stay were 41 days.