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c c

   
   

  2. ¦mmobilization

 Î Manual
Î Skin- adhesive- plaster or adhesive is applied
Diagnostic Procedures longitudinally on the lower extremeties and an
1.  

elastic bamndage applied in an spiral motion
a. ×  

b. c     or CT scan 3. Bryant͛s traction- indicated for children aged 0-3 year͛s
Non- invasive procedure where a body part can be acanned from not more than 40 lbs.
different angles with an x-raybeam and a computer calculates Î Traction is always applied on both ends
varrying tissue densities and records a cross section image on
paper done to determine extent of fracture in difficult to define 3ursing Responsibility
areas Nurse should be able to pass hand between the patient͛s buttocks
and mattress
c.   
 ¦njection of radioopaque dye into 0
^ 
  
subarachnoid space at posterior spine to ¦ndicated for older patients and to those weighing over 40 lbs.
determine level of disc herniation or site of
tumor 3ursing Responsibility
‰     
    
2.    
 Ôadioopaque or air injected into joint cavity-   
outines soft tissue structure and contour of -sed in affectations of the upper extremities
joint
3ursing Care of Clients with Adhesive Traction
3. 0
  1. -nwrap and wrap and elastic bandage at least once a
 ÷arenteral injection of bone seeking shift
radioactive isotope 2. Check skin integrity for allergic reactions to plaster
3. Note circulation, sensation and mobility of the affected
4. ^    extremities
 uraphic presentation of the electrical potential Skin- non adhesive
of muscles m -ses canvass or cloth that is applied on the patient͛s skin

5.   
      
 Noninvasive scanning technique that uses  pplied like a girdle and connected to two
magnetism and radiofrequency waves to ropes with weights that hang at the foot part
produce cross-sectional images of body tissues of the bed
on computer screen  ¦ndicated for low back pain

6.  
      
 ^ndoscopic direct visualization of joint,  pplied on chin and occipital region connected
especially knee to a hanger with weights that hangs at the
head part of the bed
7.   

  -sually indicated for cervical spine affectations
 Needle aspiration of synovial fluid Skin- non adhesive traction

8. 00


 c   
 Combination of the head halter and pelvic
   traction used in scoliosis
 -ric acid
 ntinuclear antibody (N for systemic Lupus 

  
^rythematosus  ÷ermits patient to move freely in bed and
 Complement fixation (CF for Ôheumatoid permits flexion of the knee and hip joint
rthritis  Buck͛s extension and the knee is suspended in
 Calcium, lkaline ÷hosphate, ÷hosphorus a sling to which a rope is attached

Musculo-Skeletal Therapeutic Modalities 3ursing Care of Clients with non-adhesive traction
Ôest period are provided
1. Ôeduction
 Ôealigning an extremity into anatomical    
position m pplied into a bone
 ‰pen- use of surgical methods
 Closed- use of non-surgical methods; c     
manipulation  pplied into the parietal; bones
 ¦ndicated for cervical spine affectations
Crutchfield Tong Transfer and ssistive ievices
Skeletal Traction 1. transferring a client from bed to stretcher
Balanced Skeletal Traction  stretcher must be perpendicular to bed
 pplied alone or with skeletal traction to 2. transferring a client from bed to wheelchair
promote patient mobility  the wheelchair must be parallel to the head of
the bed
÷rinciples of Care 3. Canes
1. The patient should always be on either supine or dorsal  eight of cane is from floor to waist level
recumbent position  Cane is held by opposite the affected
2. The traction should always have a counteraction extremity
(patient͛s weight
3. The line of deformity should be in line with the traction Transfer and ssistive ievices
4. Traction should be continuous 4. Crutches
5. There should be no friction within the line of traction  eight of crutch is from floor to axilla minus 2
6. inches
Cast- Comparison of Cast Materials  ÷atient͛s weight is borne by the palm, of the
hand and not on the axilla
Braces  ëhen going upstairs, unaffected leg first
 Mnight-taylors  ëhen going upstairs, affected leg first
 For thoraco-lumbar affectations
 Milwaukee Crutch-walking techniques
 For scoliosis      (two alternate gait
3ursing Care     
 -se cotton clothing as barrier  r  
Fixators      

 Ô^F  Both legs are lifted off the ground


 Ôoger nderson ^xternal Fixator simultaneously and swung forward while
 ¦lizarov device patient pushes up on crutches
 ¦ndicated for comminuted fractures     
 Lift and swing body up to crutches
3. Ôehabilitation      
 ctive or dynamic program aimed at enabling an ill or  Lift swing body beyond crutches
disabled to achieve the highest level of physical, mental,
social, and economic self-sufficiency of which he is ^xercises
capable a. ¦sometric
 lternate contraction and relaxation of the
Members of the Ôehabilitation team muscle without moving the joint
a.   ione on the affected extremity
 Mey member of health team b. ¦sotonic
b.   
  Ôange of motion exercises
 ievelops plan of patient care  ione on the unaffected extremity
c. 
 
 Makes medical diagnosis; directs team eat or Cold pplication in Trauma
d. 
 
c 
 ÷hysician specialist in physical medicine  first 24 hours
e. 
   
 To decrease hemorrhage
 Teaches or supervises patient in prescribed  To relieve pain
exercise program  To reduce inflammation

Members of the Ôehabilitation team   
f.
 
fter 24 hours
 elps patient or family explore feelings To relieve pain from muscle spasms
g. ‰    
To reduce swelling by increasing circulation
 elps develop skills for home and work To promote healing by increasing oxygenation
situations
h.    4. ‰rthopedic ‰perative ÷rocedures
 ssists patient and family adjust socio- a.   
economically
i. w  c
 Surgical opening into a joint
 Tests patient͛s interest and aptitudes a.  


j.   ^
 -ses technology in designing or constructing Fixation of a joint
devices to help the handicapped a.  

Surgical removal of 1 or more vertebra and fusing them together
4. ‰rthopedic ‰perative ÷rocedures ueneral Classifications of Fractures
d.   !

÷lacement of prosthesis on the hip joint ‰ne side broken and other bent

¦   


ip fracture Straight across the bone
¦nability to move leg voluntarily
Shortening and external rotation of the leg ‰"
ngle or slanting across the bone

        
void positioning on the operative site  
Maintain abduction of hip Twisting or coils around shaft
÷illows between legs
÷rovide chair with firm, non-reclining seat and arms c 
Splintered into several fragments

        
void hip flexion beyond 60 degrees for 10 days
void hip flexion beyond 90 degrees from day 10 to 2 months ueneral Classifications of Fractures
void adduction of the affected leg beyond midline for 2 months
÷artial weight bearing status for 2 months iepressed
Fragments are drived-in; facial or skull
Trauma
Compression
Contusion Fractured bone compressed by another bone; vertebra
¦njury to the soft tissue produced by blunt force
¦mpacted
Sprain Fractured bones are pushed into each other (telescoped
¦njury to the ligamentous structures caused by wrenching or
twisting iisplaced
Forcible hyperextension of a joint with tissue damage like Fragments are separated from fracture line
whiplash injury
 Linear
   Fracture parallel with long axis
Tearing of musculotendenous unit caused excessive stretching


 
Joint articulating surfaces are partially separated
No longer in anatomical contact

r  

Break on continuity of bone

3ursing Assessment
1. ÷ain- ¦ncreasing until immobilized
1. Loss of function
2. Localized swelling or discoloration
3. ieformity
4. c 
 - urating sound

ueneral Classifications of Fractures


Simple or closed
Skin is intact over fracture site

Compound or open
ëith an external wound in contact with the underlying fracture

Complete
^ntire cross section is displaced

¦ncomplete
÷ortion of cross section undisplaced