What is an expected finding at the pin sites on a patient in skeletal traction?
100
Plaster of Paris casts can take up to a few days to completely dry. Synthetic casts may be hardened enough to be durable in 30 minutes.
What is one difference between plaster of Paris and synthetic casts?
100
Circular turn for terminating the wrap.
Always overlap turns of the bandage equally.
What is the type of turn for terminating the bandage wrap and one off the rules for wrapping the bandage?
100
Skin breakdown and pressure injuries as a result of decreased circulation from pressure and ischemia/necrosis of tissue.
What complications of the integumentary system can arise from immobilization and why?
100
Shear and friction are reduced or eliminated because the cushions give with the patient during movement or rest.
It also controls moisture on the skin through the cushion controls.
What are the advantages of the low-air-loss mattress?
200
1. Using sterile swabs, cleanse closest to the pin in a circular motion. Use one swab for each circle. Work your way out in succeeding circles until 1 1/2 inch from the pin.
2. Apply antimicrobial ointment with a sterile swab and dress with sterile gauze if ordered.
3. Secure ends of wires with cork.
4. Monitor for infection.
What is: How to do pin care for patient in skeletal traction.
200
1. Elevate the extremity on 1-2 pillows to reduce edema.
2. During the drying period, use the palm and flat parts of the fingers when handling the cast to protect it from uneven pressure and use cloth-covered pillows.
3. Perform neurovascular assessments (CMS) to the area distal to the cast to detect altered perfusion.
4. Instruct the patient not to put anything inside cast.
5. Assess cast condition for cracks, crumbling or rough edges.
What is the nursing care for a patient with a new plaster of Paris extremity cast?
200
Patient's elbows are bent to 15-30 degrees while upright and grasping the handgrips.
What is the proper positioning for a patient's walker?
200
Thrombus formation, thrombophlebitis, pulmonary embolus, orthostatic hypotension as a result of venous stasis, increased cardiac workload and BP alterations.
What are immobilization complications of the cardiovascular system and why?
200
Prevents pressure occlusion of blood vessels and shearing of tissues against the mattress during movement. The warm air protects the skin from damage by wetness.
What are the advantages of an air fluidized bed?
300
Heel of the good foot.
What is a high-risk area for skin breakdown for a patient in skeletal traction?
300
1. Inform them that the skin underneath will be dry and dirty and may have an unpleasant odor.
2. Wash area with warm soapy water, rinse and apply cream or lotion to help remove the dead cells and return the skin to normal.
3. Apply sunscreen if area is going to be exposed to the sun.
What patient education should be provided to a patient having a cast removed?
300
Hand should be 4 inches above the elbow.
What is the proper position of a triangular bandage?
300
Precipitation of calcium salts which can cause kidney stones, frequency and dysuria from a UTI and urine stasis which can cause a UTI.
What urinary system complications can arise from immobilization and why?
300
Patients with unstable spines such as a spinal cord injury.
What type of patient is not recommended to use either the air fluidized bed or low air loss mattresses?
400
Head of the bed should be no higher than 20 degrees (unless ordered otherwise) to keep the patient from sliding down in the bed and to keep the weights hanging free.
Elevate the foot of the bed slightly to provide countertraction and keep the patient from sliding down in bed.
What is the proper position for a patient in Buck's traction?
400
To maintain the desired angle at the hip.
What is the purpose of a spreader bar on a spica cast?
400
Bring the good leg up first.
What are instructions for the patient who is on crutches for going up the stairs?
400
Bone loss can occur due to loss of calcium from the bone matrix which can cause osteoporosis.
Permanent loss of function can occur due to shortening of muscles, decreased muscle mass and muscle tension resulting in muscle atrophy and weakness.
Other problems: Joint contractures and fibrosis of connective tissue.
What problems of immobility can occur to the musculoskeletal system and why?
400
To set the proper flexion and extension limits.
What are the nurse's responsibilities with a continuous passive motion machine?
500
Reduces muscle spasm that accompanies fractures.
What is the primary use for Buck's traction?
500
Grasp the cast over the leg to assist in turning.
What is proper technique for turning or lifting a patient with a spica cast?
500
1. Use the cane on the unaffected side unless provider or therapist directs otherwise.
2. No leaning or full weight bearing on the affected leg.
3. Caregiver walks beside the patient on the affected side to provide support.
4. Handgrip is at hip level and patient's elbow is bent at a 15-30 degree angle when placing weight on the cane.
5. Patient should look straight ahead while walking.
What are proper guidelines for using a cane?
500
Hypostatic pneumonia, bacterial pneumonia, atelectasis and decreased gas exchange can occur from stasis of secretions, decreased elastic recoil and decreased vital capacity.
What are problems that can occur to the respiratory system due to immobility and why?
500
1. Passive/active ROM
2. Increase fluid intake to 3000 mL/day
3. Encourage adequate nutritional intake and dietary fiber
4. Frequent turning (q 2 hours)
5. Encourage deep breathing
6. Administer stool softeners and laxatives as ordered
What interventions would the nurse use to prevent complications of immobilization?