Nursing-Management-of-Patients-with-Fractures (1).pptx

Nursing-Management-of-Patients-with-Fractures (1).pptx

1. Nursing Management of Patients with Fractures اعداد الطالب: اثير عبد احمد

2. Objectives: 1 Define and classify the different types of fractures. 2 Explain the clinical manifestations and potential complications of fractur 3 Analyze diagnostic findings to differentiate between simple and complex fractures. 4 Demonstrate appropriate emergency nursing interventions for a patient with a suspected fracture

3. Fracture: FRX, FX or # A fracture is a complete or incomplete disruption in the continuity of bone structure and is defined according to its type and extent. Fractures occur when the bone is subjected to stress greater than it can absorb.

4. Etiology Understanding the various causes of fractures is essential for prevention and treatment planning. Fractures can result from multiple factors ranging from traumatic incidents to underlying medical conditions. 1 Trauma from a fall 2 An accident (usually a motor vehicle). 3 A crushing injury 4 Sudden twisting motions and extreme muscle contractions 5 Bone disease (such as osteoporosis and metastatic bone cancer) 6 Malnutrition 7 Side effects from medications can cause a decrease in bone density

5. Types of Fractures

6. Clinical Manifestations Pain Loss of Function Deformity. Shortening Crepitus Localized Edema and Ecchymosis

7. Diagnostic Tests An x-ray examination:. Computed tomography (CT). MRI. A hemoglobin and hematocrit level. The erythrocyte sedimentation rate (ESR). A serum calcium level.

8. Factors Inhibit Fracture Healing Age >40 years. Bone loss. Cigarette smoking. Comorbidities (e.g., diabetes, rheumatoid arthritis). Corticosteroids, nonsteroidal anti-inflammatory drugs. Extensive local trauma. Inadequate immobilization. Infection. Malalignment of the fracture fragments. Weight bearing prior to approval.

9. Emergency Management of Fractures Immobilize the affected limb immediately. Apply splints and padding above and below the fracture site unless there is bleeding, which may require visualization before applying pressure. 3. For leg fractures, bandage the unaffected leg to the injured one; for arm fractures, use a sling or bandage the arm to the chest. 4. Remove clothing gently, starting from the uninjured side.

10. Emergency Management of Fractures 5. Assess circulation, warmth, color, and movement below the fracture. 6. Cover an open fracture with a sterile dressing. 7. Do not realign or straighten the fractured limb; minimize movement. 8. Transport the patient to an emergency department promptly.

11. Medical Management of Fracture 1. Reduction a. Closed Reduction b. Open Reduction 2. Bandages and Casts.

12. Medical Management of Fracture

13. Medical Management of Fracture 3. Traction. Skin Traction Skeletal traction. 4. Open Reduction with Internal 5. External Fixation.

14. Complications of Fractures Early Complications Shock Neurovascular status Infection Venous thromboembolic complications Acute compartment syndrome Fat embolism syndrome Delayed Complications Delayed Union, Nonunion, and Malunion Avascular Necrosis of Bone (AVN; Osteonecrosis) Heterotopic Ossification

15. Nursing Process for the Patient With a Fracture Checking of neurovascular status (circulation, sensation, mobility) distal to the fracture site to detect problems. 2. Pain is managed by both medications and complementary therapies. Bone pain can be excruciating and must be treated aggressively. Nursing Assessment

16. Nursing Process for the Patient With a Fracture Acute Pain related to a fractured bone Identify pain level on a 0 to 10 pain scale to establish baseline for further interventions. Provide analgesics and anti-inflammatories as ordered to relieve pain and swelling. Monitor for compartment syndrome if patient has a cast in place to prevent neurovascular complications. Apply ice as ordered to decrease swelling and pain. Teach alternative methods for pain relief to maximize relief of pain. Nursing Diagnoses and Implementation.

17. Nursing Process for the Patient With a Fracture Impaired Physical Mobility related to bone fracture a. Observe patient’s mobility to provide baseline assessment data. b. Encourage independence to promote mobility. c. Utilize other disciplines such as occupational and physiotherapy to encourage and promote patient mobility. d. Provide equipment and resources such as crutches and wheelchairs to improve mobility. Nursing Diagnoses and Implementation.

18. Nursing Process for the Patient With a Fracture Impaired Physical Mobility related to bone fracture a. Observe patient’s mobility to provide baseline assessment data. b. Encourage independence to promote mobility. c. Utilize other disciplines such as occupational and physiotherapy to encourage and promote patient mobility. d. Provide equipment and resources such as crutches and wheelchairs to improve mobility. Nursing Diagnoses and Implementation.

19. Nursing Process for the Patient With a Fracture Risk for Peripheral Neurovascular Dysfunction related to increased tissue volume or restrictive envelope a. Assess often for compartment syndrome to promote prompt reporting. b. Assess for swelling of affected limb (especially if patient has a cast or tight dressing c. Keep limb elevated above heart to minimize edema. d. Administer anti-inflammatory agents as ordered to reduce pain and swelling. e. Monitor for increasing pain even after analgesic administration to detect complications. . Nursing Diagnoses and Implementation.

20. Evaluation The success of nursing interventions for patients with fractures is measured through specific evaluation criteria that demonstrate improved patient outcomes and recovery progress. Pain Management Reports or demonstrates that pain is within tolerable levels on a pain assessment scale. Physical Mobility Demonstrates increased physical mobility. Neurovascular Function Maintains peripheral pulses, warm skin, and sensation. Extremity Function Ability to move extremity.

21. Refernces Hinkle, J. L., & Cheever, K. H. (2022). Brunner & Suddarth’s textbook of medical-surgical nursing (15th ed.). Wolters Kluwer. Harding, M. M., Kwong, J., Roberts, D., Hagler, D., & Reinisch , C. (2023). Lewis’s medical-surgical nursing: Assessment and management of clinical problems (12th ed.). Elsevier. Shi, X., & Ma, W. (2024). Effect of collaborative nursing method based on RAM model on postoperative functional reconstruction, soft tissue pain and living quality in patients with femoral trochanter fracture. BMC Musculoskeletal Disorders, 25(1), 627.‏