This seminar discusses fractures, including their definition, causes, classification, pathophysiology, clinical manifestations, diagnosis, complications, and medical and nursing management. Fractures are breaks in bone continuity and can be caused by direct blows, twisting motions, or muscle contractions. They are classified based on their relationship to the environment (closed vs open), degree of displacement, fracture pattern (transverse, oblique, etc.), and etiology (traumatic vs pathological). Treatment involves reduction, immobilization using devices like casts, splints, or traction, and restoring function through exercises. Nursing care focuses on pain management, preventing complications like infection or neurovascular issues, and promoting mobility and independence.
what is a sprain and what is the strain, define sprain and grading of sprain, strain and grading of strain, symptoms, causes, treatment, RICE protocol, exercise, prevention, healing of sprain and strain
this presentation explain about the fracture, don't miss to take a look on it, it will help you, you will find a useful knowledge through this a brief presentation.
This short presentation is to help those in medical fields to have a summary knowledge of what bursitis is and it can also help students in their assignments and or course works. It contains what bursae are, what bursitis means, causes, risk factors, common sites, clinical features, how to diagnose bursitis, other conditions that can mimic bursitis, how to prevent bursitis and management.
what is a sprain and what is the strain, define sprain and grading of sprain, strain and grading of strain, symptoms, causes, treatment, RICE protocol, exercise, prevention, healing of sprain and strain
this presentation explain about the fracture, don't miss to take a look on it, it will help you, you will find a useful knowledge through this a brief presentation.
This short presentation is to help those in medical fields to have a summary knowledge of what bursitis is and it can also help students in their assignments and or course works. It contains what bursae are, what bursitis means, causes, risk factors, common sites, clinical features, how to diagnose bursitis, other conditions that can mimic bursitis, how to prevent bursitis and management.
fracture is the breakdown in the continutity of the bone alignment this has many types as the fracure this topic include its definition , etiology, pathophysiology, clinical menisfestation, diagnosis and its treatment which can be used by nursing students for taking care of the patient suffering from fracture and for learning for their examination and knowledge purpose
Define
Define related concepts nursing care of patients with musculoskeletal disorders.
Recognize
Recognize different types of musculoskeletal disorders.
Identify
Identify the clinical manifestations of musculoskeletal disorders.
Recognize
Recognize the medical management of musculoskeletal disorders.
Recognize
Recognize the nursing management
patients with musculoskeletal disorders.
A tibial shaft fracture occurs along the length of the bone, below the knee and above the ankle. It typically takes a major force to cause this type of broken leg. Motor vehicle collisions, for example, are a common cause of tibial shaft fractures.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
2. Objectives
After completion of the class students will be
able to
• Define fracture
• Enlist the Causes of fracture
• Describe the types of fracture
• Discuss the Pathophysiology of fracture
• Enumerate the Clinical manifestations
• Explain the medical & nursing management
of the fracture
3. DEFINITION
• A fracture is a break in the continuity of
bone and is defined according to its type and
extent.
• Fracture is a break in any bone in the body.
7. a. CLOSED FRACTURE (simple fracture) is one that
does not cause a break in the skin.
b. AN OPEN FRACTURE (compound, or complex,
fracture) is one in which the skin or mucous membrane
wound extends to the fractured bone.
Open fractures are graded according to the following
criteria:
• Grade I is a clean wound less than 1 cm long.
• Grade II is a larger wound without extensive soft tissue
damage.
• Grade III is highly contaminated, has extensive soft
tissue damage, and is the most severe.
8. Classification: based on displacement
NON - DISPLACED FRACTURE
The bone cracks either part or all the
way through, but does not move and
maintains proper alignment
DISPLACED FRACTURE
The bone snaps into two or more
parts and moves so that the two
ends are not lined up straight
10. Transverse Fracture
A fracture in which the
# line is perpendicular
to the long axis of the
bone
Oblique Fracture
A fracture in which the #
line is at oblique angle
(45)to the long axis of
the bone
11. Spiral Fracture
A severe form of
oblique fracture in
which the # plane
rotates along the long
axis of the bone. These
#s occur secondary to
rotational force
12. Comminuted Fracture :
The bone is broken into
many fragments.
Segmental fracture
There are two fractures
in one bone , but at
different angles
13. Classification: Based on Etiology
1. TRAUMATIC
2. PATHOLOGICAL
– Tumors
– Bone cysts
– Osteomyelitis
– Osteoporosis
– Rickets
14. Pathophysiology
Due to any etiology(crushing movement)
|
Fracture occurs , muscle that were attached to bone
are disrupted and cause spasm
|
Proximal portion of bone remains in place, the distal
portion can become displaced in response to both
causative force & spasm in the associated muscles
15. continue..
In addition, the periosteum and blood vessels in
the cortex and marrow are disrupted
|
Soft tissue damage occurs, leads to bleeding and
formation of hematoma between the fracture
fragment and beneath the periosteum
|
Bone tissue surroundings the fracture site dies,
creating an intense inflammatory response
16. release chemical mediators histamines,
prostaglandins
|
Resulting in vasodilatation, edema, pain,
loss of function, leukocytes and
infiltration of WBC
continue..
17. • Pain
• loss of function
• deformity
• Muscle spasm
• crepitus
• swelling and discoloration
19. • STAGE OF HAEMATOMA
Last up to 7 days. Deprived of blood supply
some osteocytes die, while others sensitive to
form daughter cells.
• STAGE OF GRANULATION TISSUE( 2-3 wks)
Proliferation and differentiation of
daughter cells into vessels, fibroblast etc.
fracture still mobile.
20. • STAGE OF CALLUS (4-12 WEEKS)
Mineralization of granulation tissue. First sign of
union. Fracture is no more movable. Callus
radiologically visible usually 3weeks after #.
• STAGE OF CONSOLIDATION(1-2 YEAR)
Callus or woven bone is replaced by mature bone
with a typical lamellar structure.
• STAGE OF MODELLING(MANY YEARS)
Bone is gradually strengthened
21. COMPLICATIONS OF FRACTURE
Immediate
Hypovolemic Shock
Early complications
• fat embolism
• Adult respiratory distress syndrome
• compartment syndrome
• Crush syndrome
• deep vein thrombosis
• infection
24. According to the research conducted by López
and Flors they found that patients with multiple
fractures will have Respiratory symptoms were
the most frequent , followed by neurological
symptoms .
The average time of presentation of the
syndrome after admission was 42 hours. The
overall incidence of Fat embolism syndrome
after bone fractures was 0.14%, and mortality
was 10.5%.
26. MEDICALAND SURGICAL MANAGEMENT
1. Reduction
Reduction of a fracture (“setting” the bone) refers to restoration
of the fracture fragments to anatomic alignment and rotation.
Correction of bone alignment through a surgical incision.
External/Internal fixation devices (metallic pins, wires,
screws, plates, nails, or rods) may be used to hold the
bone fragments in position until solid bone healing
occurs.
30. Closed reduction
• closed reduction is accomplished by bringing the
bone fragments into apposition (ie, placing the
ends in contact) through manipulation and
manual traction, with no surgical intervention.
• Extremity is held in the desired position while the
physician applies a cast, splint, or other device.
• X - rays are obtained to verify that the bone
fragments are correctly aligned.
• Traction (skin or skeletal) may be used to effect
fracture reduction and immobilization.
31. 2.Immobilization
• Immobilization may be accomplished by
external or internal fixation.
• Methods of external fixation include
bandages, casts, splints, continuous traction,
and external fixators.
• Metal implants used for internal fixation serve
as internal splints to immobilize the fracture.
32. Traction
Traction is the use of weights, ropes and pulleys to apply force
to tissues surrounding a broken bone.
33. Traction
1. Skin traction-
• Bucks traction used for knee , hip bone
fracture
• Weight usually 5-7 pounds attach to skin
2. Skeletal traction –
• Needs invasive procedure
• Weight is up to 10 kg attached to bone
35. Why Do We Splint?
• To stabilize the extremity
• To decrease pain
• Actually treat the injury
36. Possible items for Splinting
• Soft materials. Towels, blankets, or pillows,
tied with bandaging materials or soft cloths.
• Rigid materials. A board, metal strip,
folded magazine or newspaper, or other
rigid item.
37. Guidelines for Splinting
1. Support the injured area.
2. Splint injury in the position
that you find it.
3. Don’t try to realign bones.
4. Check for color, warmth, and
sensation.
5. Immobilize above and below
the injury.
38. The splint should go beyond the joints above and
below the fractured or dislocated bone to prevent
these from moving
39.
40. 3. Maintaining and restoring
function
• Restlessness, anxiety, and discomfort are
controlled with a variety of approaches, such as
reassurance, position changes, and pain relief
strategies, including use of analgesics.
• Exercises are encouraged to minimize disuse
atrophy and to promote circulation.
• Participation in activities of daily living (ADLs)
is encouraged to promote independent
functioning and self-esteem.
41. NURSING MANAGEMENT
Patients with closed fractures:
• Encourage patient not to mobilize
fracture site.
• Exercises to maintain the health of
unaffected muscles for using
assistive devices (eg, crutches,
walker).
42. Continue….
• Teach patients how to use assistive
devices safely.
• Patient teaching includes self-care,
medication information, monitoring for
potential complications, and the need for
continuing health care supervision.
43. Patients with open fractures:
• Administers tetanus prophylaxis if
indicated.
• Wound irrigation and debridement in
the operating room are necessary.
• Intravenous antibiotics are prescribed
to prevent or treat infection.
• Wound is cultured.
44. Continue….
• Fracture is carefully reduced and stabilized by
external fixation.
• Any damage to blood vessels, soft tissue,
muscles, nerves, and tendons is treated.
• Heavily contaminated wounds are left
unsutured and dressed with sterile gauze to
permit swelling and wound drainage.
45. CARE OF CLIENT WITH CAST
Before application of a cast preparation of the
client includes:
• Detailed explanation of the procedure
• Skin preparation involves through cleansing
of the skin
• Presence of unremovable particle or dust
should be reported to the physician
• Roll the cast material are individually
submerged in clean water and excess water is
squeezed from the roll ,apply bandage is
applied to encircle the injured the body parts
46. Continue…
• As the water evaporates the cast will dry
• Do not cover the cast
• Windowing or bivalving a cast means cutting a
cast along both sides then splitting it to decrease
pressure on underlying tissue.
• Window may also be cut into cast to allow the
physician or nurse to visualize wounds under
the cast or removes drains.
48. Continue..
• Neurovascular assessment: It should be
performed every 30 minutes for 4 hours.
• Assess the cast extremity for color, warmth,
pulse distal to the cast, capillary refill.
• Movement of the distal fingers or toes,
awareness of light touch distal to the cast,
change in the sensation.
• Assess the degree of pain
49. Assessment of the cast:
The skin around the cast edges should
be observed for damage or swelling.
“Hot spots” areas of the cast that feel
warmer than other section may
indicate tissue necrosis or infection
under the cast.
“Wet spots” may indicate drainage
under the cast
50. CARE OF EXTERNAL FIXATION
• Assessment- pain, nerve supply,infection,pin
site etc.
• Small bleeding from pin site is normal
• Critical, If extend more than 24 hours
• Administer antibiotics, analgesic medicine
51. CARE OF TRACTION
• Assessment – skin breakdown, pain,
neurovascular ,constipation
• Stool softener
• Plenty of fluids
• Provide bedpan and urinals for elimination
• Encourage clients activity
53. Acute pain related to tissue trauma as
evidenced by guarding of affected area.
• Goals: Patient reports satisfactory relief of
pain.
• Intervention:
– Assess the onset, duration, location, severity and
intensity of pain.
– Administer the analgesic according to physician
order.
– Provide comfort devices like sand bags for
immobilization of affected parts and to reduce
pressure on nerves and tissues.
54. Impaired physical mobility related to application of traction or
cast, pain as evidenced by assessment
• Intervention:
– Provide range of motion exercises to the patient.
– Perform passive or assisted ROM exercise.
– Provide assistance while using walker or
crutches if required.
– Prevent from complication which usually
occurs due to immobility.
•
55. Risk for peripheral neurovascular dysfunction related
to vascular insufficiency and nerve compression
secondary y to edema and application of traction,
splints or casts.
• Goal: Experience no peripheral neuro
vascular dysfunction
• Intervention:
– Elevate the affected limb above the level of heart
to reduce edema.
– Check for periferal pulse, capillary
refill,temperature
– Immobilize or support the affected body part to
prevent pressure and injury.