TOMAS CLAUDIO COLLEGES

MORONG, RIZAL
COLLEGE OF NURSING

A CASE STUDY IN SURGICAL WARD:

VA (VEHICULAR ACCIDENT) - SELF ACCIDENT

SUBMITTED BY:

Pelises, Darvic, R.

MARCH, 2025
Objectives

General Objective

This study aims to examine the potential risks and complications associated with
vehicular accidents (VAs). Through this analysis, the student will gain a comprehensive
understanding of the primary challenges involved in managing patients affected by such
incidents. The goal is to equip nursing students with the knowledge and practical skills
necessary to deliver optimal care, enabling them to handle these patients effectively
and promote a successful recovery. By applying theoretical learning to patient care,
students will develop the ability to assess, manage, and provide appropriate
interventions tailored to the unique needs of individuals involved in vehicular accidents.

Student-Centered Objectives

 The student should be able to accurately understand and comprehend the

patient’s care based on the facts of their assessments on the patient.
 The student should be able to perform and provide a more accurate nursing care
process including: assessment and diagnosis, planning and implementation.
 The student should be able to have the ability to enumerate and recollect
everything they have learned about the condition’s nature including its
characteristics, symptoms, diagnosis, and therapy.
 The student should be able to demonstrate the critical thinking skills and
interventions required to deliver safe and effective nursing care.
 The student nurse should be able to confidently execute nursing interventions,
having gained enhanced skills through patient interviews.
 The student should be able to discuss and describe the clinical importance and
have gained knowledge about the initial intervention to a patient whom
experienced a vehicular accident.
Client-Centered Objectives

 The client will gain the ability to understand the precise interventions and care
necessary to prevent the worsening of her condition.
 The client will be able to recognize the signs that indicate that her condition is
worsening requiring her to seek medical attention.
 The client will become more inform about her condition.
 The client be able to engage and self-reflect about her condition accepting that
her physical optimum capability will be hindered and limited as a result.
 Introduction

A motor vehicle accident, commonly known as a "car accident" or "traffic

collision," refers to an incident in which a motor vehicle comes into contact with another
vehicle, a pedestrian, an animal, or a stationary object. While such accidents are often
caused by collisions with other vehicles, this is not always the case. The impact of a
motor vehicle accident can lead to a wide range of physical damage to the vehicle and
varying degrees of injury to the individuals involved, depending on the severity of the
collision (Hosko, M., 2021). For instance, a vehicular accident can result in fractures
such as broken legs, ribs, arms, ankles, and wrists, which are common injuries. Some
victims may even suffer a broken pelvis. The severity of these fractures can vary,
ranging from simple breaks that require a cast to more serious or compound fractures
that may necessitate surgical intervention for proper repair (Webb, W. S., et al., 2025).
According to the Department of Health (DOH), the Philippines is falling short of its
goal to reduce road crash fatalities. Health Secretary Ted Herbosa reported that the
current death rate from traffic collisions stands at 11 per 100,000, which is taking the
country further away from its target of reducing this rate to four per 100,000 (Jaymalin,
M., 2025.) On the other hand, according to data released by the World Health
Organization (WHO) in 2021, road accidents cause 1.3 million deaths and 50 million
injuries worldwide each year, with one person being killed in a traffic accident every 24
seconds. This global statistic highlights the severity of the issue, further emphasizing
the Philippines' struggle to meet its target of reducing road crash fatalities (Expert
Systems with Applications, 2022).
In summary, motor vehicle accidents remain a significant public health issue,
causing both injuries and property damage. The Philippines, as highlighted by the
Department of Health, is struggling to meet its target of reducing traffic-related fatalities,
with current rates far exceeding the desired goal. Global statistics from the World Health
Organization further emphasize the severity of the problem, with road accidents causing
millions of deaths and injuries each year. This underscores the need for stronger safety
measures, stricter traffic regulations, and enhanced public awareness to reduce the
impact of these accidents and move closer to achieving the goal of fewer fatalities.
 Patient Profile and Medical History

Name: P.E
Age: 50
Civil Status: Widowed
Nationality: Filipino
Educational Attainment: N/A
Religion: Roman Catholic
Occupation: Seamstress
Sex: Female
Chief Complaint: Pain the left patella
Admitting Physician: N/A
Admitting Diagnosis: Complete fracture in the left patella
Final Diagnosis: Complete fracture of the left patella with displacement of the fractured
segments and associated soft tissue swelling
Fiscal Year: 2025
Ward: Surgical
Bed No: N/A
Date of Admission: March, 23, 2025

Past Medical History

In 2018, the patient underwent laboratory tests to evaluate her hypertension,

which she attributed to stress. Based on these findings, the physician prescribed
Amlodipine and Losartan. The patient has since attended regular follow-up
appointments, primarily to monitor her hypertension, but also for ongoing assessment of
her stress levels, as per the patient's account.
 Present Medical History
On February 20, the patient was involved in a vehicular accident and reported
experiencing pain radiating from her left knee to the upper left thigh. Her left foot is
immobilized with a splint, and she requires assistance, such as from her daughter, to
stand. The patient also expressed difficulty sleeping due to the ongoing pain. Although
the accident occurred on February 20, the patient was only admitted on March 23, 2025,
due to various challenges, including financial concerns. Additionally, the patient
mentioned that the nursing staff advised her to return as the physician would be on a
two-week vacation, further delaying her admission despite seeking medical attention
immediately after the accident.

DOI: February 20, 2025

POI: N/A
TOI: 12:10 PM
NOI: Vehicular Accident- Self Accident
 Gordon’s Functional Health Pattern
Pattern Before During Interpretation/Analysis
Hospitalization Hospitalization
Health  The patient is  The patient is The patient is actively
well aware of still taking her managing her health by
Perception
the benefits maintenance continuing her prescribed
and Health of taking her medication. maintenance medication
medication,  The patient and following the doctor's
Management
as she adheres to all instructions. Additionally,
verbalized, instructions she has expressed an
"Syempre, provided by intention to increase her
kailangan eh, the doctor. water intake,
para  The patient understanding its
gumaling stated that she significance in supporting
talaga will be drinking her recovery process.
susundin more water
mo." from now on,
 The patient recognizing its
acknowledge importance for
d the benefits her recovery.
of staying
active, such
as engaging
in exercise,
but stated
that she is
not
participating
due to a lack
of time, as
she
verbalized,
"Yes, alam
ko naman
sadyang
wala lang
talagang
oras eh."
 The patient
does not
regularly eat
unhealthy
foods, but
occasionally
does. She is
 aware that
such foods
are not
beneficial for
her health
and is not
particularly
fond of junk
food,
excessive
sweets, or
soda. As she
verbalized,
"Wala akong
hilig sa mga
ganyang
pagkain, pag
bumili lang
anak ko ayon
binibigyan
ako pero di
naman
talaga ako
kumakain
lagi, baka
makasama
pa."
 The client
has no vices,
such as
alcohol or
cigarettes,
and is aware
that these
could worsen
her high
blood
pressure.
She
verbalized,
"Nako, bawal
ako sa mga
ganyan, mas
tumataas
dugo ko."
Nutrition  Prior to  The patient's The patient's diet and
hospitalizatio diet is as metabolism pattern
and
n, the client tolerated and indicates that she follows
Metabolism was able to is not a flexible eating routine,
eat three restricted to consuming a variety of
Pattern meals a day. any specific foods as tolerated and
 The patient is foods following without any post-surgery
aware that her surgery. restrictions. She is mindful
consuming of moderating her intake
too much of unhealthy foods,
sugar and particularly those high in
salt is sugar and salt, and
harmful to prioritizes the
the body, consumption of fruits and
which is why vegetables. Although her
she focuses diet is not restricted, she
on eating understands the
more fruits importance of balance,
and especially due to her lack
vegetables. of regular exercise. This
As she suggests a conscious
verbalized, effort to maintain a
"Masama healthy diet and
yung mga metabolism, with
ganong adjustments made based
pagkain e, on her health needs and
kaya more preferences.
on gulay and
prutas talaga
ako."
 The patient
has no
known
allergies to
any foods or
medications,
allowing her
to eat
anything, but
in
moderation.
As she
verbalized,
"Lahat
naman
pwede,
sadyang ako
lang yung
may ayaw sa
mga
masasaaman
g pagkain sa
katawan.
Syempre,
wala na nga
 akong
ehersisyo,
kaya
bumabawi na
lang ako sa
pagkain."
Elimination  The client  The client’s The client's elimination
stated that elimination of pattern appears to be
Pattern
over a 24- both urine and normal and consistent,
hour period, feces is with no difficulties in
she does not normal and urination or bowel
experience regular, with movements. Her regularity
any trouble no in eliminating both urine
urinating or complications and feces indicates
eliminating such as healthy urinary and
feces, and constipation, gastrointestinal function,
her diarrhea, or suggesting no issues or
elimination is pain during complications in these
regular. urination. She areas.
verbalized,
"Oo, normal
naman, ang
problema lang
talaga is pag
tatayo ako
since yun nga
nadisgrasya."
Activity and  The patient  Due to her The patient's activity
does not hospitalization pattern is currently limited
Exercise
engage in and her left due to her hospitalization
Pattern any activities foot being and the immobilization of
other than immobilized her left foot. Her primary
her with splints, activities consist of using
occupation the patient's her phone to
as a only activities communicate with friends
seamstress. are using her and family and engaging
However, phone to talk in phone games. This
she is aware with friends suggests a largely
of the and family, as sedentary lifestyle at the
benefits of well as playing moment, with physical
regular games on her activity being restricted.
exercise, as phone. However, her
she engagement in social
verbalized, interactions and
"Alam ko entertainment indicates an
naman na effort to stay mentally
mahalaga active and connected
talaga para despite her physical
maging limitations.
healthy kaso
 wala talaga
akong oras
e."
Sleep and  Before  The patient is The patient's sleep pattern
hospitalizatio now able to has improved during her
Rest Pattern
n, the client sleep hospitalization. She
typically went peacefully and reports being able to
to sleep at 8 has been sleep more comfortably
PM and completing the and complete the
woke up at 3 necessary necessary hours of rest,
AM. She hours of sleep. which she finds difficult to
mentioned As she achieve at home due to
that this verbalized, disturbances. This
sleep pattern "Mas suggests that her current
is not nakakatulog environment is more
healthy, as nga ako ng conducive to restful sleep,
she struggles komportable allowing her to experience
to fall back dito kesa sa better sleep quality and
asleep after bahay e, duration.
waking up. walang
As she sagabal, mas
verbalized, nakaka-
"Ayon, kompleto ako
maaga ng tulog."
natutulog
pero maaga
rin nagigising
kahit gusto
ko pa
matulog, di
nako
makakuha ng
tulog, wala
naman ako
magawa sa
mga oras na
'yon, na-
stress lang
ako."
Cognitive  The patient is  During The patient's cognitive
literate and hospitalization, function appears to be
and
rational, the patient's intact during her
Perception demonstratin cognitive hospitalization. She
g the ability perception remains aware of her
Pattern
to remains environment and is
understand unchanged. capable of engaging in
and make She is fully meaningful
informed aware of her communication, indicating
decisions surroundings that her mental status is
regarding her and is able to stable and unaffected by
 health and engage in her current condition. This
treatment. conversations suggests that she is
effectively. cognitively alert and
oriented.
Self-  Despite her  The client The client shows a clear
Perception age, the expresses a understanding of the
patient strong desire importance of maintaining
and Self- expresses a to adopt a a healthy lifestyle post-
strong desire healthier hospitalization. She
Concept
to maintain lifestyle after recognizes the challenges
Pattern her health being of being in the hospital
and achieve discharged, and is motivated to
the proper aiming to engage in exercise and
level of support her manage stress as part of
wellness. As recovery her recovery plan. This
she stated, effectively. As indicates a proactive
"Kahit she stated, attitude toward improving
nagkaka- "Aba, ngayong her health and preventing
edad nako, nadisgrasya further health
syempre ako, alam ko complications. Her
gusto ko pa na ang hirap commitment to adopting a
rin healthy ma-hospital, healthier routine reflects
ako. Ayaw ko kaya maganda her determination to
nung katulad talaga na regain and maintain
nung iba na paglabas ko wellness.
matanda na, dito ay mag-
okay na kahit exercise ako
ano kainin o at umiwas sa
kahit anong stress."
gawin, ayaw
ko non."
Role and  The client  According to The client's hospitalization
maintains a the client, her has positively impacted
Relationship
close bond hospitalization her relationship with her
Pattern with her has family, deepening their
family, strengthened connection. She feels
enjoying the bond with more closely bonded to
activities her family, as her children, as they have
such as they have actively cared for her and
watching been the ones expressed concern during
television taking care of her hospitalization. This
and riding her. She feels experience has likely
motorcycles that her family increased her sense of
together. She values her emotional support and
values a more now. As reaffirmed the importance
healthy she of family in her recovery
social expressed, process.
environment "Mas napalapit
and actively ako sa mga
avoids anak ko, sila
 stress, nag-aalaga
choosing to sakin pati nag-
surround alala din sila
herself with nung nadala
supportive ako rito."
individuals
for her well-
being. As
she
verbalized,
"Iwas nalang
sa mga
stress.
Ganon sa
mga anak ko
lang talaga,
pag nag-
bonding
kami, yung
pagiging
nanay talaga
di parin
nawawala
kasi gusto ko
sila
nakakasama,
kaya
hahanapan
talaga ako ng
oras para
lang
makasama
sila. Ayaw ko
rin ng away
at gulo,
Diyos ko,
nakakasama
lang yan."
Sexuality  The client  She is not The client is widowed and
reported that sexually currently does not have a
Pattern
she is active, as she sexual partner. She
menopausal, is now verbalized that she is
indicating widowed. menopausal and has not
cessation of experienced menstruation
her for some time, which is
menstrual consistent with her age.
period. She There were no expressed
is a widow concerns regarding her
and did not sexual health. Based on
mention any available information,
 concerns there has been no change
related to in her sexual pattern
sexual before and during
activity. hospitalization. Sexual
Further activity does not appear to
assessment be a current aspect of her
regarding her lifestyle.
sexual health
was not
conducted at
this time.
Coping  The client  During her The patient finds
enjoys hospitalization, emotional support and
Stress
listening to she coped stress relief through
Tolerance the radio, with stress by communication with her
particularly talking to her children. Listening to their
Pattern
horror family and stories provides her with a
stories, and listening to sense of connection and
music, which their stories. comfort, which helps
help ease the She alleviate her stress during
stress she is verbalized, hospitalization. This
feeling. "Ayan, mga indicates that her family
According to anak ko, plays a significant role in
her, these kinukuwentuh her coping mechanism
activities are an ako ng mga and overall emotional
part of how nangyayari sa well-being.
she copes buhay nila.
with stress, Nakakawala
as she ng stress kasi
verbalized, malapit sila sa
"Ayon, akin."
mahilig ako
makinig ng
music tas
makinig sa
radio ng mga
horror,
nakakawala
din yun ng
stress."
Values and  The client is  One of the The client’s belief in her
a Roman reasons she recovery is strongly rooted
Belief
Catholic and believes she in her faith. She feels
Pattern stated that will recover is assured that God will heal
she and her her faith in her and protect her from
children God. She feels harm, largely because of
attend that God will her responsibility toward
church every protect her her children. This belief in
Sunday. from harm divine protection and
 She believes because she healing provides her with
that there is has children to a sense of hope and
no problem take care of, motivation to persevere
that cannot as she through her health
be resolved verbalized, challenges. Her faith and
and prays "Alam kong maternal bond appear to
that papagalingin be important
everything ako ng Diyos psychological and
will be okay, kasi may mga emotional resources in
especially anak ako na coping with her condition.
during dapat balikan."
difficult times
when she is
struggling.
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