Complications of fractures Prevent complications of immobility Constipation Renal calculi Cardiopulmonary deconditioning DVT/pulmonary emboli Infection High incidence in open fractures and soft tissue injuries Devitalized

Nursing Management: Fractures Neurovascular assessment Peripheral vascular Color and temperature Capillary refill Pulses Edema Motor function Sensory function Paresthesia Nursing diagnoses Impaired physical mobility related

Role of Nursing Personnel Registered Nurse (RN) Perform neurovascular assessment on the affected extremity. Assess for manifestations of compartment syndrome. Monitor cast during drying for

Electric bone growth stimulation Used to facilitate healing process Increase calcium uptake Activate intracellular calcium stores Increase bone growth factor production Non-invasive, semi-invasive, and invasive

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

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

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

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

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

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,

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

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