Open Reduction and Internal Fixation or ORIF is a type of surgery performed by an orthopedic surgeon to repair or heal bones that need to be put back together. If the bone whether it is of leg, arm, or ankle is in pieces, it might need to be repositioned in its place with metal screws or plates so that it can be stabilized and held in place (Hastings 2nd & Leibovic, 1993). In the case of Edward Smith, the patient presented with excruciating pain in his right ankle after falling off a ladder and a past medical history of surgery of the lower back due to chronic lower back pain was admitted to the hospital for ORIF due to a right ankle fracture.
The signs and symptoms that led to ORIF were excruciating pain in the ankle, hypertension, past surgery of the lower back, high blood pressure, mild temperature, and impaired physical mobility. Moreover, Smith was in his fifties and his Hgb was so low because of the blood loss during the surgical incision method performed to put his ankle bone in place which would lead to more complications if ORIF was not done in the first place.
The nursing interventions presented to Smith that he must adhere to according to his doctor’s and nurse’s plans included elevating his legs for stability, performing passive ROM, promoting proper nutrition, and taking all prescribed medications. Nursing considerations during the shift included repositioning the patient every 2 hours to avoid skin breakdown. Moreover, nursing interventions would include managing the patient’s pain, monitoring neurovascular status, preventing infection, administering medications, and assisting with repositioning as well as exercising for speedy recovery (Hoffman & Sullivan, 2019).
In summary, the patient was admitted to the care setting because he was at risk of falls and the situation worsened due to impaired physical mobility. The short-term outcome of the nursing care plan suggested that the patient would report 2/10 pain in his right leg by the end of the shift for which ORIF was performed to heal the fractured bone. Nursing interventions and considerations included passive ROM, proper nutrition to overcome the weakness the patient was feeling due to blood loss, repositioning of the patient, and checking the surgery area for signs of infection to minimize edema on the part of the nurse. The goal to reduce patient pain by 2/10 at the end of the shift was met as Smith reported less pain as compared to the severity he felt when he was presented to the surgeon. The patient was instructed to adhere to all the recommendations his doctor suggested and by the end of the shift he demonstrated that he had the understanding of all patient teaching.
References
Hastings 2nd, H., & Leibovic, S. J. (1993). Indications and techniques of open reduction. Internal fixation of distal radius fractures. The Orthopedic Clinics of North America, 24(2), 309–326.
Hoffman, J. J., & Sullivan, N. J. (2019). Davis Advantage for Medical-Surgical Nursing (2nd ed.). F.A. Davis Company.
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