Fractures may be mild to severe. Observe and evaluate splinted extremity for resolution of edema. Learning the correct way to use aids is important to maintain optimal mobility and patient safety. Note: This condition constitutes a medical emergency and requires immediate intervention. A fracture is a complete or incomplete disruption in the continuity of the bone structure and is defined according to its type and extent. Apply commercial skin traction tapes (or make some with strips of moleskin or adhesive tape) lengthwise on opposite sides of the affected limb; Rationale: Traction tapes encircling a limb may compromise circulation. Inspect the skin for preexisting irritation or breaks in continuity. Investigate abrupt onset of pain and limitation of movement with localized edema and erythema in injured extremity. Rationale: Failure to relieve pressure or correct compartmental syndrome within 4–6 hr of onset can result in severe contractures or loss of function and disfigurement of extremity distal to injury or even necessitate amputation. Both vertebroplasty and kyphoplasty can be done on an outpatient basis. Nursing: The cornerstone of prevention. Compression fractures happen when there is too much pressure on the vertebra. Demonstrate techniques that enable resumption of activities. Demonstrate body mechanics that promote stability at fracture site. Instruct patient to continue exercises as permitted; Rationale: Reduces stiffness and improves strength and function of affected extremity. Auscultate bowel sounds. Coagulation deficits may occur secondary to major trauma, presence of fat emboli, or anticoagulant therapy. Rationale: Adding bulk to stool helps prevent constipation. Achieve timely wound healing, be free of purulent drainage or erythema, and be afebrile. Note: Length of application depends on degree of patient comfort and as long as the skin is carefully protected. Observe for symptoms of life-threatening fat embolus, which may include personality change, restlessness, dyspnea, crackles, white sputum, and petechaie over the chest and buccal membranes. Identify diversional activities appropriate for patient age, physical abilities, and personal preferences. Handle injured tissues and bones gently, especially during first several days. fracture of vertebra pedicle; PMMA migration from the vertebral body, causing nerve root and spinal cord compression or pulmonary embolism; vasovagal response to the injection or sedation; infection; hemorrhage. Osteoporos Int. Investigate tenderness, swelling, pain on dorsiflexion of foot (positive Homans’ sign). By performing an accurate nursing assessment on a regular basis, the nursing staff can manage the patient’s pain and prevent complications. Nursing Care Plan 1. Long-term use of alendronate (Fosamax) may reduce risk of stress fractures. Wrap the limb circumference, including tapes and padding, with elastic bandages, being careful to wrap snugly but not too tightly; Rationale: Provides for appropriate traction pull without compromising circulation. Nursing Interventions Rationale; Maintain bed rest or limb rest as indicated. Demonstrate use of relaxation skills and diversional activities as indicated for individual situation. Cultures and sensitivity of wound, serum, bone; Rationale: Identifies infective organism and effective antimicrobial agent(s). Inform patient that muscles may appear flabby and atrophied (less muscle mass). Review restrictions imposed by therapy such as not bending at the waist and sitting up with Buck traction or not turning below the waist with Russell traction. Bend wire ends or cover ends of wires or pins with rubber or cork protectors or needle caps; Rationale: Prevents injury to other body parts. The number one cause of hip fractures is related to osteoporosis which causes weak bones. Gas-forming foods may cause abdominal distension, especially in presence of decreased intestinal motility. © 2020 Nurseslabs | Ut in Omnibus Glorificetur Deus! Assess position of splint ring of traction device. Skeletal traction (pins, wires, tongs) permits use of greater weight for traction pull than can be applied to skin tissues. Rationale: Anemia may be noted with osteomyelitis; leukocytosis is usually present with infective processes. Cleanse excess plaster from skin while still wet, if possible; Rationale: Dry plaster may flake into completed cast and cause skin damage. Apply ice bags around fracture site for short periods of time on an intermittent basis for 24–72 hr. Note continued bleeding at trauma or injection site(s) and oozing from mucous membranes. A vertebral compression fracture (VCF) is a collapse or breakdown in a bone in your spine. Hoffman traction provides stabilization and rigid support for fractured bone without the use of ropes, pulleys, or weights, thus allowing for greater patient mobility, comfort and facilitating wound care. Note. Note nonverbal pain cues (changes in vital signs, emotions and behavior). Rationale: Prevents boredom, reduces muscle tension, and can increase muscle strength; may enhance coping abilities. Test stools or gastric aspirant for occult blood. VCFs most often occur in the thoracic (middle) and lumbar (lower) areas of your spine. Many factors, including level of anxiety, may affect perception of pain. Rationale: Proper use of pain medication and antiplatelet agents can reduce risk of complications. Based on location and the form of the fracture, the nursing care plan for the fracture of right hand or left hand will include wearing a supporting cast, using splint or being in straps under. Monitor laboratory studies (Serial ABGs;Hb, calcium, erythrocyte sedimentation rate (ESR), serum lipase, fat screen, platelets) as appropriate. Failure to properly support limbs in casts may cause the cast to break. Continuous antimicrobial drip into bone may be necessary to treat osteomyelitis, especially if blood supply to bone is compromised. Encourage use of trapeze if possible. Rationale: Traction permits pull on the long axis of the fractured bone and overcomes muscle tension or shortening to facilitate alignment and union. Monitor vital signs. Provides stability, reducing the possibility of disturbing alignment and muscle spasms, which enhances healing. Rationale: Impaired gas exchange or presence of pulmonary emboli can cause deterioration in patient’s level of consciousness as hypoxemia or acidosis develops. Rationale: Protects from moisture, which softens the plaster and weakens the cast. Recommend cleaning external fixator regularly. Rationale: Local debridement and cleansing of wounds reduces microorganisms and incidence of systemic infection. Rationale: Maintains body warmth without discomfort due to pressure of bedclothes on affected parts. Consult with physical, occupational therapist or rehabilitation specialist. Encourage patient to discuss problems related to injury. Do not elevate extremity. Review restrictions imposed by therapy such as not bending at waist and sitting up with Buck traction or not turning below the waist with Russell traction. List activities patient can perform independently and those that require assistance. Evaluate presence and quality of peripheral pulse distal to injury via palpation or Doppler. Let we learn to respect them,the angels in our lives :). Assist with placement of lifts under bed wheels if indicated. To prevent further injuries. Rationale: Prevents tissue breakdown and infection by fecal contamination. Rationale: Muscle rigidity, tonic spasms of jaw muscles, and dysphagia reflect development of tetanus. Skeletal traction (pins, wires, tongs) permits the use of greater weight for traction pull than can be applied to skin tissues. Fracture Nursing Assessment. The treatment of these fractures can be surgical or conservative (such as immobilisation with a cast or brace). Recommend supporting the joint above and below the affected part and the use of mobility aids (elastic bandages, splints, braces, crutches, walkers, or canes). Rationale: Prompt intervention may reduce severity of complications such as infection or impaired circulation. Rationale: May be performed to differentiate between true nerve dysfunction, muscle weakness and reduced use due to secondary gain. Rationale: These factors may be the cause of or be indicative of tissue pressure, ischemia, leading to breakdown and necrosis. Use sufficient personnel for turning. Failure to properly support limbs in casts may cause the cast to break. Know the assessment, goals, related factors, and nursing interventions with rationale for fracture in this guide. Extend the tapes beyond the length of the limb; Rationale: Traction is inserted in line with the free ends of the tape. Maintain position or integrity of traction. Institute prescribed isolation procedures. Rationale: Improves muscle strength and circulation, enhances patient control in situation, and promotes self-directed wellness. Percutaneous dorsal root ganglion block for treating lumbar compression fracture-related pain. Since we started in 2010, Nurseslabs has become one of the most trusted nursing sites helping thousands of aspiring nurses achieve their goals. Fractures can be caused at joints or along the length of a bone. Note presence of chills, fever, malaise, changes in mentation. Provide privacy. Maintain neutral position of affected part with sandbags, splints, trochanter roll, footboard. Auscultate breath sounds, noting development of unequal, hyperresonant sounds; also note presence of crackles, rhonchi, wheezes and inspiratory crowing or croupy sounds. Five major types are as follows: Nursing care planning of a patient with a fracture, whether in a cast or in traction, is based upon prevention of complications during healing. Client will display callus formation/beginning union at fracture site as appropriate. Rationale: Impaired feeling, numbness, tingling, increased or diffuse pain occur when circulation to nerves is inadequate or nerves are damaged. The body of the vertebra, which bears the weight, can break. Other causes are low bone density and osteoporosis, which cause weakening of the bones. Outcomes include pain management (short and long term), mortality, functional status, pain medication use, mental status, health-related quality of life, quality of sleep, ability to participate in rehabilitation, return to pre-fracture living arrangements, health services utilization, and adverse effects. Note reports of dizziness. Rationale: Facilitates dressing and grooming activities. Administer prescribed medications, which may include opioid or nonopioid analgesics and prophylactic antibiotics for an open fracture. Increase the amount of roughage or fiber in the diet. Provide support of joints above and below fracture site, especially when moving and turning. Limit gas-forming foods. Ascertain that all clamps are functional. Remove skin traction every 24 hr, per protocol; inspect and give skin care. Medicate before care activities. Risk for Peripheral Neurovascular Dysfunction, Direct vascular injury, tissue trauma, excessive edema, thrombus formation. Hommel, A., Kock, M. 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