Nursing Care for Patients with Pathologic Fracture of Mid-shaft Tibia from Lung Cancer Metastasis : A Case Study.

Abstract

      This case study aimed to investigate the holistic nursing process in patients with fractures resulting from lung cancer metastasis. The study design was a case study of a 70-year-old Thai female patient diagnosed with a pathologic fracture of the mid-shaft tibia from lung cancer metastasis. She underwent surgery to implant an internal bone fixation plate (ORIF with Nail). Data were collected through interviews, observation, physical examination, and medical records.

      The results showed that during initial hospitalization, the patient experienced pain and limited mobility. Key nursing activities included: pre-operative assessment of peripheral circulation, administration of anticoagulants (Enoxaparin) to prevent venous thromboembolism, a significant problem in cancer patients receiving chemotherapy, and physical and mental preparation; post-operative care addressed anemia, surgical blood loss (EBL 300 ml), hemoglobin levels of 24%, requiring a 1 unit transfusion (PRC); and hypertension, requiring antihypertensive medication and initiation of anticoagulant therapy to prevent further thromboembolism; and rehabilitation. Movement was promoted with the use of a walker. The patient was able to walk well with the walker. Wound care was provided. The doctor allowed the patient to go home. Total hospital stay: 6 days.