ATI Proctored Med Surg Focused Review notes

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Safety & Infection Control: Care of client with Halo device for spinal injury:  Clients who have cervical fractures may be placed in a halo fixation device or cervical tongs.  The purpose is ... to provide traction and/or immobilize the spinal column.  Screws are placed through a halo-type bar that encircles the head into the outer table of the bone of the skull. This halo is attached to rods that are secured to a vest worn by the client. Ensure that the wrench to release the rods is attached to the vest when using halo traction in the event CPR is necessary.  Maintain body alignment and ensure cervical tong weights hang freely.  Monitor skin integrity by providing pin care and assessing the skin under the halo fixation vest as appropriate.  Do not use the halo device to turn or move a client.  If the client goes home with a halo fixation device on, provide instruction on pin and vest care.  Teach the client signs of infection and skin breakdown. Basic Care & Comfort: Fractures & Immobilization devices: Maintaining proper traction: Types of Immobilization Devices:  Casts  Splints/immobilizers  Traction  External fixation  Internal fixation *Traction uses a pulling force to promote and maintain alignment of the injured area. Goals of traction include:  Prevent soft tissue injury.  Realign of bone fragments.  Decrease muscle spasms and pain.  Correct or prevent further deformities. *Traction prescriptions should include the type of traction, amount of weight, and whether traction can be removed for nursing care. Classification of Traction: Straight or running: The counter traction is provided by the client’s body by applying a pulling force in a straight line. *Movement of the client’s body can alter the traction provided. Balanced suspension: The counter traction is produced by devices such as slings or splints to support the fractured extremity while pulling with ropes and weights. *The client’s body can be moved without altering the traction. Types of Traction:  Manual: A pulling force is applied by the hands of the provider for temporary immobilization, usually with sedation or anesthesia, in conjunction with the application of an immobilizing device.  Skin: Primary purpose is to decrease muscle spasms and immobilize the extremity prior to surgery. The pulling force is applied by weights that are attached by rope to the client’s skin with tape, straps, boots, or cuffs. Examples include Bryant’s traction (used for congenital hip dislocation in children) and Buck’s traction (used preoperatively for hip fractures for immobilization in adult clients).  Buck's traction/skeletal: The pulling force is applied directly to the bone by weights attached by rope directly to a rod/screw placed through the bone to promote bone alignment. Examples include skeletal tongs (Gardner-Wells) and femoral or tibial pins (Steinmann pin). Weights 15 to 30 lb. can be applied as neede [Show More]

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