fracture and nursing management
Post on 07-Jan-2017
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PRESENTATION ON FRACTURE
“UNDER GUIDANCE OF”
Mr. SURESH PATIL Msc Nursing
H.O.D OF PEDIATRIC NURSING
BVVS SION BAGALKOT
PRESENTATION ON
Mr. Shivakumar.S.Chawan Bsc Nursing
B.V.V.S . SION BAGALKOT
Shivakumar.chawan@gmail.com
OBJECTIVESAfter completion of the class students will be
able to • Define fracture• Enlist the Causes of fracture • Describe the types of fracture• Discuss the Pathophysiology of fracture • Enumerate the Clinical manifestations• Explain the medical & nursing management of
the fracture
DEFINITION• Fracture may be defined as the break in the continuity of any long or
short bone .• OR
• A fracture is a structural break in the normal continuity of a bone .
• Fracture may be due to any excessive and pressure so that the bone cannot able to withstand .
• Fracture may be due to any causes like direct and indirect• Direct : force directly to the bone• Indirect : force to the surrounding area of the bone
ETIOLOGY & R.FACTOR
Traumatic injuries
Extreme force & stress greater then it can absorb
Direct blows
Crushing forces
Extreme muscle contraction
Sudden twisting motions
TYPES OF FRACTURE• Open fracture• Closed fracure• Linear fracture• Oblique fracture• Longitudinal fracture • Transerve fracture• Spiral fracture• Greenstic fracture• Compression fracture• Impacted fracture• Pathogenic fracture• Cooleys fracture
TYPES OF FRACTURE
Fig. 61-4
PATHOPHYSIOLOGY Due to etiological factorthere
When bone get fractrued , there is a destruction of surronded blood vessel , periosteum and soft tissue
Bleeding occurs and haematoma is formed in medullary canal between the fracture ends the bone & beneath the periostrum
Death of the tissue immediately occurs adjacent to fracture
Inflammatory response occurs
Vasodilation, edema , pain, loss of function , excudate of plasma & leuckocyte & infiltration of wbc cells
They build the formation of bone healing
CLINICAL FEATURE• Swelling
• Discoloration
• Edema
• Loss of function
• Crepitus
• Brushing
• Shortening
• Hypovolemic shock
• pain
COMPLICATIONS
Early complications
• Shock
• fat embolism
• compartment syndrome
• deep vein thrombosis
• disseminated intravascular coagulopathy
• infection
MEDICAL /SURGICAL MANAGEMENT OF FRACTURES:
1. Reduction Reduction of a fracture (“setting” the bone) refers to restoration of
the fracture fragments to anatomic alignment and rotation.
Open reduction
It’s a surgical approach, the fracture fragments are reduced. External/Internal fixation devices (metallic pins, wires, screws, plates, nails, or
rods) may be used to hold the bone fragments in position until solid bone healing occurs.
Internal fixation
External fixation
Difference between internal or external fixation
2. IMMOBILISATION
3. ADEQUATE SUPPORT FOR FRACTURED BONES DURING TURNING AND
POSITIONING
4. MAINTANCE OF FLUID AND ELECTROLYTE BALANCE
5. ADMINISTRING OF CORTICOSTEROIDS
TO TREAT A INFLAMATORY PROCESS
TO TREAT A CEREBRAL EDEMA
6. ADMINISTRING VASOACTIVE MEDICATIONS
FOR SUPPORTING CVS FUNCTION
TO PREVENT
HYPOTENSION
SHOCK
INTERSTIAL PULOMNARY EDEMA
7. MORPHINE MAY ADMINISTRE TO TREAT RELIVING OF PAIN
8 . PLASTER OF PARIS ( POP )9 . SPLINT10. RESTRAINTS
NURSING DIAGNOSIS: Acute pain related to fracture Immoblity related to fracture Risk of infection retaled to damage of protective barrier Constipation related to immobilization skin integrity relatead to applying immobilising devices
Acute pain related breakdown of continuity of the bone as evidenced by facial expressions and verbalization of patient.
• Goals: Patient will not feel pain • Intervention:
– Assess the onset, duration, location, severity and intensity of pain.– Administer the analgesic according to physician order.– Provide comfort devices like sand bags for immobilization of affected
parts.– Provide diversion therapy
Impaired physical mobility related to application of traction or cast as evidenced by assessment
• Goal: Patient will able to move unaffected area.• Intervention:
– Provide range of motion exercises to the patient.– Assist the patient in ambulation after recovery of fracture.– Provide assistance while using walker or crutches if required.– Prevent from complication which usually occurs due to immobility.
•
Self care deficit related to fracture as evidenced by poor personal hygiene.
• Goal: Patient will maintain the personal hygiene • Intervention:
– Assess the need of self care – Encourage the patient or relatives to do self care activity– Head to foot care to be provided to the patient.– Educate about importance of maintaining personal hygiene.
Imbalanced nutrition less than body requirement relate to increase demand of nutrient for bone healing as evidenced by observation.
• Goal: Maintain the nutritional status of the patient• Intervention:
– Assess the nutritional status by intake/output chart, biochemical measures, body mass.
– Maintain intake output chart daily.– Encourages the patient to take protein rich diet.– Plenty of fluids and frequent intake of meal is necessary.– Try to assess the daily weight of the client
HEALTH TALK TO MOTHER Away from traumatic injuries
THANKING YOU
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