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Download Neurovascular Checks Assess for Infection Crutch Walking Two
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Musculoskeletal Disorders Part I Osteoporosis Osteomyelitis Osteoarthritis Rheumatoid Arthritis Gout Musculoskeletal Disorders Part II Fractures Amputations Manifestations of Fractures • • • • • • Pain Swelling Deformity Numbness Hematoma Formation Muscle spasm Emergency Care of Fractures • Neurovascular Assessment • Five Ps − − − − − Pain Pulses Pallor Paralysis Paresthesia • Immobilization • Alignment • Wound Care Diagnosis of Fracture • X-ray • Bone Scan • Lab Studies • CBC • Coagulation studies Factors Which Promote Bone Healing • Local • Good emergency care and fracture setting • Ice • Systemic • • • • Ca++, Vitamin D, Growth Hormone Adequate Blood Supply Young and Active No Infection Fracture Treatments • Medications • Surgery • Fixation Devices • External • Internal • Traction • Casts Medications • • • • Analgesics Antibiotics Anticoagulants GI Meds • Constipation • Ulcer prevention Surgical Treatment External Fixation Nursing Care for External Fixation Devices • Maintain Alignment • Frequent Neurovascular and Skin Assessments • Infection Prevention • Skin care per policy Surgical Treatment • Internal Fixation (ORIF) Nursing Care for Internal Fixation Devices • Neurovasuclar Assessment • PAIN • Suture Care • Hemovac? • Hazards of Immobility • Lungs, heart, bowels, legs Traction •Manual Traction • Bucks also called Straight Traction Traction • Balanced Suspension Care of the Client in Traction • Maintain alignment • Let weight hang free • Maintain ropes free • Position client • Skin Traction • NO more then 6 pounds of traction per extremity Casts Immobilizes Body Part • Note Composition • Plaster • Fiberglass • Teaching • • • • No objects in cast Keep Dry Assess Neurovascular Position Sling to prevent neck injuries − Even distribution of weight • Alignment • ID wrinkles in fabric • Check skin Nursing Care of Client with a Cast • Neurovascular Checks • Assess for Infection • Crutch Walking • • • • Two Point Gait Four Point Gait Swing to Gait Swing through Gait Complications Related to Fractures • Compartment Syndrome • Fat Embolism Syndrome • Deep Vein Thrombosis • Reflex Sympathetic Dystrophy • Compartment Syndrome (CS) • Fascia Lines the Compartment within the limb • Increased pressure from hemorrhage or edema • Pressure from cast being too tight • Results • Nerve, vessels, muscles are damaged COMPARTMENT SYNDROME • Fat Embolism Syndrome • Globules of fat, released from fractured bone • Fat mixes with platelets • Emboli travel to lungs, brain, or other areas. • Clotting cascade activated = petechiae Assessment of Fat Embolism Syndrome • Notify MD Immediately • Dyspnea • Confusion • Pulmonary complications − Pulmonary Edema − ARDS • Petechiae Treatment of Fat Embolism Syndrome • Maintain Pulmonary Function • Intubation • Ventilation • Fluid Balance • Steroid Treatment • Stabilize Long Bone Fractures Deep Vein Thrombosis Reflex Sympathetic Dystrophy Posttraumatic Condition •Persistent Pain •Hyperesthesias •Swelling •Skin color changes •Temperature changes Treatment Sympathetic Nervous System Blocking Agent (Alpha or Beta Blocker) Hip Fracture Nursing Care of Client with Hip Fracture • Neurovascular Assessment • Nursing Diagnosis • Acute Pain • Risk for Infection • Impaired Mobility • Impaired Sensory Perception Amputations Amputations • Causes • • • • PVD Trauma Infections Tumors Teaching Principals For Clients with an Amputation • • • • • • Wrap Stump Positioning of the Stump Stump Exercises Physical Activities Household modifications Referrals for Social Services The End
