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Learn about mechanical immobilization to reduce pain, muscle spasms, and support skeletal injuries. Explore different splint and brace types, as well as cast care and traction principles. Delve into nursing implications and gerontologic considerations for orthopedic procedures.
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Chapter 25 Mechanical Immobilization
Purposes of Mechanical Immobilization Mechanical immobilization is usually used to treat musculoskeletal trauma in order to: Reduce pain and muscle spasms; support and align skeletal injuries Restrict movement and maintain functional position while injuries heal; allow activity while restricting movement of injured area
Question Is the following statement true or false? Mechanical immobilization of a body part can relieve muscular pain.
Answer True. Most clients who require mechanical immobilization have suffered trauma to the musculoskeletal system. Mechanical immobilization relieves muscular pain and spasms.
Splints Splint types include: Emergency Commercial Inflatable Traction
Question Is the following statement true or false? A splint is a device that mobilizes and protects an injured body part.
Answer False. A splint is a device that immobilizes and protects an injured body part. Splints are used before or instead of casts or traction.
Other Splints Commercial splints More effective than improvised splints Include: Immobilizers Molded splints, cervical collars
Mechanical Immobilizing Devices • Slings • Braces • Types of braces • Prophylactic • Rehabilitative • Functional
Question Is the following statement true or false? Braces that allow protected motion of an injured joint that has been treated operatively are called rehabilitative braces.
Answer True. Braces that allow protected motion of an injured joint that has been treated operatively belong to the category of rehabilitative braces.
Casts Casts are used to immobilize injured body structures Types of casts Cylinder (may be bivalved) Body (may be bivalved) Spica
Cast Application (Refer to Skill 29-1 in the textbook.)
Casts (cont’d) Cast application and care Cast removal Electric cast cutter may frighten clients due to noise Skin care important after cast removal
Traction Traction is used to: Reduce muscle spasms Realign bones Relieve pain Prevent deformities
Traction (cont’d) Traction types include: Manual Skin Skeletal
Traction (cont’d) Traction care External fixator Pin site care to prevent infection Effective traction depends on consistent application of traction principles
Traction Care (Refer to Nursing Guidelines 25-3 in the textbook.)
External Fixators Metal devices surgically inserted into or through one or more broken bones to stabilize during healing
Question An external fixator is inserted through which body part? a. Nostrils b. Broken bones c. Mouth d. A gaping wound in the leg
Answer b. Broken bones An external fixator is a metal device inserted into and through one or more broken bones to stabilize fragments during healing.
Nursing Implications Nursing diagnoses include: Acute pain; impaired physical mobility or bed mobility Risk for disuse syndrome, peripheral neurovascular dysfunction, impaired skin integrity, ineffective tissue perfusion Self-care deficit: bathing/hygiene
General Gerontologic Considerations Common causes of hip fractures in older adults Longer healing time due to brittle bones Stiffer joints due to decreased synovial joint fluid
General Gerontologic Considerations (cont’d) Due to diminished tactile sensation, older adults may be unaware of skin pressure from cast, brace, etc. Remove indwelling catheters as soon as possible after surgery to prevent incontinence and urinary tract infections Cautious use of narcotics for pain management to avoid adverse effects
General Gerontologic Considerations (cont’d) Implement measures to increase bone density in older adults to prevent fractures: Drink liquid supplements high in nutrients; include protein, calcium, and zinc in diet to promote healing in a musculoskeletal injury Encourage sun exposure for vitamin D absorption
General Gerontologic Considerations (cont’d) Post-orthopedic surgery interventions for older adults Bladder training schedules to maintain or regain continence Appropriate rolling technique when using fracture-style bedpan
General Gerontologic Considerations (cont’d) Nonsurgical treatment of fractures of the upper extremities includes: Immobilization Occupational and physical therapy to regain function and range of motion