19 NANDA Nursing Diagnosis for Fracture |Nursing Priorities & Management

Last updated on December 28th, 2023

In this post, you will find 19 NANDA nursing diagnosis for fracture. These include actual and risk nursing diagnoses.

Fracture nursing assessment, interventions, priorities, and patient teaching are all included.

In nursing, a fracture can be defined as a break in a bone due to direct or indirect pressure that exceeds the bone’s normal elasticity.

Fracture causes damage to surrounding soft tissues, nerves, tendons, and vasculature and is associated with severe pain and as well.

Click Here to Review Fracture Notes.

19 Fracture Nursing Diagnosis

  1. Acute pain
  2. Impaired physical mobility
  3. Impaired skin integrity
  4. Self-care deficit
  5. Disturbed body image
  6. Fear
  7. Deficient knowledge
  8. Impaired comfort
  9. Anxiety
  10. Risk for peripheral neurovascular dysfunction
  11. Risk for infection
  12. Risk for thrombosis
  13. Risk for impaired gas exchange
  14. Risk for ineffective peripheral tissue perfusion
  15. Risk for decreased cardiac tissue perfusion
  16. Risk for decreased cardiac output
  17. Risk for unstable blood pressure
  18. Risk for ineffective cerebral tissue perfusion
  19. Risk for imbalanced fluid volume

NANDA nursing diagnoses for Fracture (Actual)

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Fracture Nursing Diagnosis (Part 1)

#1 Acute pain

May be related toAs evidenced by
Fracture, movement of bone fragments, soft tissue injury, vascular trauma, nerve injury, traction device, muscle spasms, tendon injuryReport of pain as severe on a standardized pain scale, crying, facial grimace, guarding behavior, diaphoresis, tachycardia, tachypnea, increased blood pressure
Acute pain

#2 Impaired physical mobility

May be related toAs evidenced by
Altered bone integrity, immobilization, traction device, decrease in muscle strength and control, neuromuscular impairmentDecreased range of motion, poor muscle control, muscle pull/spasm, reduced muscle strength, need for restriction of movement,  postural instability  
Impaired physical mobility

#3 Impaired skin integrity

May be related toAs evidenced by
Open fractures, internal/external fixation devices, traumatic injury, surgical intervention, prolonged immobilizationOpen wound, surgical incision site, paresthesia, presence of pressure ulcers on bony prominences
Impaired skin integrity

#4 Self-care deficit (Dressing/Bathing/Toileting)

May be related toAs evidenced by
Immobilization, pain, limited range of motion (ROM)  Inability to perform activities of daily living (ADLs) independently, difficulty in putting on and removing clothes, difficulty in using assistive device, difficulty in walking
Self-care deficit

#5 Disturbed body image

May be related toAs evidenced by
Fracture(s), presence of immobilizing devices, amputation, tubes and drainsVerbal expression of negative feelings about injury, unhappiness, fear of rejection, unwillingness to meet people
Disturbed body image

#6 Fear

May be related toAs evidenced by
Impending surgical intervention, hospital environment, hospital procedures, orthopedic equipmentVerbal expression of fear, tensing of muscles, tachypnea, tachycardia, crying, insomina

#7 Deficient knowledge

May be related toAs evidenced by
Lack of factual information, presence of learning disabilityNon-compliance with treatment, statement of inaccurate statement, inquiry about the condition, requests for information, development of preventable complications
Deficient knowledge

#8 Impaired comfort

May be related toAs evidenced by
Cast application, internal fixation devices, restricted movement,Presence of casts, reports of discomfort and altered sleep-wake cycle, difficulty in relaxing, irritability
Impaired comfort

#9 Anxiety

May be related toAs evidenced by
Surgery, hospitalization, acute change in health statusReports of psychological distress, irritability, apprehension, agitation, altered sleep-wake cycle

Risk nursing diagnosis for Fracture

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Fracture Nursing Diagnosis (Part 2)

#1 Risk for peripheral neurovascular dysfunction

Associated risk factors

  • Interrupted blood flow
  • Thrombus formation
  • Vascular and soft tissue injury
  • Hypovolemia

#2 Risk for infection

Associated risk factors

  • Impaired skin integrity
  • Invasive procedures
  • Prolonged hospital stay
  • Traction devices

#3 Risk for thrombosis

Associated risk factors

  • Presence of fracture
  • Prolonged immobilization
  • Surgical intervention

#4 Risk for impaired gas exchange

Associated risk factors

  • Altered blood flow
  • Presence of blood/fat emboli
  • Pulmonary edema
  • Pulmonary tissue trauma

#5 Risk for ineffective peripheral tissue perfusion

Associated risk factors

  • Altered blood flow due to fracture
  • Presence of casts

#6 Risk for decreased cardiac tissue perfusion

Associated risk factors

  • Altered blood flow due to fracture
  • Internal bleeding

#7 Risk for decreased cardiac output

Associated risk factors

  • Decrease in circulatory blood volume due to hemorrhage

#8 Risk for unstable blood pressure

Associated risk factors

  • Altered blood flow
  • Internal bleeding

#9 Risk for ineffective cerebral tissue perfusion

Associated risk factors

  • Altered blood flow
  • Internal bleeding

#10 Risk for imbalanced fluid volume

Associated risk factors

  • Internal bleeding
  • Active bleeding

Nursing Priorities for Fractures

  • Prevent further bone/tissue damage.
  • Pain management
  • Restoration of function
  • Prevent infection and other complications
  • Health education on fractures, pain management, immobilization, medical treatment, orthopedic device care, home care, and rehabilitation

Nursing Management for Facture

Nursing Assessment

  • Asses pain: location, severity, duration, alleviating and aggravating factors
  • Asses and monitor vital signs
  • Asses muscle strength and ROM in unaffected joints
  • Asses affected extremities regularly for signs of neurovascular compromise such as paresthesia, paralysis, weak and thread pulses and sluggish capillary refill.
  • Obtain x-ray films to determine the extent of injury

5 P’s in Nursing Assessment of a Patient with a Fracture.

Subjective dataObjective data
Localized pain (To fracture site)Guarding behavior, restlessness, irritability, moaning and crying
Muscle spasms/ cramping on immobilizationLimited range-of-motion (ROM)
Gait and/or mobility problemsDiscrepancy in limb length
Numbness or tingling (paresthesia)Hypertension, tachycardia, diminished pulses, pallor
Fatigue and weaknessLoss of function of affected extremity
Objective & Subjective data for Fracture Assessment

Nursing Interventions

  • Monitor circulation (check for changes in peripheral pulses, capillary refill, and skin temperature distal to the injury).
  • Monitor vital signs (check for tachycardia, hypotension, tachypnea, and elevated body temperature)
  • Administer analgesics, anticoagulants, and muscle relaxants as indicated
  • Give/encourage analgesia 30-45 minutes before physiotherapy sessions
  • Maintain immobilization while elevating affected extremity
  • Apply non-pharmacological pain relief measures such as ice pack application, deep-breathing techniques
  • Facilitate physiotherapy sessions as soon as possible (Early ambulation for better outcomes)
  • Assist with range of motion (ROM) exercises as needed while encouraging independence.
  • Monitor for signs of thromboembolisms
  • Apply anti-embolic stockings or other compression devices as per institution’s protocol

Patient Teaching for Fracture

Patient teaching for fracture should include the following.

  • Treatment regimen including medication doses, purpose, and possible side effects
  • Non-pharmacologic methods to manage pain
  • Limb elevation
  • Proper use and care of orthopedic assistive devices, casts, etc.
  • Self-initiated range of motion exercises
  • Aseptic wound care
  • Danger signs such as pus formation, severe pain, fever and chills, paresthesia and paralysis
  • Importance of follow up, and provide a date and time for follow up.


To sum up, you now know 19 NANDA-I nursing diagnosis for fracture that you can use in your nursing care plans.

Additionally, you have also learned about nursing assessment, nursing interventions, nursing priorities, and patient teaching for bone fractures.


Ackley, B., Ladwig, G., Makic, M., Martinez-Kratz, M., & Zanotti, M. (2020). Nursing Diagnoses Handbook: An Evidence-based Guide to Planning Care (12th ed.). Elsevier.

Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2013) Nurses pocket guide: Diagnoses, interventions, and rationales (13th ed.). F. A. Davis Company

Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, and outcomes. Elsevier Health Sciences.

Herdman, T., Kamitsuru, S. & Lopes, C. (2021). NURSING DIAGNOSES: Definitions and Classifications 2021-2023 (12th ed.). Thieme.

Swearingen, P. (2016). ALL-IN-ONE Nursing Care Planning Resource (4th ed.). Elsevier/Mosby.

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