Orthopaedic nursing
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Shaken baby syndrome is a significant cause of infant morbidity and mortality and is widely recognized in the medical literature. Classic signs include retinal hemorrhage, subdural or subarachnoid hemorrhage, and associated fractures. Most victims are younger than 6 months old and have been affected by violent shaking with rapid angular deceleration and possible terminal impact. This article summarizes issues related to clinical presentation, diagnosis, risk factors, and interventions for healthcare professionals.
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Orthopaedic nursing · Jul 2002
ReviewThe management and prevention of rigid cervical collar complications.
The rigid cervical collar has been a great addition to the successful management of cervical spine injuries. But the collar has been known to offer a false sense of security in terms of totally preventing additional and further spinal cord compromise and damage. ⋯ Photographs are used to demonstrate examples of related skin breakdown, show proper collar fit, present the result of ineffective cervical immobilization, and show how to stabilize the head and neck during a collar change. These problem areas are addressed with the dos and don'ts for nursing management.
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People experiencing blunt thoracic trauma may sustain multiple rib fractures, flail chest, cardiac or pulmonary contusions, injury to the great vessels, sternal fractures, clavicular fractures, neck injuries, and lacerations of the liver and/or spleen. Long-term sequelae from blunt chest trauma include chest wall deformities, persistent dyspnea, and cardiac, neurologic, or esophageal complications. Chronic pain, depression, and loss of functional status are also frequent components of recovery from trauma.
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Orthopaedic nursing · Jan 2001
Managing delirium and agitation in elderly hospitalized orthopaedic patients: Part I--Theoretical aspects.
Managing behavioral disorders such as delirium and agitation while simultaneously attending to the acute needs of elderly patients is a challenge that confronts orthopaedic nurses on a daily basis. This will only increase in frequency and complexity as the new century dawns. Delirium and agitation affect morbidity, mortality, length of stay, and costs--in short, outcomes. ⋯ With the knowledge of the pathophysiology of delirium and agitation, nurses then need to refine their assessment and intervention skills. This article describes the phenomena of agitation and delirium in the elderly acute orthopaedic patient, outlines current perceptions regarding pathophysiology, and offers guidelines for prevention and intervention. An algorithm has been developed that can assist with the identification of at-risk individuals, causes of delirium, and early assessments in the acute care setting.
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To determine if postoperative pain is a predictor of functional outcomes for elderly hip fracture patients who were previously independent ambulators (with or without assistive device). ⋯ Pain assessment of postoperative older patients should be conducted during movement. Efforts to reduce postoperative pain severity in the immediate postoperative period may yield better functional outcomes months later.