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    Traction

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    KoRnflakes
    The document discusses guidelines for applying and caring for patients with casts, including plaster and non-plaster materials. It covers nursing actions and rationales for applying casts, preventing complications, and caring for patients with body or spica casts.

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    Traction

    Uploaded by

    KoRnflakes
    15K views79 pages
    The document discusses guidelines for applying and caring for patients with casts, including plaster and non-plaster materials. It covers nursing actions and rationales for applying casts, preventing complications, and caring for patients with body or spica casts.

    Original Description:

    Notes on traction and musculoskeletal problem. Pointers focusing on the different kinds of traction, using traction and its purposes. It also includes notes on how to manage casts and notes on casting, the materials used in casting, it's purposes and adverse effects.

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    The document discusses guidelines for applying and caring for patients with casts, including plaster and non-plaster materials. It covers nursing actions and rationales for applying casts, preventing complications, and caring for patients with body or spica casts.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    15K views79 pages

    Traction

    Uploaded by

    KoRnflakes
    The document discusses guidelines for applying and caring for patients with casts, including plaster and non-plaster materials. It covers nursing actions and rationales for applying casts, preventing complications, and caring for patients with body or spica casts.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 79
    At a glance
    Powered by AI
    The key takeaways are about managing patients with fractures using casts and traction methods. Casts are used to immobilize injured bones and promote healing while traction is used to apply pulling forces to align and mobilize fractures.

    The different types of casts mentioned are short-arm cast, long-arm cast, short-leg cast, long-leg cast, walking cast, body cast, shoulder spica cast, hip spica cast, and double hip spica cast.

    The guidelines for applying a cast include positioning and maintaining the part to be casted, draping the patient, washing and drying the part, applying padding and stockinette, wrapping padding, applying plaster or nonplaster casting material, and finishing the cast.

    MANAGING

    A
    PATIENT
    IN CAST
    CAST
    •IT IS A RIGID DEVICE APPLIED TO
    IMMOBILIZE THE INJURED BONES
    AND PROMOTE HEALING.
    •IT IS APPLIED TO IMMOBILIZE THE
    JOINT ABOVE AND BELOW THE
    FRACTURED BONE SO THAT THE
    BONE WILL NOT MOVE DURING
    HEALING.
    •THESE ARE APPLIED ON CLIENTS
    WHO HAVE RELATIVELY STABLE
    FRACTURES.
    TYPES OF CASTS
    SHORT-ARM CAST
    LONG-ARM CAST
    SHORT-LEG CAST
    LONG-LEG CAST
    WALKING CAST
    BODY CAST
    SHOULDER SPICA CAST
    HIP SPICA CAST
    DOUBLE HIP SPICA CAST
    CASTING
    MATERIALS
    PLASTER
    NONPLASTER
    GUIDELINES FOR APPLYING A
    CAST
    NURSING ACTION RATIONALE
    2. SUPPORT IT MINIMIZES
    EXTREMITY OR MOVEMENT;
    BODY PART TO MAINTAINS
    BE CASTED. REDUCTION AND
    ALIGNMENT;
    INCREASES
    COMFORT
    GUIDELINES FOR APPLYING A
    CAST
    NURSING ACTION RATIONALE
    2. POSITION AND FACILITATES
    MAINTAIN PART CASTING;
    TO BE CASTED REDUCES
    IN POSITION INCIDENCE OF
    INDICATED BY COMPLICATIONS
    PHYSICIAN (eg, MALUNION,
    DURING NONUNION,
    CASTING CONTRACTURE)
    PROCEDURE.
    GUIDELINES FOR APPLYING A
    CAST
    NURSING ACTION RATIONALE
    3. DRAPE PATIENT. AVOIDS UNDUE
    EXPOSURE;
    PROTECTS
    OTHER BODY
    PARTS FROM
    CONTACT WITH
    CASTING
    MATERIALS.
    GUIDELINES FOR APPLYING A
    CAST
    NURSING ACTION RATIONALE
    4. WASH AND DRY REDUCES
    PART TO BE INCIDENCE OF
    CASTED. SKIN BREAKDOWN
    GUIDELINES FOR APPLYING A
    CAST
    NURSING ACTION RATIONALE
    2. PLACE KNITTED PROTECTS THE SKIN
    MATERIAL (eg, FROM CASTING
    stockinette) OVER MATERIALS.
    PART TO BE PROTECTS SKIN FROM
    CASTED. PRESSURE
    1. APPLY IN SMOOTH
    AND
    FOLDS OVER EDGES
    NONCONSTRICTIVE OF CAST WHEN
    MANNER FINISHING
    2. ALLOW ADDITIONAL APPLICATION;
    MATERIAL CREATES SMOOTH,
    PADDED EDGE;
    PROTECTS SKIN
    FROM ABRASION
    GUIDELINES FOR APPLYING A
    CAST
    NURSING ACTION RATIONALE
    2. WRAP SOFT, PROTECTS SKIN FROM
    NONWOVEN ROLL PRESSURE OF CAST
    PADDING PROTECTS SKIN AT
    SMOOTHLY AND BONY
    EVENLY AROUND PROMINENCES
    PART. PROTECTS
    1. USE ADDITIONAL
    PADDING OVER
    SUPERFICIAL
    BONY NERVES
    PROMINENCES TO
    PROTECT
    SUPERFICIAL
    NERVES (eg, HEAD
    OF FIBULA AND
    OLECRANON
    GUIDELINES FOR APPLYING A
    CAST
    NURSING ACTION RATIONALE
    2. APPLY PLASTER OR CREATES SMOOTH, SOLID,
    NONPLASTER CASTING WELL-CONTOURED CAST
    MATERIAL EVENLY ON FACILITATES SMOOTH
    BODY PART APPLICATION
    1. CHOOSE CREATES SMOOTH, SOLID,
    APPROPRIATE WIDTH
    OF BANDAGE
    IMMOBILIZING CAST
    2. USE CONTINOUS SHAPES CAST PROPERLY
    MOTION, FOR ADEQUATE
    MAINTAINING SUPPORT
    CONSTANT CONTACT STRENGTHENS CAST
    WITH BODY PART
    3. USE ADDITIONAL
    CASTING MATERIALS
    (SPLINTS) AT JOINTS
    AND AT POINTS OF
    ANTICIPATED CAST
    GUIDELINES FOR APPLYING A
    CAST
    NURSING ACTION RATIONALE
    2. FINISH CAST PROTECTS SKIN
    1. SMOOTH EDGES FROM ABRASION
    2. TRIM AND ALLOWS FULL
    RESHAPE WITH RANGE OF
    CAST KNIFE
    MOTION OF
    AND/OR CUTTER
    ADJACENT JOINTS
    GUIDELINES FOR APPLYING A
    CAST
    NURSING ACTION RATIONALE
    9. REMOVE PREVENTS
    PARTICLES OF PARTICLES FROM
    CASTING LOOSENING AND
    MATERIALS SLIDING
    FROM SKIN UNDERNEATH
    CAST
    GUIDELINES FOR APPLYING A
    CAST
    NURSING ACTION RATIONALE
    2. SUPPORT CAST CASTING MATERIALS
    DURING HARDENING BEGIN TO HARDEN IN
    1. HANDLE HARDENING MINUTES. MAXIMUM
    CAST WITH PALMS OF HARDNESS OF
    HANDS NONPLASTER CAST
    2. SUPPORT CAST ON BEGINS IN MINUTES.
    FIRM, SMOOTH MAXIMUM HARDNESS
    SURFACE OF PLASTER CAST
    3. DO NOT REST CAST OCCURS WITH DRYING (
    ON HARD SURFACES 24 TO 72 HOURS,
    OR ON SHARP EDGES DEPENDING ON
    4. AVOID PRESSURE ON ENVIRONMENT AND
    CAST THICKNESS OF CAST)
    AVOIDS DENTING OF CAST
    AND DEVELOPMENT OF
    PRESSURE AREAS.
    GUIDELINES FOR APPLYING A
    CAST
    NURSING ACTION RATIONALE
    11. PROMOTE DRYING OF FACILITATES DRYING.
    CAST.
    1. LEAVE CAST
    UNCOVERED AND
    EXPOSED TO AIR
    2. TURN PATIENT
    EVERY 2 HOURS
    SUPPORTING MAJOR
    JOINTS
    3. FANS MAY BE USED
    TO INCREASE AIR
    FLOW AND SPEED
    DRYING.
    PROCEDURE FOR BIVALVING A
    CAST
    THE FOLLOWING PROCEDURE IS FOLLOWED WHEN A CAST IS
    BIVALVED.

    • WITH A CAST CUTTER, A LONGITUDINAL CUT IS


    MADE TO DIVIDE THE CAST IN HALF.
    • THE UNDERPADDING IS CUT WITH SCISSORS.
    • THE CAST IS SPREAD APART WITH CAST
    SPREADERS TO RELIEVE PRESSURE AND TO
    INSPECT AND TREAT THE SKIN WITHOUT
    INTERRUPTING THE REDUCTION AND ALIGNMENT
    OF THE BONE.
    • AFTER THE PRESSURE IS RELIEVED, THE ANTERIOR
    AND POSTERIOR PARTS OF THE CAST ARE SECURED
    TOGETHR WITH AN ELASTIC COMPRESSION
    BANDAGE TO MAINTAIN IMMOBILZATION.
    • TO CONTROL SWELLING AND PROMOTE
    CIRCULATION, THE EXTREMITY IS ELEVATED ( BUT
    NO HIGHER THAN THE HEART LEVEL, TO MINIMIZE
    THE EFFECT OF GRAVITY ON PERFUSION OF THE
    TISSUES).
    CARE OF THE PATIENT WITH A
    BODY OR SPICA CAST
    NURSING ACTION RATIONALE
    1.
    PREVENTING
    COMPLICATIONS OF
    IMMOBILITY BASED ON THE
    SYSTEM
    CARDIOVASCULAR
    • COMPLICATION • NURSING
    – ORTHOSTATIC INTERVENTION
    HYPOTENSION – EXERCISES
    – DEEP VEIN – PLANTARFLEXION AND
    THROMBOSIS AND DORSIFLEXION FOOT
    PULMONARY EMBOLISM EXERCISES
    – INCREASED WORKLOAD – QUADRICEPS AND
    ON HEART GLUTEAL SETTING
    EXERCISES
    – FREQUENT TURNING
    – SLOW MOBILIZATION
    – NO PILLOWS BEHIND
    THE KNEES
    – ANTIEMBOLISM
    STOCKINGS
    RESPIRATORY
    • COMPLICATION • NURSING
    – DECREASED CHEST INTERVENTION
    EXPANSION – FREQUENT
    – ACCUMULATION OF TURNING
    SECRETIONS IN – ENCOURAGE
    RESPIRATORY FREQUENT
    TRACT COUGHING AND
    DEEP BREATHING
    INTEGUMENTARY
    • COMPLICATION • NURSING
    – BREAKDOWN OF INTERVENTION
    SKIN INTEGRITY – FREQUENT TURNIG
    (ABRASIONS, AND
    DECUBITUS ULCER) REPOSITIONING
    CAUSED BY – REGULAR
    FRICTION, INSPECTION OF
    PRESSURE, OR SKIN FOR SIGNS OF
    SHEARING FORCE PRESSURE
    – GENTLE MASSAGE
    OF SKIN,
    ESPECIALLY OVER
    BONY
    PROMINENCES
    GASTROINTESTINAL
    • COMPLICATION • NURSING
    – CONSTIPATION INTERVENTION
    – FREQUENT MOVEMENT
    AND TURNING IN BED
    – INCREASE FLUID INTAKE
    – ADEQUATE DIETARY
    INTAKE WITH INCREASE
    IN HIGH-FIBER FOODS
    – USE OF STOOL
    SOFTENERS AND
    LAXATIVES AS
    ORDERED
    MUSCULOSKELETAL
    • COMPLICATION • NURSING
    – ATROPHY AND INTERVENTION
    WEAKNESS OF – EXERCISES
    MUSCLES – ENCOURAGE
    – CONTRACTURES PARTICIPATION IN
    – DEMINERALIZATION ADL AS MUCH AS
    OF BONES POSSIBLE
    (OSTEOPOROSIS) – PROPER
    POSITIONING AND
    REPOSITIONING OF
    JOINTS
    URINARY
    • COMPLICATION • NURSING
    – INCREASED INTERVENTION
    CALCIUM – INCREASED FLUID
    EXCRETIONFROM INTAKE
    BONE – DECREASE IN
    DESTRUCTION CALCIUM INTAKE,
    (CALCULI ESPECIALLY MILK
    FORMATION) AND MILK
    – INCREASED URINE PRODUCTS
    pH (ALKALINE) – USE OF ACID-ASH
    – STASIS OF URINE IN FOODS
    KIDNEY AND – USE OF COMMODE
    BLADDER IF POSSIBLE
    – URINARY INFECTION
    NEUROLOGIC
    • COMPLICATION • NURSING
    – SENSORY DEPRIVATION INTERVENTION
    AND ISOLATION – FREQUENT CONTACT BY
    STAFF
    – ORIENTING MEASURES
    (CLOCK, CALENDAR)
    – DIVERSIONAL
    ACITIVITIES (TV, RADIO,
    HOBBIES)
    – INCLUSION OF CLIENT
    IN DECISION-MAKING
    ACTIVITIES
    CARDIOVASCULAR
    • COMPLICATION • NURSING
    – ORTHOSTATIC INTERVENTION
    HYPOTENSION – ACTIVE OR PASSIVE
    – DEEP-VEIN ROM EXERCISES
    THROMBOSIS AND
    PULMONARY
    EMBOLISM
    – INCREASED
    WORKLOAD ON THE
    HEART
    THE PATIENT WITH
    SPLINTS OR BRACES
    THE PATIENT WITH AN
    EXTERNAL FIXATOR
    MANAGING
    THE PATIENT IN
    TRACTION
    TRACTION
    IS THE APPLICATIONOF A
    STRAIGHTENING OR PULLING
    FORCE TO RETURN OR MAINTAIN
    THE FRACTURED BONES IN
    NORMAL ANATOMIC POSITION.
    TYPES OF TRACTION
    1. STRAIGHT OR RUNNING
    TRACTION
    2. BALANCED SUSPENSION
    TRACTION
    STRAIGHT TRACTION

    THE PULLING FORCE IS


    APPLIED IN A STRAIGHT LINE
    TO THE INJURED BODY PART
    RESTING ON THE BED
    BUCK’S TRACTION

    IT IS THE MOST COMMON TYPE OF


    STRAIGHT TRACTION. THE LOWER
    PORTION OF THE INJURED
    EXTREMITY IS PLACED IN A
    CRADLE-LIKE SLEEVE. THIS SLEEVE
    IS HARNESSED TO ITSELF AND A
    WEIGHT IS HUNG FROM THE
    BOTTOM OF THE TRACTION FRAME.
    IT IS A FORM OF SKIN TRACTION.
    SKIN TRACTION
    ADVANTAGE: THE RELATIVE EASE
    OF USE AND ABILITY TO MAINTAIN
    COMFORT
    DISADVANTAGE: THE WEIGHT
    REQUIRED TO MAINTAIN NORMAL
    BODY ALIGNMENT OR FRACTURE
    ALIGNMENT CANNOT EXCEED THE
    TOLERANCE OF THE SKIN, ABOUT
    6 lb PER EXTREMITY.
    IN SKIN TRACTION,
    REMOVE
    WEIGHTS ONLY
    WHEN
    INTERMITTENT
    SKIN
    TRACTION
    HAS BEEN
    ORDERED TO
    ALLEVIATE THE
    MUSCLE SPASM.
    BALANCED
    SUSPENSION TRACTION
    IT INVOLVES MORE THAN ONE
    FORCE OF PULL. SEVERAL FORCES
    WORK IN UNISON TO RAISE AND
    SUPPORT THE CLIENT’S INJURED
    EXTREMITY OFF THE BED AND PULL
    IT IN A STRAIGHT FASHION AWAY
    FROM THE BODY.
    BALANCED
    SUSPENSION TRACTION
    ADVANTAGE: IT INCREASES
    MOBILITY WITHOUT THREATENING
    JOINT CONTINUITY
    DISADVANTAGE: THE INCREASED
    USE OF MULTIPLE WEIGHTS MAKES
    THE CLIENT MORE LIKELY TO SLIDE
    IN THE BED.
    TYPES OF TRACTION
    1. SKIN TRACTION – 2-3.5 kg
    2. SKELETAL TRACTION
    3. BALANCED SUSPENSION
    TRACTION –
    7 -12 kg
    4. THOMAS SPLINT AND PEARSON
    ATTACHMENT
    5. MANUAL TRACTION
    TYPES OF SKIN
    TRACTION
    1. BUCK’S EXTENSION
    TRACTION
    2. RUSSEL TRACTION
    3. CERVICAL TRACTION
    4. PELVIC TRACTION- 4.5-9
    kg
    SKIN TRACTION, FREQUENTLY ASSESS SKIN FOR EVIDENCE OF PRESSUR
    SHEARING OR PENDING SKIN BREAKDOWN.
    IN SKIN TRACTION, PROTECT PRESSURE SITES WITH PADDING AND
    PROTECTIVE DRESSINGS AS INDICATED.
    MANUAL TRACTION

    THE HAND DIRECTLY


    APPLIES THE PULLING
    FORCE
    SKELETAL TRACTION
    • IT IS THE APPLICATION OF A
    PULLING FORCE THROUGH
    PLACEMENT OF PINS INTO THE
    BONE.
    • THE CLIENT RECEIVES A LOCAL
    ANESTHETIC , AND THE PIN IS
    INSERTED IN A TWISTING MOTION
    INTO THE BONE
    • THIS TYPE OF TRACTION SHOULD
    BE APPLIED IN A STERILE
    CONDITION BECAUSE OF THE RISK
    OF INFECTION
    •ONE OR MORE PULLING FORCE IS
    MAY BE APPLIED
    • IN SKELETAL TRACTION, NEVER REMOVE THE
    WEIGHTS.
    • MAY REQUIRE MORE FREQUENT ANALGESIC
    ADMINISTRATION.
    SKELETAL TRACTION

    ADVANTAGE: MORE WEIGHT


    CAN BE USED TO MAINTAIN
    THE PROPER ANATOMIC
    ALIGNMENT IF NECESSARY
    DISADVANTAGE: INCREASED
    ANXIETY, INCREASED RISK OF
    INFECTION, INCREASED
    DISCOMFORT
    FREQUENT SKIN ASSESSMENTS SHOULD INCLUDE PIN CARE PER POLIC
    REPORT SIGNS OF INFECTION AT THE PIN SITES.
    ASSIST IN REPOSITIONING. THE AREA OF THE FRACTURE MUST BE
    STABILIZED WHEN THE CLIENT IS REPOSITIONED.
    MAINTAIN THE LINE OF PULL:
    B. CENTER THE CLIENT ON THE BED.
    C. ENSURE THAT WEIGHTS HANG FREELY AND DO
    NOT TOUCH
    THE FLOOR.
    PERFORM NEUROVASCULAR ASSESSMENTS FREQUENTLY.
    DO NOT WEDGE THE CLIENT’S FOOT OR PLACE IT FLUSH WITH
    THE FOOT-BOARD OF THE BED.
    MANAGING THE PATIENT
    IN UNDERGOING
    ORTHOPEDIC SURGERY

    JOINT REPLACEMENT
    TOTAL HIP REPLACEMENT
    ORTHOPEDIC
    SURGERIES
    OPEN REDUCTION
    INTERNAL FIXATION
    ARTHROPLASTY
    HEMIARTHROPLASTY
    JOINT ARTHROPLASTY OR REPLACEMENT
    TOTAL JOINT ARTHROPLASTY OR
    REPLACEMENT
    MENISCECTOMY
    AMPUTATION
    BONE GRAFT
    TENDON TRANSFER
    FASCIOTOMY
    JOINT REPLACEMENT
    TOTAL HIP REPLACEMENT
    METHODS FOR AVOIDING HIP
    DISLOCATION AFTER SURGERY
    • KEEP THE KNEES APART AT ALL TIMES
    • PUT A PILLOW BETWEEN THE LEGS WHEN
    SLEEPING.
    • NEVER CROSS THE LEGS WHEN SEATED.
    • AVOID BENDING FORWARD WHEN SEATED IN A
    CHAIR.
    • AVOID BENDING FORWARD TO PICK UP AN
    OBJECT ON THE FLOOR.
    • USE A HIGH-SEATED CHAIR AND A REAISED
    TOILET SEAT.
    • DO NOT FLEX THE HIP TO PUT ON CLOTHING
    SUCH AS PANTS, STOCKINGS, SOCKS, OR SHOES.

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