1) Explain Kyphosis (hunchback) and explain the type of kyphosis.
2) Explain the Etiology, Clinical manifestation and diagnostic evaluation of Kyphosis.
3) Explain the management of Kyphosis. Write the management of kyphosis.
1) Explain the Kyphosis (hunchback). Describe kyphosis.
Kyphosis is an abnormality of the spine in which there is an outward curvature of the spinal cord.
Spinal coda is rounding or hunchback.
In kyphosis, the convexity of the spine increases outwards.
explain the type of kyphosis.
1) Angular
knuckle
gibbus
2) Round
other type:=
1) Postural kyphosis (postural kyphosis)
2) Scheuermann’s kyphosis
3) Congenial Kyphosis (Congenital Kyphosis)
1) Angular
In kyposis, the vertebrae of the spinal cord form a curved curvature.
and forms an angle.
knuckle
In this, only one vertebra in the spinal cord is curved.
2) gibbus
This involves the involvement of more than two vertebrae in the curvature of the spinal cord.
2) Round
This involves the involvement of more than three vertebrae in the curvature of the spinal cord.
Many vertebra are joined together and form a round shape curvature.
Other type of kyphosis:=
1) Postural kyphosis (postural kyphosis)
Postural kyphosis is the most common type of kyphosis.
Postural kyphosis is mainly due to abnormal posture.
2)scheuermann’s kyphosis (kyphosis from Scheuer):=
Kyposis is primarily named after a Danish radiologist.
Scheuersmann kyphosis mainly affects the thoracic spine.
This is mainly seen in the (lower) lumber back area.
3) congenital kyphosis (congenital kyphosis)
In some infants, the spinal cord does not develop properly during intrauterine life.
2) Explain the Etiology.
Due to degenerative diseases of the spine.
Due to injury.
Due to trauma.
scoliosis.
Due to one vertebra being forward over the other.
Marfan syndrome.
Due to infection.
Muscular dystrophy.
Neurofibromatosis.
Paget Diss.
Polio.
poor posture.
Age.
osteoporosis (weakening of bone).
Due to injury to the spinal cord.
Due to congenital abnormality.
Ankylosis spondylosis.
spina bifida.
tumor and endocrine disease.
explain the clinical manifestation/sign and symptoms.
poor posture.
“Hunchback”.
Round back appearance.
Mild back pain.
Difficulty breathing.
Burning sensation in upper back and neck area.
Muscle fatigue.
Pulmonary and heart failure.
Stiffness in the spine.
Loss of bowel and bladder control.
Explain the diagnostic evaluation. (Write the diagnostic evaluation.)
history taking and physical examination.
Neurological examination.
X Ray.
ct scan.
MRI.
Pulmonary function test.
explain the management
explain the medical management.
Providing bone-strengthening drugs to strengthen the bones of the spinal cord and prevent fractures.
Asking a child with Scheuermann’s disease to wear body braces to prevent progression of kyphosis to prevent bone growth.
Perform stretching exercises that increase the flexibility of the spinal cord.
Exercise strengthens muscles and improves body posture.
Exercise strengthens the abdominal muscles and helps improve body posture, so the patient should be asked to exercise.
If the kyphosis is more severe, surgery is needed to reduce the spinal curvature.
In the surgery “spinal fusion” is done.
Providing analgesic medicine to the patient.
Explain the nursing management of Kyphosis.
Elevate the affected leg.
Ask the patient to take adequate rest.
Ask the patient to engage in maximal activity.
Ask the patient to adopt relaxation techniques.
Reducing muscle tension.
Inspect the skin daily for any redness, warmth, pressure sore or not.
Assess the patient’s circulation.
Ask the patient to exercise regularly.
Ask the patient to do range of motion exercises.
Ask the patient to do daily routine exercises in small amounts.
To provide all the information about the treatment and disease to the patient in a proper manner.
To clear all the doubts of the patient and his family members.
To provide counseling to the patient to provide coping ability.
1) Explain the Lordosis. Define lordosis.
2) Explain Etiology, Clinical manifestation, and diagnostic evaluation of Lordosis.
3) Explain the management of Lordosis.
1) Explain the Lordosis.
In lordosis, the curvature of the lumber spine increases inward curvature.
So in lordosis “sway back” (swayback: = swayback means the pelvis tilts forward and the abdomen protrudes) is seen.
Explain the type of Lordosis.
1) Cervical Lordosis.
Lordosis is seen in the cervical region.
2)Lumber Lordosis
This lordosis is seen in the lumbar region.
3) Hyper Lordosis
It has an inward curvature in the lumber region.
4)hypolordosis
In this, inward curvature occurs in the lumber region to a lesser extent.
explain the Etiology:=Describe the reason
Because of obesity.
Kyphosis.
Rickets.
Pregnancy.
Because of too much fat.
Due to inflammation (dicities) in the intervertebral disc.
at birth due to developmental abnormalities.
spondylolithiasis (in this the vertebrae in the lumber region are forward forward)
osteoporosis (bones become fragile in this).
Achondroplacia (In this the bones do not grow normally and instead remain short.)
Due to abnormal posture.
Muscular imbalance.
Explain the clinical manifestation/sign and symptoms of Lordosis.
Symptoms in lordosis depend on its severity.
Back pain.
Muscle pain.
“sway back” appearance.
Discomfort in the lower back.
Movement problems.
Numbness, tingling sensation.
Loss of bowel bladder control.
Difficulty standing up.
Compression of the spinal canal.
Weakness in legs.
explain Diagnostic evaluation (Write the diagnostic evaluation.)
history taking and physical examination.
X Ray.
ct scan.
MRI.
neurological examination.
Explain the management of Lordosis.
Treatment of lordosis depends on its severity.
if mild cases
Asking the patient to do yoga increases body strength, flexibility and range of motion.
Ask the patient to undergo physical therapy.
Ask the patient to exercise adequately.
use braces in children and teenagers.
Provide analgesic medicine to the patient and take measures to reduce swallowing.
explain surgery:=
1) Spinal fusion
In this, more than two vertebrae of the spinal cord are jointed with each other and moments are prevented.
2) Discectomy
This involves removing damaged discs in the spinal cord.
3) laminectomy
In this, the lamina in the vertebra is removed.
Explain the prevention of Lordosis.
Weight should be limited to prevent lordosis.
Good posture should be maintained.
Asking human being to do regular exercise.
Asking the human being to continue doing regular physical activity.
EXPLAIN “ROM” AND GIVE FULL FORM OF “ROM ” (“ROM:=RANGE OF MOTION (Range of Motion) “
EXERCISE.)
Range of motion exercises help patients who are unable to move.
Exercise helps joint mobility to maintain muscle strength.
Exercise is performed one to two times throughout the day.
Exercises can be performed independently or with any assistant.
EXPLAIN THE TYPE OF “ROM (RANGE OF MOTION)”
1) “ACTIVE RANGE OF MOTION EXERCISE” (Active Range of Motion Exercise)
2) “PASSIVE RANGE OF MOTION EXERCISES”
1) “ACTIVE RANGE OF MOTION EXERCISE” (Active Range of Motion Exercise)
Active range of motion exercises are exercises that the patient performs on their own.
In these exercises, any nurse or physical therapist supervises the patient performing the exercise to see if the patient is performing the exercise properly.
Doing these active range of motion exercises increases muscle strength and helps maintain muscle strength.
By doing this exercise, joint problems and contractures can be prevented from developing.
2) “PASSIVE RANGE OF MOTION EXERCISES” (Passive Range of Motion Exercises)
Range of motion exercises help the patient perform what the nurse or physical therapist does for the patient.
This type of exercise is performed by a nurse or physical therapist for patients who are completely immobilized and cannot perform range of motion exercises.
Because in range of motion exercises, muscles do not contract, muscles strength does not increase and it does not maintain.
And this can only be done on a patient by any nurse or physical therapist.
Explain indications of exercise.
Important to reduce the risk of injury to the musculotendenous unit.
To reduce prolonged immobilization.
Joints and soft tissues are required for normal range of motion.
To prevent muscle contraction.
To maximize the flexibility of joint tissues.
Explain the contraindication of exercise.
It should not be done in someone who is already hypermobile.
Individuals who have any major disease condition.
In persons in whom the joint is inflamed.
When a bone block prevents joint movement in a condition.
explain the goal of exercise. (Describe the goal of the exercise.)
GOAL FOR PASSIVE RANGE OF MOTION EXERCISE:=
To maintain mobility of joint and connective tissues.
To minimize the formation of contractures.
To maintain mechanical elasticity of muscles.
To improve circulation.
To improve synovial movement.
To inhibit pain.
To improve healing after any injury or surgery.
To bring awareness to the moment in the patient.
GOAL FOR ACTIVE RANGE OF MOTION EXERCISE.
To maintain physiological elasticity and contractility of muscles.
To provide feedback from contracting muscles.
To provide stimuli to the integrity of bone and joint tissue.
To increase circulation and prevent thrombus formation.
To develop coordination and motor skills for functional activities.
explain the guidelines and precaution.
Muscles need to be warmed up prior to vigorous stretching.
Care should be taken while stretching the muscles around the painful joint.
Caution should be exercised while stretching in patients with or suspected osteoporosis and those on prolonged bed rest.
Straching should be done at least three times and maximum five to six times in a week.
Care should be taken while stretching in elderly people as collagen has lost its elasticity and capillary blood supply is also less.
To increase flexibility, muscles must be stressed and stretched through their elastic range of motion.
The ligament and capsule around the joint should not be overstretched.
Ballistic stretching should only be done by a patient who is already flexible.
Patients with frail integumentary vada should exercise caution while stretching.
The necessary equipment should be kept ready.
Explain the principle and procedures for applying ROM techniques.
examination, evaluation and treatment planning.
Examine and evaluate the patient’s impairment and level of function.
Assess whether the patient has any precaution and prognosis.
ASSESSING THE PATIENT’S ABILITY FOR:=ROM (RANGEOF MOTION EXCERCISE).
Assess what type of exercise the patient is able to perform. ACTIVE RANGE OF MOTION EXERCISE (AROM) OR PASSIVE RANGE OF MOTION (PROM) EXERCISE.
Assess the patient’s range of motion.
Assess the patient’s general condition.
To assess the patient’s vital signs.
Assess the patient for any warmth and abnormal color or not.
Documenting.
Do re-evaluation.
patient preparation.
Communicating with the patient.
Explain the complete procedure to the patient.
Do not ask the patient to wear tight clothing.
Provide a comfortable position to the patient.
Health care personnel also take proper position.
Explain the active range of motion exercises. (Describe active range of motion exercises.)
Active range of motion exercises help to improve joint function.
By doing range of motion exercises, the joint is properly movable and muscle strength increases.
Movement makes the joint flexible, pain level is reduced, balance and strength are also improved.
1) Explain the neck exercise.
Sit or stand before doing the neck exercise.
Forward the face and keep both shoulders straight and relaxed.
Head tilts forward and backward :=
Bringing the head forward and trying to touch the chest by chin.
Then take the head backwards and keep it backward as long as it is comfortable.
Then bring the head back to the normal starting position.
HEAD TILT SIDE TO SIDE:=
Move the head side to side and try to bring the ears up to the solder and do this procedure on both sides.
Then bring the head back to the normal position.
HEAD TURN:=
Try to bring the head towards the solder without turning it.
Then touch the solder by the chin but do not raise the solder to touch the chin.
Do this procedure on both sides.
Then come back to normal position.
2) Explain shoulder and elbow exercise
standing or sitting
Keep both arms straight down by your side.
Palms should be facing towards your body.
shoulder movement up and down:=
Lift both hands forward and then overhead.
Try to raise it so that the inner arm can touch the ear.
Then bring both hands back down. And keeping the arms behind the body as far as possible.
Then bring the arm back to its normal position.
explain the shoulder movement side to side :=
Raise both arms of the person and then keep both arms above the head as long as possible.
Then bring the arms back to the side then bring the arms to the front of the body and bring the arms to opposite shoulders then bring the arms back to their normal position.
shoulder rotation:=
Raise both your shoulders towards your ears.
As if trying to shrug.
Then lower it back to the starting position.
Then relax the shoulders by pulling your shoulders back and then letting them relax back.
Then rotate the shoulder in a simple circle and then rotate the shoulder back in the opposite direction.
Elbow bent:=
Bend the elbow then try not to touch the solder with the finger tip and bring the arm back to the normal position.
3) Arm and wrist exercise:=
Sit quietly, then bend the elbows and place both hands to rest on a flat surface such as a table or lap and ensure that both wrists hang loosely.
wrist bends:=
Bend both your arms back towards your elbows so that your fingers point to the ceiling.
Then bend your arms downwards so that your fingers point to the floor.
wrist rotation:=
Move your hand from one side to the other.
Then rotate your arm in a circle in one direction followed by an arm circle in the other direction.
palm up, palm down
Stay in the same position.
But tuck the bent elbow in front of your side.
Then lower the palm and turn the palm so that it faces the ceiling, then turn the palm so that its face is downwards.
4) Hand and finger exercise:=
Hold your hand in front of you after sitting or standing.
Finger bends:=
Make a very tight fist then open it and relax the hand.
Finger spread :=
After opening the hand, stretch the fingers as far as possible.
To bring the finger back to its normal position.
Finger to thumb:=
To touch the fingers one by one with the thumb.
Thumb to palm:=
Touching the palm with Thumb.
5) Hip and knee exercise:=
If any person has hip injury or surgery then hip exercise is done.
Hip and knee bends:=
Point your toe.
Then bend the knee towards the chest.
Then straighten the legs back and place them back in a flat position on the bed.
leg lifts:=
Raise the legs then let them stay in the air and bring them back to the normal position on the bed.
leg movement side to side:=
After flexing your leg, keep the toe in such a way that its point is pointed at the ceiling.
Then move your leg side to side and bring the leg back to its normal position.
leg rotation in and out:=
Place your foot on the bed then roll the foot inwards so that the big toe touches the bed then roll the foot outwards so that the little toe touches the bed.
knee rotation in and out:=
Lie down on the bed.
Then bend the band to the foot.
Bend the band in such a way that the soles of the feet touch the bed.
Then perform knee rotation to bring the foot back to its normal position.
6) Ankle and foot exercise:=
Sit comfortably on it.
Ankle bends:=
Keep your toes on the floor and lift your heels.
Then bring the heel back to the normal position and keep it on the floor and raise the toes.
Ankle rotation:=
Lift your feet slightly off the floor then roll the ankle in a circular motion and then roll it in the opposite direction.
toe bends:=
Rest your toes towards the ground then straighten them towards the ceiling and bring the foot back to its normal position.
toe spread:=
Spread your toes and then bring them back together.
explain passive range of motion exercises:=(Explain passive range of motion exercises.)
By doing passive range of motion exercises, one’s joints become flexible.
Exercising makes a person’s joint fully move.
1)Neck exercise:=
Provide support to the patient’s head with your hands then return the patient’s head to a normal position after each exercise.
Head turn:=
To do it in the side of the patient’s head, then turn it to the other side and bring the head back to the normal position.
Head tilt :=
Head tilt involves turning the patient’s head towards the shoulder so that the head touches the shoulder and then turning the head back towards the other shoulder.
and return the head to the normal position.
chin to chest:=
Turning the person’s head towards China.
2)Shoulder and elbow exercise:=
Support the patient’s shoulder with one hand and then provide support to the patient’s wrist with the other hand.
shoulder movement, up and down:=
Raise the person’s arms forward and above the head and bring the arms back to the normal position at the side.
shoulder movement, side to side:=
Raise the person’s arm as far as possible and bring it back to its normal position.
elbow bends :=
Keeping the person’s arms in such a way that their palms are facing upwards, then bending and straightening the person’s arms.
3)Forearm and wrist exercise:=
Provide support to the person’s wrist and also hold his fingers.
Wrist bends:=
Bend the person’s arms so that their fingers are towards the ceiling, then bend their hands down so that their fingers are towards the floor.
wrist rotation:=
Gently grasp the person’s hand then rotate the wrist in a circular motion and rotate it back in the opposite direction.
Palm up and down:=
Holding the person’s hand properly then keeping the palm facing the ceiling and then downwards so that the palm touches the floor.
4) Hand and finger exercise:=
Holding the person’s hand with both of your hands.
finger bend :=
Bend and straighten one’s fingers, then bend and straighten one finger at a time.
finger spread:=
This involves spreading the thumb and the second finger and bringing them to the normal position, then straightening the first finger and middle finger and bringing them to the normal position, in this way straightening the fingers simultaneously and bringing them to the normal position.
finger to thumb:=
Touching the finger tip with one’s thumb. Touch the thumb in each finger tip in turn and bring it to normal position.
finger rotation:=
This involves rotating the finger in one direction and then rotating it in the other direction.
Then rotate the thumb in one direction and rotate it back in the other direction thus rotating all the fingers simultaneously.
5) hip and knee exercise:= hip and knee bends:=
Bend the knee and bring it towards the chest then bring it back to the nanonormal position.
Leg movement:=
This involves bringing the lag from one leg to the other leg in the side direction and then bringing the lag back to the middle position.
leg rotation:=
Bringing one’s lag to another lag and then taking it out.
6) Ankle and foot exercise:=
Ankle bends:=
This involves bending one’s legs and bending one’s feet in such a way that one’s toes are pointing towards the ceiling, then bending them back in the other direction in such a way that one’s toes are pointed.
Ankle rotation:=
Ankle rotation involves rotating a person’s ankle in one direction and then rotating it in the other direction.
EXPLAIN THE TRACTION
Traction is a type of force that is applied in a specific direction.
Traction is a type of force which is provided for reduction of fracture (positioning bone fragments in correct alignment) and forcefully pulling of body part, and to reduce moment and relieve pain.
Traction immobilizes the fractured part and helps to reduce the deformity.
In it the weight is applied on the effected lemon through which the weight is applied through ropes, pulleys.
Counter traction is a type of traction that applies force in the opposite direction and brings the fractured body part back to its normal position.
Explain the purpose of traction:=(Write the purpose of traction.)
To immobilize the fracture.
To minimize the deformity.
To keep the length and alignment of the injured extremity normal.
To reduce or eliminate muscle spasm.
To prevent deformity.
To reduce muscle contracture.
To reduce pain.
Explain the principle of traction.
When traction is applied, counter traction works as an effective traction to return to normal position.
The traction applied should not rest on the bed or floor but allow it to hang freely.
Traction is primarily responsible for immobilization of fractures in the body.
ropes should not be obstructed.
Do not remove weight if continuous traction traction is to be applied.
Keeping the body alignment of the patient is good.
Keep the patient in the center of the bed while applying traction.
Explain the type of traction. (Describe the type of trackson.)
1) Balanced suspension traction (Balanced suspension traction).
In this traction, the affected body part is pulled in the opposite direction and supported by a splint.
and weight is applied to prevent moment immobilization.
2)Running traction: =
In this traction, direct force is applied and the body part is placed on the bed, then direct pulling force is provided without applying the splint so that the body part can remain in balance.
Ex:=Buck extension, pelvic traction.
3)continues traction:=
Continuous traction is continuously applied.
Used to prevent some types of fracture and dislocation.
It is mainly applied for the management of fractures.
4)Intermittent traction:=
Intermittent traction is applied intermittently and this traction is mainly applied in individuals who experience muscle spasms.
5) manual traction:=
Manual traction is mainly applied manually.
And this is mainly by hand and for temporary time.
6) Explain the skin traction.
Skin traction is applied directly on the skin.
Skin traction mainly involves the application of tape, sponge, rubber, or special devices such as boots, cervical halters, and pelvic belts that come in contact with the skin.
And this force is directly transmitted to the muscular skeletal structure.
Skin traction is primarily a temporary measure for individuals with muscle spasm or pain.
It is mainly used before surgery in hip fractures and femoral fractures.
And this is mainly used to treat the factor in children.
nursing consideration
To ensure that traction is effective or not.
See if the bandage applied over the traction is slipped or not.
Maintaining proper position of the patient The patient should be in the middle of the bed so that traction is more effective.
The leg should be neutral to maintain proper position.
No creases or bandages should slip to maintain counter traction.
Avoid moving the patient which may cause the traction not to move.
Limit the mobility of the patient to whom traction is applied.
To provide proper psychological support to the patient.
Keep checking the color, temperature, pulse or screen integrity of the body part on which the traction is applied and the condition as in ED or not.
And keep checking whether the patient has any other problem including pressure sore, constipation, urinary tract infection, loss of appetite, lung congestion and screen break down.
Closely monitor skin break down or not.
Provide back care to the patient every two hours and use air and water meters to prevent pressure ulcers.
7) Skeletal traction:=
Mainly used for fractures of femur bone, tibia, and cervical spine.
In this traction is applied by orthopedic surgeon maintaining aseptic technique and wire pin and tongue placed in the bone.
Nursing consideration:=
Adequate amount of weight should be provided while providing skeletal traction.
While applying traction, the patient should have good body alignment and the patient should have a proper position so that the foot does not drop.
Keep checking for any redness, swelling, warmth, drainage on the side where traction is applied.
Continuously monitor the neurovascular status of patients with impaired blood flow.
Keep checking whether the equipment is functioning properly.
Keep checking the skin integrity at the pressure point.
Properly maintain traction.
The traction applied should not touch anything below it should be allowed to hang freely.
Traction apparatus:=
Weight, ropes,
Pulleys, spreader bars, footplate,
Trapeze, hammocks, slings, and halter.
complication
infection of skin.
skin break down.
stasis pneumonia.
thrombophlebitis.
pressure ulcer.
Urinary infection.
Constipation.
Explain the nursing management of patients with traction.
1) Minimizing the effect of immobility.
Asking the patient to do regular exercise due to which the strength and function of the joint is maintained.
Ask the patient to do a deep breathing exercise.
Auscultate lungs sound twice a day.
Ask the patient for fluid intake.
Ask the patient to take a high fiber diet.
Provide stool softener and enema to the patient.
To check whether the patient has thrombophlebitis or not.
2) Avoiding infection at pin site.
Assess for any pressure sores on the bony prominence side.
Assess for any skin irritation.
Release the pressure a little.
Checking for burning sensation at the site where traction is applied.
Linen and clothin are wrinkle free or not.
To check patient’s vital sign continuously.
The type of site on which traction is applied
Immobilization.
Checking for any other signs of infection.
3) promoting tissue perfusion.
Assess the patient’s motor sensory function.
Checking the patient’s sensation level.
Assess the patient’s neurovascular status.
Use a protective device to prevent pressure ulcers.
The nurse should listen to the patient’s lung sound.
General care of patient with traction.
Assess the patient’s neurovascular status.
To check if the patient has pain sensation, and active and passive range of motion exercise, akin color, joint motion temperature, capillary refill time, numbness, and coldness.
Checking the patient’s skin area.
Adequate application to the patient.
Ask the patient to do regular exercise, regular deep breathing, and wearing elastic stocking.
Repeatedly assess the area where traction is applied to see if there are any abnor lines.
Keep the patient in a neutral position.
Providing the patient with work and a comfortable position.
explain orthopedic splint
A splint is a device used to support and immobilize the extremity and spinal cord.
Splints are used in many situations including temporary immobilization for broken, damaged joints, and support for joints during activities.
Splint is used to provide support to the injured body part.
Ex:= broken bone, muscle sprain,
A splint is used to provide support after surgery.
Splint is heavily padded due to which pressure can be prevented and skin break down can be prevented.
Splint is mainly used in conditions where rigid immobilization is not required.
explain the purpose of splint.
To prevent injured extremity movement.
To prevent further injury.
To reduce oedema.
To reduce pain.
To maintain joint alignment.
To prevent contractures.
To support the joint, to protect it, and to
There is a splint for immobilization.
To stabilize the joint if there is any ligament injury.
To maintain the range of motion of the joint.
To correct the deformity.
To maintain tissue elongation.
To stabilize and rest the joint if any ligamentous injury has occurred.
To promote wound healing.
To relieve pressure points.
To protect the graft if it is placed.
To correct the deformity.
Vic to strnthen the muscles.
Post-operative joint support and
To immobilize until healing is done properly.
Explain the indication for splinting.
Fracture, acute arteritis, sprain,
severe lacerations and abrasions,
joint infection,
skin lesions,
tenosynovitis (inflammation of tendon),
puncture wound,
laceration over joint puncture wound,
reduced joint dislocation.
animal bites of hands or feet.
Explain the contraindication of splint. (Write the contraindication of splint.)
compartment syndrome (compartment syndrome := an increase pressure in side the muscles which restrict blood flow and cause pain).
Skin that is at high risk of infection.
need for open reduction.
Open Factor.
Chronic neuropathy (nerve damage).
active infection.
explain the type of splint
Splints come in many shapes and sizes.
Ex:= buddy taping (for finger injury),
Some types of splints are large ones that are used to provide support to the hip and thigh.
Some splints are made of plastic and fabric.
The splint is fitted with a hook or a buckle.
type of splint
1) Soft splint.
2) hard splint (hard splint).
3) air/vacuum splint (air or vacuum splint).
4) Traction splint (Traction splint).
1) Soft splint.
This tractor is primarily provided at home or by an emergency medical provider.
This is a type of simple splint that is provided using a pillow or a blanket.
This splint is secured around the injured area and tied with tape.
A soft splint is mainly provided for support and comfort of the injured extremity.
2) hard splint (hard splint).
A hard splint is mainly used in injured extremities.
Hard splint is provided using cardboard and padded board.
Some types of hard splints are made of fingerglass or plaster to support the patient’s extremities.
The splint used in thumb injury is called thumb spica.
Volar splint is used in wrist and forearm injuries.
Boxer splint is used in hand and fist injury.
Originally aluminum splints were mainly used to stabilize the finger.
3) air/vacuum splint (air or vacuum splint).
Air splints are primarily used to provide support to orthopedic injuries.
Air or vacuum splints are mainly provided for the comfort of injured extremities.
4) Traction splint (Traction splint).
Traction splints are mainly used in broken bones and to reduce the amount of deformity, align the bones, provide traction and prevent the bones from moving.
Track splint is mainly used to align when there is an injury in the femur bone or if there is any injury in the mid shaft of the lower leg.
Explain the nursing care of patient with the splint.
Checking the skin where the splint is applied for any cracks, damage, or swelling or soreness.
Keep the area where the splint is applied properly dry.
Keep a proper pad on the place where the splint is placed so that cracks in the skin and skin break down can be prevented.
Properly wrap plastic over the splint when the splint is applied and bathing. So that the splint can be prevented from getting wet.
Apply a soft pad to the area where the splint is applied and if there are bony prominences.
Checking that blood vessels or nerves are not compressed at the place where the splint is applied.
Keeping the splint properly clean.
Providing support to the injured area.
Elevate the affected limb and prevent swelling.
loosen the elastic bandage.
Due to not applying powder or deodorant inside the skin, itching can increase in the skin.
Don’t try to crack the hard splint inside the skin with a sharp object because the skin can get cut.
Application of pad inside the skin so that the skin can be protected.
Do range of motion exercises.
and providing support to patients.
Explain pop application and removal
1) Explain the plaster cast.
A cast is a rigid device that is applied to immobilize injured bone and soft tissue and promote healing.
A cast is mainly applied above and below the fractured bone for bone immobilization.
A cast is primarily a supporting bandage that is solid that is wrapped around the extremity.
explain the purpose of cast
To support and protect bone and soft tissue.
To reduce pain.
To reduce swelling and muscle spasm.
To immobilize the broken bone.
explain the casting material
1) Plaster cast
Plaster of Paris strips are rolls of precut crinoline that come in a variety of sizes.
And plaster is also attached to it.
Rolls of bandage are dipped in cold water and applied easily on the body.
It then undergoes a crystallization reaction and generates heat.
It is then exposed to air to dry.
Then it cools down after about 15 to 20 minutes.
A plaster cast takes 24 to 72 hours to dry completely.
Plaster casts are heavy and dry slowly.
2) Fiberglass cast:=
This water is made of activated polyurethane which has the versatility of plaster.
It is light in weight, quick drying, strong water resistant and durable.
Skin problems can also be prevented due to the fact that there are holes in it.
If this gets wet it must be dried to prevent skin breakdown.
Fiberglass and plastic cast are mainly expensive and they also macerate the skin.
Cotton and other synthetic materials are used to make the inside of the cast so that the inside is soft and works as padding that provides softness around bony areas such as the wrist or elbow.
Some type of special waterproof cast is used due to which the plaster cast can be prevented from getting wet and the screen problem can also be prevented.
1) Short arm cast:=
Short arm cast is mainly applied from elbow to thumb only and it is mainly used only when radius, humerus, carpal, metacarpal are affected.
2) Long arm cast:=
A long arm cast is primarily used from the axillary area to the palmar crease of the hand and is primarily used to treat upper extremity fractures.
3) Short leg cast:=
A short leg cast is applied from below the knee to the base of the toe.
Short leg cast is mainly used to treat fractures of tibia, fibula, ankle.
4) Long leg cast:=
A long leg cast is mainly applied from the base of the thigh to the base of the toe.
And this cast is mainly used to treat fractures of femur, tibia and fibula.
5) walking cast:=
Short and long leg casts are mainly used as weight bearing.
6) body cast:=
This cast is applied around the trunk.
7) Shoulder spica cast:=
This cast is mainly used to enclose the trunk, solder and elbow and it is mainly used to treat solder fractures.
8) hip spica cast:=
This cast is mainly applied from the middle of the trunk to the feet and is used to treat mainly hip fractures.
Explain preparation of patients for plaster cast:=
Explaining the procedure to the patient.
Assessing the patient’s general health.
To check patient’s vital signs.
Proper shaving of the area where the plaster cast is to be applied.
Paying special attention to the skin and bony area.
Plaster bandage mainly depends on the size and number of bone fracture.
Consult properly before applying plaster cast.
Explaining the procedure completely.
Clean the affected area properly with shop solution.
Sugaring gentally.
To remove tight clothes and ornaments.
Ask the patient to sit comfortably.
Apply the pad properly on the pressure point.
Explain the nursing management of patients. Explain the assessment of patients
Checking the extremity at the site where the cast is applied.
To check whether there is circulation in the area where the cast is applied.
To check whether the area on which the cast is applied is warmth or not.
To check whether there is sensation on the area where the cast is applied.
Assess motor ability of affected limb.
Checking that the site on which the cast is applied is too tight.
Assess skin integrity.
Explain the nursing interventions
Elevate the affected extremity to stimulate circulation.
Changing the patient’s position frequently while the cast is applied.
Providing support to the foot to prevent foot drop when a splint is applied.
If the patient has pain over the area of bony prominences, check the area which is the pressure bony part.
Assess the patient’s neuromuscular function.
To check the circulation of the patient’s body and the movement of his extremity.
Ask the patient to moment the body parts.
Checking the patient for any complications like compartment syndrome, pressure ulcer or tissue damage.
Ask the patient to eat a well-balanced diet including a high-fiber diet that prevents constipation.
Ask the patient to take adequate amount of fluid.
The patient should avoid gas-forming food while the cast is applied.
Nursing care
1) keep the cast dry:=
Keep the cast fully dry and when washing the body part protect it with plastic so that the cast is not exposed to water.
2) Watch the cast carefully:=
Check the area where the cast is applied for any redness, skin break down and bluish discolouration.
3) elevate the cast:=
Elevate the affected extremities to prevent swellings.
4)exercise the extremity:=
Exercising the affected extremity properly.
5) Apply an ice bag to the cast:=
Applying an ice pack to the area where swelling is present can reduce the swelling.
6) Instruct the doctors if the following conditions occur:=
A body temperature above 101°f degrees Fahrenheit is when interest occurs.
When the pain level is increasing.
Swelling is increasing.
When there is numbness or tingling sensation.
When smelling any fouls from the cast.
When the toes are cooling.
Explain the nursing care after removal of plaster.
Plaster is mainly cut using electric plaster cutters and manual plaster cutters.
After removal of the plaster, wash it thoroughly, then dry it properly and do not wipe forcibly on the affected extremity due to which there are chances of skin peeling.
What type of plaster should be worn so that oedema can be prevented.
After removing the plaster, ask the area not to be rubbed or sketched.
Tell the patient to elevate the affected area to prevent swelling after the cast is removed.
Ask for proper ambulation after removal of cast.
If the patient is asked to wear a creep bandage and elastic stocking by the physician, wear them properly.
complication of cast
1) compartment syndrome
Compartment syndrome is a syndrome in which blood supply is impeded and circulation is cut off at the site and swelling occurs over the affected area.
And there is pain on the affected area.
2) pressure ulcer:=
An ulcer develops at the site of the bony prominences due to the application of the cast.
Conditions like skin break down, redness, warmth, swelling are also seen in the area where the cast is applied.
Explain the health education to patient and relative.
Do not place any object over the cast applied.
If the cast is made of plaster of paris, do not let it get wet.
If fiberglass cast is applied, dry it properly if wet.
Ask the patient not to walk on wet and slippery surfaces.
Do the prescribed exercises regularly.
Elevate the area where the cast is applied to prevent swelling.
Not scratching the skin inside the cast can lead to skin breakdown.
Do not insert any object inside the cast application.
If there is pain, swelling, redness on the cast application area, report to the physician immediately.
Inform the physician immediately if the cast has broken down for any reason.
1) Explain the neurogenic bladder. Explain neurogenic bladder.
2) Explain the type, etiology, and clinical manifestation of neurogenic bladder. Write the type of neurogenic bladder, its causes, its signs and symptoms and diagnostic evaluation.
3) Explain the management of neurogenic bladder.
1) Explain the definition of neurogenic bladder. (Write the definition of neurogenic bladder.)
Neurogenic bladder is a type of neurogenic dysfunction.
Neurogenic bladder is a dysfunction of the urinary bladder mainly due to central and peripheral nervous system problems.
Neurogenic blisters are mainly seen due to impairment of normal nerve pathways.
Conditions like urinary retention, incontinence of urine, urinary tract infection, stone formation, renal failure arise due to neurogenic bladder.
2) Explain the type of neurogenic bladder. (Write the type of neurogenic bladder.)
1) flassid neurogenic bladder.
2) spastic neurogenic bladder (spastic neurogenic bladder.)
1) flassid neurogenic bladder.
Flaccid bladder is mainly seen due to motor neuron lesion and any trauma.
Due to the reduced sensation of bladder filling, the bladder does not fully concentrate the force and due to this the bladder becomes full.
And the bladder becomes distended causing urinary incontinence.
2) spastic neurogenic bladder (spastic neurogenic bladder.)
In spastic bladder mainly uncontrolled and frequent expulsion of urine from the bladder.
This is mainly due to brain damage and spinal cord damage.
Due to this, urine emptying is incomplete.
Explain the cause/Etiology
Explain the reason
Neurogenic bladder occurs at any age.
Alzheimer’s disease.
Alcohol neuropathy.
stroke.
Miningomyosheel.
Aids.
Parkinson’s disease.
Brain or spinal cord tumor.
Diabetic neuropathy.
Spina bifida.
Multiple Sclerosis.
nerve damage.
Due to any diabetes or alcoholic disorder.
Injury to the spinal cord.
Due to nine damage.
Deficiency of vitamin B12.
Explain the clinical manifestation/sign and symptoms
Describe the symptoms and signs
Excessive urine production.
Bladder over active.
Urinary incontinence.
Frequent urination.
Urinary retention.
Urinary frequency and urgency.
Problem in expelling entire urine out of the bladder.
Bladder becomes swollen and urine leaks due to this.
Bladder control is lost.
Sensation of bladder fullness is lost.
Pain and burning during urination.
Erectile Dysfunction.
Urinary tract infection.
explain the diagnostic evaluation (Write the diagnostic evaluation.)
history taking and physical examination
complete Neurological examination.
post void residual volume.
renal ultrasonography.
serum creatinine.
Cytography.
cytoscopy.
cytometrography.
urodynamic testing.
explain the treatment
Provide medicine that relaxes the bladder.
Urinary tract infection and control.
Asking for a lot of water intake due to which urinary tract infections are reduced.
Ambulate the patient frequently.
Changing the patient’s position frequently.
Instruct the patient to take low doses of calcium.
Changing the patient’s position frequently.
explain specific treatment
1) physical-psychological therapy.
2) Bladder evacuation.
3) electrical stimulatory therapy.
explain surgery
1) Transurethral resection of the bladder neck.
2) Urethral dilatation.
3) External sphincterotomy.
4) Urinary diversional procedure.
5) implantation of artificial sphincter.
6) Urethral stent.
Explain the nursing management
Monitor residual urine.
Monitor for signs and symptoms of any renal calculi.
Assess for urinary stasis or not.
To see if there is any sign of urinary tract infection and simple or not in urine color, its order, volume, frequency, urgencies.
Checking the patient’s intake output.
Administer vitamin C to the patient to prevent acidic urine and bacterial growth.
Assess patient’s voiding pattern.
Ask the patient to do kiggle exercises.
To provide different methods to empty the patient’s bladder like crede’s method, valsalva’s maneuver etc.
Use aseptic technique and sterile method while catheterizing the patient.
Prescribing drug to the saint to maintain in continence.
Ask the patient to take regular follow up.
Explain the use of orthopedic assist device
1) Explain the crutches.
Crutches are artificial devices that are used by a patient who is not able to walk on their own.
Crutches are mainly used for ambulation and independence of patients who have lower extremity injuries.
explain the indication
disease, injury, birth defect.
Explain the preparation for crutch walking
Inform the client to wear well fitted shoes.
Before using crutches, ask the patient to take the support of the chair and make the patient stand, allowing balance.
can be achieved.
Make the patient stand and support the wall and provide a neutral position.
It is necessary to practice crutches before starting walking.
Explaining the procedure to the patient.
Ask the patient to wear full clothing and ask to wear non-slippery shoes.
crutch walking gait
1) Explain four point gait:=
A four point gate is mainly used when a small amount of wait can be carried over both lower extremities.
1) Forwarding the right crutches first.
2) Then take the left leg forward.
3) Then forward the left crutches.
4) Then take the right leg forward.
5) Repeating like this in cruch-foot cruch-foot sequence.
2) Three point gait:=
A three point gate is mainly used when a small amount of weight cannot be borne.
1) In this the affected leg (Non weight bearing) and both crutches forward.
2) Then the unaffected leg (weight bearing) should be done next.
3) Repeating back to today’s sequence.
3) two point gait:=
A two point gate is mainly used when a small amount of weight is to be borne above both the lower extremities.
1) In this move the right leg and the left crutches forward.
2) Then the front of the left leg and the right side of the cruches.
3) Then repeat the sequence today.
4)swing through gait:=
This is mainly used when the lower extremity is paralyzed.
1) Bring both these extremities forward by about six inches.
2) Then advance both legs six inches.
3) Then repeat in today’s stomach.
explain walker and canes
Walker and cane are mainly mobilization aids that the patient can bear some amount of weight on the affected leg but need some amount of support.
When a walker is used, the muscles of the patient’s upper arm and upper body are used for weight bearing.
Then the following sequence should be used.
1) Hold the hand grip very tightly.
2) Then advance the walker and the affected leg for six inches.
3) Then bring the unaffected leg parallel to the affected leg.
4) Then repeat the sequence today.
Explain the use of cane
Asking the cane to hold on the unaffected site, six inches forward and six inches to the side of the foot and then follow the following sequence.
1) Forward the affected leg and also forward its parallel cane.
2) Then forward the unaffected leg which can’t
Just stay back a little.
3) Then do affect leg next.
4) Then advance the cane up to six inches.
5) To repeat in Aaj sequence.
If a small amount of support is required, both the cane and the factored leg should be combined forward.
The use of this walker and cane is used to provide support to the body part and for walking.