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PRESENTED BY:
MS. REETA KHURESHA
M.SC.(MSN)- 1STYEAR
CIMS CON
DEHRADUN
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AnkleAnkle fracturesfractures
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Rib fracturesRib fractures
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Fracture offemurFracture offemur
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HumerusfractureHumerusfracture
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SkullfracturesSkullfractures
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Prompt & thorough assessment of client to discover allinjuries,Reduction & stabilization of the fracture withimmobilization,
Observation for complications, remobilization &rehabilitation.
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Reducing fractures:Reduction isthemanipulation of
the bonesto restorealignment,
position, & length by bringing the
bony fragments into close
approximation. Reductionalsoknownas BONE SETTING.
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Two types of reduction areclosedreduction
Openreduction & internal
fixation
Externalfixation
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External fixation- depending onthe
clientscondition & the physiciansjudgment,externalfixationdevices
may beusedforfracturefragmentimmobilization
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ORIF- somefractureshavetoo many pieces
ofbone,haveneurovascular injuries, or
wouldnotstay alignedto healfollowing
closedreduction. Openreduction isa
surgical procedure wherethefracture
fragmentsarerealigned. Thisusually
performed incombination with internal
fixationforfemoral & jointfractures.Screws,
pins, plates, wires ornailsareusedto
maintainalignment offracturefragments.
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Traction:has beenusedto treat
fracturessince prehistorictimes, &its principle were wellknownto
Hippocrates traction istheapplication ofa pulling forceto an
injured body part orextremity
whileacounteraction pulls inthe
oppositedirection.
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Purposes oftractionare:
Reduce,realign & promotehealing
offracture bones
Preventsofttissuedamage
Prevent ortreatdeformitiesRestan inflamed,diseased or
painful joint
Preventdevelopment of
contractures.
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Types of traction:
Running traction- aform of
traction in which pull isexertedin one plane,may useeither
skin orskeleton. E.g. Bucksextensiontraction.
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Balancedsuspensiontraction- uses
additional weightstocounterbalancethetractionforce &
floatstheextremity inthetractionapparatus. Theline ofpull onthe
extremity remainsfairly constant
despitechanges inthe patientsposition.
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Application oftraction:
Skintraction involvesthe
application ofa pulling force
directly to skinthroughtheuse
ofskinstrips, boots orfoam
splints.
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Skeletaltractionuses pinsto applyforceto the bone.Adirectforce
can beappliedafterthe physician
insertstainlesssteel pinsthrough
the bone itself,e.g.femur,tibia &
ulna.
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NURSINGMANAGEMENT
OF
FRACTURED CLIENT
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Nursing diagnosis:-
Riskfordeficientfluidvolume
relatedto hemorrhage & shockasevidenced by dehydration.
Impaired gasexchangerelatedto
immobility & pulmonary emboli.
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Acute orchronic painrelatedto
injury asmanifested by facial
expressions.
Riskfor infectionrelatedto openfracture orsurgical intervention.
Self- caredeficitrelatedto
immobility asmanifested by poor
personalhygiene
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Nursing interventions:-
Evaluating forhemorrhage & shockMonitorfor impaired gasexchange
Relieving pain-
Promoting physicalmobility.
Promoting adequatehygiene-
Monitorfordevelopment ofinfection
Care ofclient inacast
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