Fracture and nursing management

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

[email protected]

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