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28 Cards in this Set
- Front
- Back
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What are some soft tissue injuries?
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Sprains
Strains Contusions Dislocation |
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What the signs and symptoms of a contusion?
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swelling,ecchymosis (blue-black discoloration), pain, disability
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What are the signs & symptoms of dislocation?
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swelling(sometimes),pain that increases w/ attempted passive/active, movement of the extremity, cries, appears anxious, refuses to use the affected limb
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What are the signs & symptoms of sprains?
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swelling, presence of joint laxity, complaints of the joint "feeling loose" or having heard a "snap", "pop", or tearing
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What are the signs & symptoms of strains?
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swelling, painful to touch, when muscular portion is affected, there is more bleeding, often palpable soon after injury & before edema obscures the hematoma
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Therapeutic Management for soft tissue injuries?
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RICE and ICES
"R" = rest "I" = ice "C" = compression "E" = elevation Ice should never be applied for >30 minutes, Elevation facilitates venous return and reduces swelling |
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What are some types of fractures?
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Salter-Harris, Greenstick, Closed (simple)/Open (compound)
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S/S of a Fracture?
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generalized swelling, pain or tenderness, diminished functional use of affected part, radiographic examination; also may domonstrate: bruising, severe muscular rigidity, crepitus (grating sensation at fracture site
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Therapeutic Management for Fracture?
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The goals of fracture mgt.:To regain alignment & length of the bony fragments (reduction), retain alignment & length (immobilization), restore function to injured parts, prevent further injury
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Emergency Treatment (Fracture): Assess the extent of injury - 5 P's (name them)
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1. Pain & point of tenderness
2. Pulse - pulse distal to injury site 3. Pallor 4. Paresthesia - sensation distal to site 5. paralysis - movement distal to the fracture site |
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The five P's of ischemia from a vascular injury should be included in an assessment of injury:
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1. Pain
2. Pallor 3. Pulselessness 4. Paresthesia 5. Paralysis |
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What are the four major categories of casts that are used for fractures?
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- Upper extremity (wrist/ elbow)
- Lower extremity (ankle/knee - Spinal & Cervical (spine) - Spica cast (hip/knee) |
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Observations that require prompt reporting
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pain (unrelieved by pain medications 1 hour after administration), swelling, discoloration (pallor or cyanosis) of the exposed portions, decreased pulses, decreased temperature, inability to move the distal exposed part(s)
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(NIPE)
Teaching for the parents about cast care: |
teach the 5 P's,
check especially before bed, warn -sharp edges, foreign objects inside cast elevate while resting |
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NIPE (nursing implications/Patient education)Teaching about cast removal:
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usually removed in Dr.'s office, Warn about the sound the saw will make, explain that it will not be painful and that it is going to produce a "tickly" sensation, heat may be felt, clean with warm water & soap, can use topical anti-itch medication
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Purposes of Traction are:
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1. Fatigue the involved muscles & reduce muscle spasm so bones can realign
2. To position the distal & proximal bone ends in desired realignment to promote satisfactory bone healing 3. To immobilize the fracture site until realignment has bee achieved and sufficient healing has taken place to permit casting or splinting |
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What are essential components of traction management?
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- Traction (to reduce or realign fracture site/forward force)
- Countertraction (body wt or backward force - Friction (patient contact w/bed) - All or None Law (charac. of muscle contractibility, influences the complete relaxation. |
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Name the 3 types of traction
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Manual traction, Skin traction, Skeletal traction
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Upper Extremity traction
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- Overhead suspension
- Dunlop traction |
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Lower Extremity traction
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- Bryant traction
- Buck extension - Russell traction - 90/90 traction - Balance suspension traction |
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skeletal traction is most effective when....
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the weights are hanging freely at all times
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skeletal traction is never released by _________ (except under the supervision by the __________
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nurse
practitioner. This precaution incl. not lifiging the weights that are applying traction (e.g. for moving the child in bed, for repositioning |
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Traction Care:
What do you do when your patient 30 minutes out of post-op complains fo tingling, you observe decreased pulse, pallor etc? |
Don't do anything to the patient(don't touch the traction). DO contact MD stat. Assess & Documentation is critical. If you find the weights are on the floor, call PT, becuz wts. being on the floor hinders rehab.
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What is it called when a fracture is caused purposefully?
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Distraction - process of separating opposing bone to encourage regeneration of new bone in the created space, Ilizarov External Fixator IEF
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Why would a distraction take place?
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ill healed fracture, limbs that are unequal lengths, and new bone is needed to elongate the shorter limb
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Name the Guidelines for Traction Care
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- Understand Therapy
- Maintain Traction - Maintain Alignment - Skin Traction - Skeletal Traction - Prevent Skin Breakdown - Prevent Complications |
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What do you for an amputated limb or body part that may be reattached?
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1st TREAT THE CHILD, THEN
1. Rinse limb gently w/ normal saline 2. Lossely wrap limb in sterile gauze 3. Plase wrapped limb in a watertight bag. 4. Cool (without freezing) bag in ice water (do not pack in ice because this may harm tissue) 5. Label with child's name, date, & time, and trasnport with the child to the hospital. **In lect. we were told you can also use milk instead of NS |
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Care management for amputation
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- Stump is usually in an ace bandage, keep elevated for the 1st 24 hrs
- Explain to patient that it is normal to experience phontom pain - administer analgesics for pain |
