Introduction
An ankle sprain is one of the most common injuries, with about 25,000 cases in the US each day. It involves the overstretching or tearing of ligaments that connect the bones of the lower leg, causing pain, swelling and sometimes bruising. Depending on the severity of the sprain, there are different treatments, ranging from resting and icing the joint to surgical repair of the torn ligaments.
Assessment
History of Injury: Taking a description of the mechanism of injury is one of the most important pieces of information for an ankle sprain. It helps determine the severity of the sprain and therefore what should be done to treat it.
Vitals and Health History: Checking vitals and reviewing the patient's history can help the provider determine other potential causes of the pain the patient is feeling, since ankle sprains can be confused with fractures or bone bruises.
Exam
Range of motion and Strength tests: Testing the range of motion of the joint can be done to assess for any mechanical defects or changes in alignment.
Special Tests: Special tests such as Apley's test, talar tilt test, or anterior drawer test can also be done to assess the ligaments on the front or back of the ankle that may have been stretched or torn.
Nursing Diagnosis
A nursing care plan should include an accurate nursing diagnosis, which will help guide treatment. Depending on the severity of the sprain, the nursing diagnoses may include pain, impaired mobility, decreased strength, risk for infection, and risk for skin breakdown.
Explanation of Each
- Pain: The patient may experience pain with movement due to stretching of the affected ligaments.
- Impaired Mobility: The patient may have difficulty walking due to decreased range of motion or pain.
- Decreased Strength: Loss of strength in the ankle due to reduced range of motion or pain.
- Risk for Infection: If the injury is open, then the patient may be at risk for an infection.
- Risk for Skin Breakdown: Immobility due to the injury can lead to skin breakdown, especially if the patient Is bed-bound.
Outcomes
The goal of treatment is to reduce pain, improve mobility and strength, and prevent complications such as infection or skin breakdown. The desired outcome of the nursing care plan for an ankle sprain is for the patient to return to their full activity level without pain or discomfort.
Explanation of Each
- Pain Reduction: A decrease in pain with movement is indicative of healing.
- Increased Mobility: Improved range of motion and strength can help the patient regain their independence.
- Increased Strength: The patient should be able to restore strength to the affected area.
- Infection Prevention: If the injury is open, then proper treatment can help prevent infection.
- Skin Breakdown Prevention: Appropriate interventions can help reduce the risk of skin breakdown due to immobility.
Interventions
Interventions for an ankle sprain will depend on its severity. Mild sprains may only require rest, ice, and elevation. Severe sprains may require immobilization until the patient can regain weight-bearing capacity.
Explanation of Each
- Rest: Resting the injured ankle can help reduce inflammation and allow for healing.
- Ice: Applying ice to the injured area can help reduce pain and swelling.
- Elevation: Elevating the affected area can help reduce swelling and promote circulation.
- Compression: Wrapping the ankle can help provide additional support and reduce swelling.
- Immobilization: A brace or cast may be necessary in more severe cases to keep the ankle stable while it heals.
Rationales
Rationales should be provided when determining the best course of action for the patient. Rationales for treatment for an ankle sprain include reducing inflammation, promoting circulation, and preventing further injury.
Explanation of Each
- Reducing Inflammation: Rest, ice, compression, and elevation all help reduce inflammation around the joint.
- Promoting Circulation: Elevation helps promote circulation, which is essential for healing.
- Preventing Further Injury: Immobilization helps prevent further injury to the ligaments or bones by keeping the ankle secured.
Evaluation
Evaluation of the effectiveness of the interventions should be done regularly. The patient should be assessed for pain reduction, improved range of motion and strength, and prevention of complications.
Conclusion
An ankle sprain is a common injury that can be treated through rest, ice, elevation, and immobilization. The goal of treatment is to reduce pain, improve mobility, and prevent complications.
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