Fracture immobilization
Fracture immobilization Cast Temporary Allows patient to perform many normal activities of daily living Made of various materials Typically incorporates joints above and below fracture Upper extremity immobilization Sling To support and elevate arm Contraindicated with proximal humerus fracture Ensures axillary area is well padded No undue pressure on posterior neck Encourage movement of fingers […]
Fracture reduction
Fracture reduction Closed reduction Nonsurgical, manual realignment of bone fragments Traction and countertraction applied Under local or general anesthesia Immobilization afterwards Open reduction Surgical incision Internal fixation Risk for infection Early ROM of joint to prevent adhesions Facilitates early ambulation Traction Purpose Prevent or decrease pain and muscle spasm Immobilize joint or part of body […]
Factors influencing healing
Factors influencing healing Factors influencing healing Displacement and site of fracture Blood supply to area Immobilization Internal fixation devices Infection or poor nutrition Age Smoking Complication of fracture healing Delayed union Fracture healing progresses more slowly than expected. Healing eventually occurs. Nonunion Fracture fails to heal despite treatment. No x-ray evidence of callus formation Malunion […]
Preparation and handling of chemotherapy agents
Preparation and handling of chemotherapy agents May pose an occupational hazard Drugs may be absorbed through Skin Inhalation during preparation, transportation, and administration Only properly trained personnel should handle cancer drugs Chemotherapy methods of administration Oral More available options today Storage and side effects IM – Intramuscular IV – Intravenous (most common) Central venous access […]
Respiratory System : Cardiovascular System : Biochemical : Psychoemotional : Cancer
Respiratory System Pneumonitis Radiation pneumonitis develops 2-3 months after start of treatment. After 6-12 months, fibrosis occurs and is evident on x-ray. Side effect of some chemotherapy drugs. Monitor for dry, hacking cough; fever; and exertional dyspnea. Cardiovascular System Pericarditis and Myocarditis Inflammation secondary to radiation injury. Complication when chest wall is irradiated. May occur […]
Nervous System : Cancer
Nervous System Intracranial Pressure May result from radiation edema in central nervous system. Monitor neurologic status. May be controlled with corticosteroids. Peripheral Neuropathy Paresthesias, arelexia, skeletal muscle weakness, and smooth muscle dysfunction can occur as a side effect of plant alkaloids, taxanes, and cisplatin Monitor for these manifestations in patients on these drugs. Consider temporary […]
Genitourinary Tract : Cancer
Genitourinary Tract Hemorrhagic Cystitis Cells lining bladder are destroyed by chemotherapy (e.g., cyclophosphamide, ifosfamide). Side effect of radiation when located in treatment field. Encourage increased fluid intake 24-72 hr after treatment as tolerated. Monitor manifestations such as urgency, frequency, and hematuria. Administer cytoprotectant agent (mesna [Mesnex]) and hydration. Administer supportive care agents to manage symptoms […]
Integumentary System : Cancer
Integumentary System Alopecia Destruction of hair follicles by chemotherapy or radiation to scalp. Hair loss usually is temporary with chemotherapy, but usually permanent in response to radiation. Suggest ways to cope with hair loss (e.g., hair pieces, scarves, wigs). Cut long hair before therapy. Avoid excessive shampooing, brushing, and combing of hair. Avoid use of […]
Hematologic System : Cancer
Hematologic System Anemia Bone marrow depressed secondary to therapy. Malignant infiltration of bone marrow by cancer. Monitor hemoglobin and hematocrit levels. Administer iron supplements and erythropoietin. Encourage intake of foods that promote RBC production Leukopenia Depression of bone marrow secondary to chemotherapy or radiation therapy. Infection most frequent cause of morbidity and death in cancer […]
Gastrointestinal System : Cancer
Etiology Effects Nursing managements Gastrointestinal System Stomatitis, Mucositis, Esophagitis Epithelial cells are destroyed by chemotherapy or radiation treatment when located in field (e.g., head and neck, stomach, esophagus). Inflammation and ulceration occur due to rapid cell destruction. Assess oral mucosa daily and teach patient to do this. Encourage nutritional supplements (e.g., Ensure, Carnation Instant Breakfast) […]