ppt chapter 25

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Chapter 25

Mechanical Immobilization


Purposes of 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


QuestionQuestion

•Is the following statement true or false?

Mechanical immobilization of a body part can relieve muscular pain.


AnswerAnswer

True.

Most clients who require mechanical immobilization have suffered trauma to the musculoskeletal system. Mechanical immobilization relieves muscular pain and spasms.


SplintsSplints• Splint types include:

– Emergency

– Commercial

•Inflatable

•Traction


QuestionQuestion


A splint is a device that mobilizes and protects an injured body part.


AnswerAnswer

False.

A splint is a device that immobilizes and protects an injured body part. Splints are used before or instead of casts or traction.


Emergency SplintsEmergency Splints


Inflatable SplintsInflatable Splints


Traction SplintsTraction Splints


Other SplintsOther Splints

• Commercial splints

– More effective than improvised splints

– Include:

o Immobilizers

o Molded splints

o Cervical collars


Mechanical Immobilizing DevicesMechanical Immobilizing Devices

• Slings

• Braces

• Types of braces

– Prophylactic

– Rehabilitative

– Functional


QuestionQuestion


Braces that allow protected motion of an injured joint that has been treated operatively are called rehabilitative braces.


AnswerAnswer

True.

Braces that allow protected motion of an injured joint that has been treated operatively belong to the category of rehabilitative braces.


Rehabilitative Brace Rehabilitative Brace


CastsCasts

• Casts are used to immobilize injured body structures

– Types of casts

o Cylinder (may be bivalved)

o Body (may be bivalved)

o Spica


Cast MaterialsCast Materials


Cast ApplicationCast Application

(Refer to Skill 25-2 in the textbook.)


Casts (cont’d)Casts (cont’d)

• Cast application and care

• Cast removal

– Electric cast cutter may frighten clients due to noise

– Skin care important after cast removal


Basic Cast CareBasic Cast Care


TractionTraction

• Traction: pulling effect exerted on a part of the skeletal system

• Uses

– Reduce muscle spasms; Realign bones

– Relieve pain; Prevent deformities


Traction (cont’d)Traction (cont’d)

• Traction types include:

– Manual

– Skin

– Skeletal


Traction (cont’d)Traction (cont’d)

• Traction care

– External fixator

– Pin site care to prevent infection

• Effective traction depends on consistent application of traction principles


Skin TractionSkin Traction


Traction CareTraction Care

(Refer to Skill 25-4 in the textbook.)


Principles for Maintaining Effective Traction

Principles for Maintaining Effective Traction


External FixatorsExternal Fixators

• Metal devices surgically inserted into or through one or more broken bones to stabilize during healing


QuestionQuestion

•An external fixator is inserted through which body part?

a. Nostrils

b. Broken bones

c. Mouth

d. A gaping wound in the leg


AnswerAnswer

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 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


Risk for Peripheral Neurovascular Dysfunction

Risk for Peripheral Neurovascular Dysfunction


General Gerontologic ConsiderationsGeneral 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




• 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




• Post-orthopedic surgery interventions for older adults

– Bladder training schedules to maintain or regain continence

– Appropriate rolling technique when using fracture-style bedpan




• Nonsurgical treatment of fractures of the upper extremities includes:

– Immobilization

– Occupational and physical therapy to regain function and range of motion

ppt chapter 25

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