NURSING CARE OF PATIENTS WITH ALTERATIONS IN COORDINATION

APPLICATION BALANCED SKELETAL TRACTION
INDICATION: 1. To prevent or correct deformity 2. To maintain good body alignment 3. To provide pain immobilization
4. To reduce pain and muscle spasm, reduce fracture.

5. To support the affected area

PREPARATION PHASE: 1. Check for the doctor’s order 2. Inform and explain the purpose and procedure to the patient for easy installation and cooperation 3. Assemble all equipment • • • •
• •

Thomas splint with Pearson attachment Rest splint 5 Slings (variable sizes) 5 Paper Clips or Safety pins Cord Sash (different length) Short – for thigh Long – for traction Longest – for suspension Weight’s and bags Traction wt. 10% of patient’s weight Suspension wt. (50% or ½ lighter than traction bag) Foot support – (prevent foot drop)

• • • • • •

Parts of an Orthopedic Bed 1. Firm Mattress 2. Fracture Board 3. Bed Elevator or Shock Block 4. Balkan Frame o 4 Vertical bars o 2 Horizontal bars o 1 diagonal bar o 1 Straight bar or cross bar
1 JOSEPH MANUEL RADAM DIVINE WORD COLLEGE OF BANGUED College of Nursing

Mount Thomas splint to Pearson’s attachment • • Upper part is Thomas splint. securely tied and will not fall) 7. Tie the longer rope to the Steinmann’s pin (slip knot). Finish or tie the other end of the short rope to the lateral aspect of the Thomas splint 8. Attach / apply Rest splint to Thomas splint and Pearson attachment 3. 3 Pulleys with the clamps (hold place) 6. Overhead Trapeze PROCEDURE PHASE: 1. which will support the leg Check alignment of screw of Pearson’s with knee joint • 2. pass the 3rd pulley then hang and tie the traction weight bag (any kind of knot will do. Apply the prepared set-up to the patient • • • • • • • • 3 Manpower Apply manual traction Apply manual traction Lifting the affected leg removing the Braun Bohler Insert the prepared set-up At the count of 3 do simultaneously Instruct the patient to flex the unaffected leg Hold on to the overhead trapeze Lift the buttocks 6.NURSING CARE OF PATIENTS WITH ALTERATIONS IN COORDINATION o 1 Curve bar (optional) 5. Tie the longest rope to the middle of the short rope (slip knot) • Insert to the 1st pulley Hang the suspension weight bag and anchor to the clamp • 2 JOSEPH MANUEL RADAM DIVINE WORD COLLEGE OF BANGUED College of Nursing . Apply slings to Thomas splint and Pearson attachment • • • • • • • Start from thigh area (Thomas splint) then to leg area (Pearson attachment) From medial to lateral upright Wider and long slings at thigh area Smooth / right side should be touching or in contract the patient’s skin Provide space or 1 inch apart between the slings for ventilation and prevent irritation Popliteal and heel / sole of the foot should be free sling Apply not to lose or not too tight to support and follow contour of leg 4. which support the thigh Lower part is the Pearson’s attachment. Tie the short rope (thigh rope) to medial portion of the Thomas splint with Slip Knot • Provide privacy 5.

Tie to the Tomas splint using the clove hitch knot then to Pearson attachment.) General hygiene and comfort • • • • • Skin care Hair care Nail care Oral and perineal care Sponging of affected leg 3 JOSEPH MANUEL RADAM DIVINE WORD COLLEGE OF BANGUED College of Nursing . Apply foot support using Ribbon Knot 12. Release suspension weight bag • • • • Check alignment of the traction 1st pulley – in line with inguinal area 2nd pulley – in line with the knee 3rd pulley – in line with the 1st and 2nd 11. Remove the Rest splint 13.NURSING CARE OF PATIENTS WITH ALTERATIONS IN COORDINATION • insert the rope to the 2nd pulley 9. Check the efficiency of the traction • • • Flex the unaffected side Hold on the overhead trapeze Swing the affect leg PRINCIPLES OF TRACTION APPLICATION • • • • Have an opposite pull or counter traction Line of pull should be in line of deformity Traction should be continuous Position of the point should be dorsal recumbent or supine Avoidance of friction a) Weight should be hanging freely b) Observe for signs of wear and tear on the ropes and bag c) Rope should run freely along the grove of the pulley • NURSING CARE 1. • • Be sure the rope is outside the traction rope Outside / under the rest splint (removed later) 10.

) Working pertinent observation COMPLICATION AND NURSING MANAGEMENT a) Hypostatic pneumonia Deep breathing Keep back dry b) Bed sore /decubitus ulcer Linen free from wrinkles/ creases Keep back dry. Thomas splint and Pearson’s attachment using the clove hitch knot. vitamin c. Tie the rope the rest splint.) Meeting nutritional needs – protein. lift buttock c) Joint contractor and muscleatrophy • • Active exercise (unaffected) Isometric (affected) d) Constipation • • • • Fluid intake High roughage diet Exercise Offer bedpan e) Infection • Meticulous wound care REMOVAL 1) Attach the rest splint 2) Anchor the suspension weight to the pulley 3) Remove the suspension rope 4) Apply manual traction 5) Remove traction weight.NURSING CARE OF PATIENTS WITH ALTERATIONS IN COORDINATION 2. (READY TO TRANSFER) 4 JOSEPH MANUEL RADAM DIVINE WORD COLLEGE OF BANGUED College of Nursing .) Provide diversional activities –increase coping mechanics for boredom 4.) Conditioning exercises • • Deep breathing Coning exercise Address ROM exercise Static quadricep exercise Dorsiflexion and plantar flexion of leg • • • 3. calcium 5.

PELVIC GIRDLE 15. DENNIS BROWN SPLINT 6. ZERO DEGREE TRACTION 17. BUCK’S EXTENSION TRACTION 5. BANJO SPLINT 2. DUNLOP TRACTION 8. For Congenital Hip Dislocation Fracture of hip and femur For Scoliosis Fracture of cervical spine Fracture of the supracodylar of the humerus For Scoliosis For Scoliosis (severe) Fracture of the pelvis Fracture of the cervical spine Fracture of the subtrochanteric Fracture of the supracondyle of humerus Fracture of the lumbar spine. JEWETTE BRACE 9. UNILATERAL LEG BRACE 15. CRUTCHFIELD ONG 7. YAMAMOTO BRACE INDICATOR Peripehral nerve injury Post polio with residual paralysis. Lumbo-sacral affection Prevention of wrist drop Club foot deformity Cervico-thoraco-lumbar spine affection Cervical spine affection Dorso-lumbar spine fracture Upper spine fracture Scoliosis Peripheral nerve injury Cervical spine affection (thick) Cervical spine affection (soft) Post polio with residual paralysis scoliosis GADGETS HARDWARE TYPES Crutch field Tong Circlage Wiring Gigli saw Antibiotic bead INDICATOR Cervical Spine Patella For amputations Osteomyelitis 5 JOSEPH MANUEL RADAM DIVINE WORD COLLEGE OF BANGUED College of Nursing . KNIGHT/TAYLOR BRACE 10. FORESTER BRACE 7. CHAIR BACK BRACE 4. Stove in chest INDICATION Fracture of hip and femur Post polio with residual paralysis Fracture of hip and femur. OPPEN HEIMER SPLINT/LIVELY FINGER 12. For Herniated nucleus Polposus Fracture of the cervical spine Fracture of the surgical humerus Multiple rib fractures BRACES TYPES 1. BILATERAL LEG BRACE 3. BOOST CAST TRACTION 3. HAMMOCK SUSPENSION TRACTION 11. HALO-PELVIC TRACTION 10. MILWAUKEE BRACE 11. COTREL TRACTION 6. OVERHEAD TRACTION 14. HEAD HALTER TRACTION 12.NURSING CARE OF PATIENTS WITH ALTERATIONS IN COORDINATION TRACTIONS TYPES 1. SHANTZ COLLAR 14. HALO-FEMORAL TRACTION 9. FOUR POSTER BRACE 8. PHILADELPHIA COLLAR 13. COCKED-UP SPLINT 5. 90 90 DEGREES TRACTION 13. VINKE’S CALLIPER 16. BRYANT TRACTION 4. BALANCE SKELETAL TRACTION 2.

femoral neck including acetabulum Femoral head and neck fracture Intertrochanteric fracture Fracture of mandible Fracture middle 3rd femur Degenerative uses Proximal tibia Radius ulna fracture Fracture of pelvis Infected hip prosthesis Periarticular injuries such as your knee & ankle joints 3 PRINCIPLES IN MANAGEMENT OF FRACTURE: 1. brace. cast 3. bone loss & bone lengthening Femoral head. Physical Therapy exercise OT & Surgery 6 JOSEPH MANUEL RADAM DIVINE WORD COLLEGE OF BANGUED College of Nursing . Close or Open Surgery – reduction 2. Rehabilitation – restoration of function.NURSING CARE OF PATIENTS WITH ALTERATIONS IN COORDINATION X pinning/Y bone pinning Roger Anderson External Fixator (RAEF) Total knee Arthroplasty (TKA) Harrington Rod Instrumentation Hybrid External Fixator Ilizarov external Fixator Total replacement Hip Arthroplasty (TRHA) Partial replacement Hip Prosthesis (PRHP) Compression Hip screw Fixation (CHSF) Tower/Interdental Wiring Intramedullary Nailing Tibidal Femural component T-plate or buttress planting Planting with Screw Hoffmann external fixator Spacer antibiotic Delta frame Supracondylar fx of the humerus Comminuted fracture of long bones Tibial & Femoral components Degenerative joint disease (osteoarthritis) Scoliosis Periarticular injuries such as your knee & ankle joints Mal-union. Immobilization – Traction.

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