Nursing Case Study Analysis | Assignment

Running Head: NURSING CASE STUDY ANALYSIS 1
NURSING CASE STUDY ANALYSIS
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NURSING CASE STUDY ANALYSIS 2
1. Assessing the patient and applying Lewis’s Medical-surgical Nursing pages, the condition
that the patient is experiencing can be comminuted fracture (Erturer et al, 2011). The
patient can be assumed to have multiple bone breaks in three or more pieces. This fracture
has caused excessive bleeding causing neurovascular injury with severe trauma.
2. Miley’s old age and falling by slipping down is the primary reason that is causing the
condition identified as above. The twisting force has limited her movement, causing
multiple injuries on her ankle.
3. Miley’s NV status obtained by monitoring of pain, pulse, pallor, paralysis and paresthesia
needs to be informed to her and her family members or support group.
Researching the conditions in Lewis’s Medical-surgical Nursing, the list of treatment
needed for Miley includes surgical treatment. Surgical treatment might include external
fixation by operating on metal pins or screws in the bone below the fracture site. These
pins and screws are put on the bar outside the skin and it will allow stabilizing the frame
holding the bone in proper position so that they can heal. Nonsurgical treatment is not
suggested for the patient as this is not the case of closed fracture.
4. In Miley’s case, her cast is split to relieve her condition. As Miley is 64 years old, there
might be age related changes in her muscular system that will impact her recovery leading
to future problems. Aging has been found associated losing out of muscle mass known as
sarcopenia. This decrease in muscle tissue is dramatic beyond 60 years of age and it
diminishes muscular functions (Haentjens et al, 2010). Thus, bone recovery is slower due
to reduction in musculoskeletal system.

NURSING CASE STUDY ANALYSIS 3
5. As ageing is related to progressive loss in bone-muscle mass as well as strength,
decline in mass and strength is heightened in adverse health outcomes. Understanding
bone-muscle interaction, it can be said that the possible pathological events takes
place. Osteoclasts are specialised cells that absorbs worn-out bone cells and removing
them from bone. Similarly, other cells called the osteoblasts derives calcium from
blood and redistribute in upon the bone. With age osteoblasts cannot keep up with the
activity of osteoclasts. Thus, older adults suffering bone fracture directs more
resources to bone break. Losing cycle of bone removal and replacement explains the
reason cellular metabolism takes longer time to heal in older adults.
6. There are considerable physiological changes that takes place with aging in all organs.
The cardiac output decreases, arteriosclerosis develops and blood pressure increases.
Musculoskeletal - Osteoclasts are specialised cells that absorbs worn-out bone cells
and removing them from bone. Similarly, other cells called the osteoblasts derives
calcium from blood and redistribute in upon the bone. With age osteoblasts cannot
keep up with the activity of osteoclasts. Lungs are also seen to have impaired gas
exchange, with decreasing vital capacity and lower expiratory flow rates.
Renal - Creatinine clearance reduces with age though the serum
creatinine levels are seen to be relatively constant as a result of proportionate age-
related reduction in creatinine production (Wardhan, 2013).
Gastrointestinal (GI) - Changes in functionality is majorly from altered
motility patterns taking place in the gastrointestinal system with senescence as well as
atrophic gastritis, and altered hepatic drug metabolism taking place in elderly people.
Cardiovascular (CV) – CV in ageing individual is seen to cause changes in heart and