Fractures Internal Immobilization pt.3 (Exam 3) Flashcards
Internal Devices Types
Pins
Screws
Plates
Internal Immobilization Nursing Problem: Risk for Peripheral NVD
5 P’s
Pain
Pallor
Pulselessness
Paresthesia
Paralysis
Post Op: Nursing Consideration
Elevate above heart for 48-96 hours
Apply ice to vasoconstrict
Notify provider if pain increase and is un relieved with medication (compartment syndrome)
Teach patient signs of neurovascular dysfunction (5p’s)
Nursing Problem: Acute Pain
-Around the Clock Medication
-Non-drug measures
Sudden inability of pain medication to relieve pain?
Compartment syndrome
Compartment Syndrome
Can happen and cause permanent damage within hours
Swelling within a compartment and there is nowhere for the swelling to go because the fascia isn’t budging
Compartment Syndrome Treatment
Fasciotomy
Open the fascia to allow room for compartment to swell
Nursing Problems: Risk for Infection
Assess pin insertion for indicators of infection
Aseptic technique
Culture site PRN
Administer antibiotics
Monitor temp
Monitor WBC
Nursing Problem: IMpaired Skin Integrity
Examine potential pressure areas q 4 hrs
Petal cast Edges
Do not insert items into cast to scratch
Remember moisture contributes to breakdown
Turn if permissible (avoid friction/shearing)
Instruct our patients to report
Warmth
Increase Pain
Foul odor
Nursing Problem: Impaired Physical mobility
Pain control before ROM
AROM/PROM/PT
Weight bearing or NWB?
Instruct use in assistive devices
What is a big risk with a long bone fracture?
Fat embolism (Fat globule released from long bone fracture)
Signs and Symptoms of Long Bone Fat Emboli
Chest pain
Tachypnea
Cyanosis
Apprehension
Tachycardia
Hypoxemia
Fat Embolism Syndrome
Happenens in long bone
Neurological features procedure pulmonary features by 4-6 hrs
Petechiae can appear on the conjunctiva, oral mucosa, and retina
