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how to manage traumatic amputations?
Activate the EMS, Apply direct pressure using gauze, or clean cloth to prevent hemorrhage. Elevate the extremity above the heart to decrease blood loss, Wrap the severed extremity in dry sterile gauze or in a clean cloth, and place in a sealed plastic bag or watertight container.
what could the nurse educate after total hip replacement
Can't turn on replaced side, avoid pigeon toes, crossing legs, do not ben at a 90-degree angle, use abduction pillow when turning.
These are 4 manifestations of a dislocated hip prosthesis
What are Shortening of the leg, muscle spasms, deformity, pain and reduced movement.
amputation nursing interventions
PCA pump for pain
allow patient to grief
educate patient on phantom limb pain
complications after long bone fractures.
Fat embolism
Manifestations of fat emboli related to long bone fractures
confusion, anxiety, tachycardia, chest pain, tachypnea, hemoptysis, petechiae over neck upper arms chest and abdomen (late sign)
How to prevent fractures
encourage calcium and vitamin D, exposure to sunlight, weight bearing activities
most common types of cast
Plaster of Paris, Synthetic fiber glass, splint cast, net cast, sling.
main complications for arthroplasty
DVT, Joint dislocation, infection, anemia, neurovascular compromise
Manifestations of RA
morning stiffness, pain at rest or immediately after immobility, bilateral joint inflammation with decreased range of motion, joint deformity in late stages, warmth tenderness and edema of affected areas, dry eyes and mouth (Sjogren's Syndrome), numbness tingling burning in the hands and feet
swan neck and boutonniere deformities.
OA, osteoporosis, osteonecrosis, RA, trauma, congenital changes
Cast care
Assess neurovascular status
Allow plaster to air dry while drying
Elevate affected extremity
Monitor for complications
Client may "petal" plaster cast if irritation around edges develops
Don't place objects down cast
attached directly to a bone by means of metal pin or wire
skeletal traction
post op care following lumbar puncture.
report to provider: Headache, infection, nerve damage
encourage supine position increase fluid intake helps replace CSF and minimizes headache, watch puncture site for leakage or infection.
manifestations of osteoarthritis
Cartilage destruction with bone spurn growth at joint ends: degenerative. pain with activity, Heberden's and bouchardes nodes
s/s pelvic fractures
Pain, tenderness, bruising, or swelling in your pelvic bone area, Numbness or tingling in your groin or upper thighs, Discomfort or pain when you sit, stand, walk, or have a bowel movement, Leg or thigh bone turns outward, Legs are not the same length.
Interventions for TKA
Anticoagulants, TEDs, SCDs early ambulation, neuro checks 2-4 hours, monitor site.
Manifestations of fat embolism
Dyspnea
Tachypnea
hypoxia
LOC changes
Chest pain
Contraindications for arthroplasty
Recent infections
PVD/PAD
cognitive impairment
comorbidities
Limb care w prosthetics
Dry the limb completely before applying prosthetics
Dislocation treatment
After treatment there should be no pain
Medical term for Partial dislocation
Subluxation
Traction care
perform neurovascular check of the affected part Q1 for 24 hours and 4 h after.
Avoid lifting, removing or supporting weights
MUST HANG FREELY ABOVE THE FLOOR
Diagnostic testing for carpal tunnel
Phalen's sign
involves holding downward position, the pt will feel tingling in their fingers
How to care for amputation clients
elevate stump for first 24 hours
discuss phantom limb pain
compression dressings
discourage semi fowlers position
encourage lying prone 20-20 mine every 3-4 hours