Musculoskeletal 2 Flashcards
Fracture treatment
Reduction Traction Immobilisation Maintaining and restoring function Preventing infection Drug therapy Nutritional therapy
Reduction
Closed traction realignment
Open reduction internal fixation - metallic pins, wires, screws, playes , nails and rods
Immobilisation
Casts braves splints immobilisers
External and internal fixation device’s
Internal fixation
Cannulated screw fixation
Compression hip screw and side plate
Blade plate fixation
External fixation
Metal pins inserted in the bone
Attached to external rods to stanilose fracture while it heals
Fractures : nursing problems (diagnosis)
Impaired mobility
Risk of neurovascular
Acute pain
Impaired mobility
Loss of integrity of bone structure
Movement of bone fragment
Prescribed movement restrictions
Risk for peripheral neurovascular dysfunction
Vascular insufficiency
Nerve compression
Acute pain
Oedema
movement of bone fragments
Muscle spasms
Acute interventions in perioperative nursing management
Skin preparations Neuro vascular observation Analgesia Drain care Prevention and monitoring of complications Cast care needed Mobility training Education Rehabilitation
Neurovascular assessment
Circulation
Motion
Sensation
Circulation
Colour
Temperature
Capillary refill
Motion
Weakness
Paralysis
Sensation
Paraesthesia
Unrelenting pain
Pain on passive stretch
Absence kf feeling
Cast therapy and nursing care
Acute management
Teaching patient self care
Fibre glass
Plaster
Acute management
Assess and monitor neurovascular status
Relieve pain
Monitor and management potential complications
Teaching patient self-care
Move about as normally as possible and perform prescribed exercises
Do not scratch skin under cast
Keep cast dry
Report : persistent pain , swelling , changes in sensation, paralysis
Note odour, stained areas hot spots
Report broken cast
Fibreglass
Light
Strong durable and water resistant
Plaster
Heavy slower in drying
Loses strength when becomes wet
Traction
The mechanism bu which a steady pull is exerted to a part or parts of the body
Traction principles
The line of pull must be maintained
The pull must be continuous
Ropes, pulleys and weights must be free of friction
There must be adequate counter-traction
Type of traction
Skin
Skeletal
Patient with traction nursing process
Diagnosis: acute pain Impaired mobility Impaired skin integrity Risk for ineffective coping Risk of impaired urinary elimination
Potential complications Haemorrhage Peripheral neuromuscular Deep vein thrombosis Pressure ulcer Infection
Nursing process: nursing process
Pain relief- handle traction gently, provide pain relief, positioning for comfort
Monitor neurovascular status
- monitor every hour then drop to 4/24 hrly, patient to report any changes in sensation
Dvt prevention
Compression stockings, compression devices , anticoagulant therapy
Pressure area prevention
Provide back care, keep bee dry, and free of wrinkles and crumbs
Pin site care
Keep pin sites clean and dry, and sites to be covered by sterile dressings
Direct Complicationsof fractures
Bone infection ( osteomyelitis) Bone union problems Avascular necrosis
Indirect complications
Associated with blood vessel and nerve damage resilting in conditions Compartment syndrome Venous thromboembolism Fat embolism syndrome Rhabdomyolysis Hypovolaemic shock
