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what is a sprain
stretch and or tear to the ligaments surrounding a joint
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S&S of sprain =
- loss of function
- pop or tearing sensation
- discoloration
- pain
- rapid swelling
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strain =
- excessive strething of a muscle or tendon
- usually occur in the largeer muscle groups
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strains and sprains are graded by
- mild
- moderate
- severe - torn ligament
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strain S&S
- pain
- limited motion
- muscle spasms
- swelling
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treatment for strains and sprains
- RICE
- rest - ICE - compression - elevation
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after how long should you administer mild heat to strains and sprains
- after 48 hours post injury
- X 15 - 30 minutes
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how do you prevent strains and sprains
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5 - P's =
- neurovascular assessment
- Pain
- Pulse
- Pallor
- Paresthesia
- Paralysis
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parasthesia =
numbness, tingling, prickling, etc
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dislocation vs subluxation =
- subluxation = partial or incomplete displacement or the joint
- dislocation = complete separation of the joint surfaces
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S & S of dislocation and subluxation
- deformity
- pain
- loss of function of joint
- swelling of soft tissues
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dislocation is considered an orthopedic emergency why
decreased blood flow to extremity
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treatment of dislocation =
sling and ice to the site of injury
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reduction =
moving a bone back in place
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major complications of dislocation and subluxations
- fractures
- avascular necrosis
- neurovascular tissue damage
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avascular necrosis =
death of bone tissue due to lack of blood flow
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intervertebral disc disease includes =
- herniated intervertebral disk (slipped disc)
- DDD = degenerative disk disease
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DDD =
- degenerative disc disease
- compressed discs in back
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clinical manifestations of DDD and herniated disc disease =
- low back pain
- sciatic nerve pain
- reflexes may be decreased or absent
- Cauda equina = bowel and bladder incontinence
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cauda equina =
- emergency
- pt has bowel and bladder incontinence with back injury
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straight leg raising test =
- helps in diagnosis of disk disease
- lay flat on back and raise legs up to 90 degree angle
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myelorgram =
uses dye and xray or CT to visualize bone
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care for intervetbral disc disease =
- restricted activity for several days
- medication
- local ice or heat
- physical therapy
- surgery
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types of spinal surgery
- laminectomy
- microdiskectomy
- spinal fusion
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laminectomy =
- cut off lamina
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microdiscectomy =
removal or material from herniated disc
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most important thing to do in care for pt after spine surgery =
maintain proper spinal alignment
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nursing management after spinal surgery =
- maintain proper spine alignment
- pain meds
- observe for severe headache or colorless leakage on dressing
- nuerovascular checks
- assess bladder and bowel function
- prevent constipation
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what does colorless drainage on dressing post-op spine surgery mean =
- spinal fluid leakage
- can test with glucose test strip = it is sugary
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which spinal surgery have the longest post-op course =
- spinal fusion
- brace is usually used
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education after spinal surgery =
- avoidance of sitting or standing for long periods of time
- restrict lifting
- discourage bending , stooping, twisting
- use of firm mattress or bed board
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fractures are described and classified according to
- open or closed
- complete or incomplete
- direction of fracture line
- displaced = unstable, nondisplaced = stable
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communication with external environment =
open fracture
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complex or comminuted fracture =
shattered bone into several pieces
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most common signs and symptoms of fractures
- discoloration
- pain/muscle spasms
- edema
- deformity
- crepitus
- guarding
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closed reduction vs closed reduction =
- closed = external manipulation to realign bones
- open = surgery to realign bones
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petaling a cast =
folding the top of a cast over edges to protect pt skin
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signs of infection with a casted extremity =
- fever
- hot spot on cast
- discoloration
- increase in pain
- swelling
- burning/tingling
- foul odor
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important things to educate pt in cast and fracture care =
- don't get wet
- don't remove padding
- don't insert foreign objects
- avoid covering cast
- elevate extremity for first 24 hours
- active range of motion above and below injury
- teach S&S of infection
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most important to traction =
- MAINTAIN TRACTION
- eliminate any issues that could cause traction to be impeded
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skin traction =
- attached to skin to immobilize body part and control muscle spasm continuously or intermittently over period of time
- 5 lbs
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skeletal traction =
- attached directly to pt's bone
- for long term use
- uses pins, screws, wires, or tongs
- much high weight than skin traction
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care for pt in traction =
- maintain traction
- position
- skin breakdown prevention
- pin site care
- promote exercise
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