ENGLISH ADVANCE FOR

NURSING GROUP TASK

"Safety and Accident Prevention"

 Arranged by:

Agung Laksmana NIM

161,0006
Intan Cahya P L
NIM 161,0048
Nadia Ayu K A NIM
161.0066
Nandika Ayu NF
 CONTENT

1. General Overview
2. Study Case
3. The Concept Of
Nursing Care At
Femur Fractures
General Overview of
Safety and Accident
Prevention
 SAFETY

According to Husni (2010:

152), work safety is related to
workplace accidents, namely
accidents that occur in the
workplace or known as
industrial accidents.
The legal basis states that this
personal protection equipment
is Undang-undang No. 1 Tahun
1970 Bab IX pasal 13
concerning obligations when
entering a workplace that
reads: "Whoever enters a
workplace, is obliged to obey
all work safety instructions and
 HEALTH

Health work according to that is

"a situation workers who are
free from physical and mental
disorders as a result of the
influence of work and
environment interactions ".
 Legal provisions regarding occupational health are also
contained in UU Kesehatan No. 23. This Health Law
confirms the following matters.

1. Occupational health is held to realize optimal work

productivity.
2. Occupational health includes occupational health
services, prevention of occupational diseases, and
occupational health requirements.
3. Every workplace must carry out occupational health.

Provisions regarding occupational health as referred to in

paragraph (2) and (3) are stipulated by Government
regulations.
 PREVENTION
1. Create accident prevention activities as
part of our daily activities.
2. Report when finding things that are
unsafe to your nearest supervisor /
supervisor
3. Avoid joking at work
4. Follow the Instructions / Work
instructions / Procedures
5. Suggest improvement
6. Good in housekeeping
7. Neatat work
Study Case Of Safety and Accident
Prevention

“Femur Fracture”
 Definition

Fractures are fractures, usually

caused by trauma or physical
energy. The strength and angle of
the energy, the state of the bone
itself and the soft tissue around the
bone will determine whether the
fracture that occurs is complete or
incomplete. (Helmi, 2012)
 Classification

a)Femoral intracapsular
fractures that occur in the
joints , pelvis and through
the head of the femur
(capital fracture)
b)Extractapsular fracture.
 Etiology

1. Direct trauma / direct trauma

2. Indirect trauma / indirect
trauma
3. Even mild trauma can cause a
fracture if the bone itself is
fragile / there is an "underlying
disease" and this is called a
pathological fracture.
 Pathophysology

Fractures are most often caused

by trauma. The hard impact of
an accident involving the bone
will cause the bone to become
broken and irregular bone
fragments or discontinuities in
the bone. (Padila 2012)
 Clinical Manifestations of Femur
Fractures
1. Continuous pain and weight gain until
the bones are mobilized.
2. Deformity (visible or palpable).
3. In long fractures, there is actual
shortening of the bone due to muscle
contraction attached above and below
the fracture location.
4. When extremity is examined by hand,
palpable crunch of bone is called crepitus
which is palpable due to friction between
the fragments of one another.
 Supporting Examination
1. X-ray examination: determining the location /
extent of trauma fracture
2. Bone scan, tomogram, CT / MRI scan: showing
fracture, can also be used to identify soft
tissue damage.
3. Arteriogram: performed when vascular
damage is suspected.
4. Calculate the complete area: HT may increase
(hemoconcentration) or decrease (white blood
cell bleeding is a normal stress response after
trauma).
5. Creatinine: Muscle trauma increases creatinine
load for kidney clients, coagulation profile,
 Management of Femur
Fractures
a. Reduction ; Fracture reduction means
returning bone fragments to their
alignment or anatomical rotation.
b. Immobilization ; Immobilization can be
used with the external method and
internally maintaining and restoring
the functions of neurovascular status
are always monitored including blood
circulation, pain, touch, movement.
The Concept of Nursing Care
at Femur Fractures
 1. Assessment of Clients Femur
Fractures
• Clinical manifestations of femoral fractures are
similar to clinical manifestations of common
long bone fractures, such as pain, loss of
function, deformity, shortening of lower
extremity due to muscle contraction attached
above and below the site of fracture,
crepitation, swelling, and local changes in skin
color due to trauma and fracture bleeding.
B1 (Breathing). On examination of the respiratory
system, it was found that the client fractured the femur
did not experience respiratory abnormalities.

B2 (Blood). Inspection: no heart jaundice. Palpation:

the pulse increases, the iktus is palpable.

B3 (Brain).
Level of consciousness, usually compost mentis.
Examination of cerebral function. Mental status:
observation of appearance and client behavior. Usually
the mental status does not change.
B4 (Bladder). Assess urine conditions including
the color, amount, and characteristics of urine,
including urine specific gravity.

B5 (Bowel). Abdominal inspection: flat,

symmetrical, no hernia.

B6 (Bone). The presence of a fracture in the

femur will interfere locally, both motor,
sensory and circulatory functions.
 Nursing Diagnosis
1. Acute pain associated with physical injury agents, muscle spasm,
movement of bone fragments, edema, soft tissue injury, traction
installation.
2. Barriers to physical mobility are associated with neuromuscular
skeletal damage, pain, restrictive therapy (immobilization).
3. Risk of infection associated with trauma, primary body immunity
decreases, invasive procedure (traction installation).
4. Anxiety is associated with situational crises, economic status, and
changing role functions. Acute pain associated with physical injury
agents, muscle spasm, movement of bone fragments, edema, soft
tissue injury, traction installation.
 CASE
Client entered hospital on July 3, 2018 Hours 13.10 Time. The assessment was carried out on July 9,
2018 at 8:30 a.m. obtained through direct observation, physical examination, review of medical records and
nurse records. The main complaint is felt, the client complains of pain in the legs of the right thigh part after
surgery, pain such as stabbing, scale of pain 4, pain arises when moved, the client looks nervous, grimacing
facial expressions .

Medical history now the client enters Bahteramas Hospital through referral from District Hospital.
Konawe Utara, a client is hit by wood while working. Then the client enters through the General Hospital of
the Bahteramas Hospital, while at the client's emergency room complains of pain in the extremity of the
right leg thigh. Clients get RL infusion therapy 20 drops per minute, and staining. X-rays of the right lower
extremity are fractured femur 1/1 proximal right. After that the client is taken to the surgical room at 16.30
for treatment and waiting for the surgery schedule. The operation was carried out on July 4, 2018 at 10:00
a.m. It was finished at 12:30 a.m.
 Previously the client had experienced fever. Family health history, the client
said that in family members no one suffered from hereditary diseases such as
diabetes mellitusand hypertension. In the family tree, Mr. D is the first child of the
siblings.

The results of the client's general condition inspection are weak The level of
awareness of the client is fully aware (compos mentis) with the value of the
Glasglow Coma Scale (GCS): 15 (eye 4, verbal 5, motoric 6). The results of
examination of vital signs are as follows, blood pressure 110/70 mmhg, pulse 68
times per minute with a regular and strong rhythm, respiratory frequency 20
times per minute with regular rhythm, and temperature 36.5o C.
 Data analysis
Ds:
- Client complains of pain in the leg of the right thigh part
- Pain is felt after surgery
- Pain like stabbing
- Scale of pain 4
- Pain arises when right foot is
Doped
Do:
- General condition is weak
Problem :
- Consciousness composment
- Client looking nervous
- grimacing facial expression
- at the lowerthigh
rightis attached to the container
PAINT ACCUTE
extremity the(draine) and the turban
- the x-ray results in a fracture
of the right 1/8 proximal.
- Vital Signs:
BP: 110/70 mmHg S: 36,5oC
HR: 68 x / minute
RR: 20x / minute
 Nursing Diagnosis

Acute pain associated withinjury

agents physical: post op ORIF