Nursing 213

N213: Health Differences Across the Lifespan 3 Study Guide

Nursing interventions for slipped femoral epiphysis: • Assess pain frequently and offer analgesics per MDorder • If MD orders corrective traction, monitor placement and provide skincare • Prepare patient for surgery if necessary; teach the family what to expect, rehabilitation, and recovery time • Post-operative: assess pain and offer analgesics, check peripheral circulation, and perform wound care at surgical site • Encourage rest and teach patient to pace activities as tolerated • Teach parents about rehabilitation: range of motion exercises, nutrition, and skin care Expected outcomes for slipped femoral epiphysis: • Patient demonstrates increased comfort and relief from pain • Patient is compliant with limitations on mobility and activity • Patient remains free from injury and complications from surgery • Parents verbalizes an understanding of the treatment plan and rehabilitation process Contractures Contractures develop due to muscle inactivity. When a muscle is not used for a long period of time it begins to shorten along with the tendon. The joints are then unable to move and it is very painful to the patient if a joint is forced to move. This condition often becomes permanent if the joints are not moved with passive range of motion exercises or splinting. Those most at risk factors include patients with a neurological dysfunction or coma, those with illnesses that cause immobility, and burn patients. The less a patient moves, the more the joints and muscles contract. When the patient attempts to move a contracted joint, they tend to expend more energy. This spirals into permanent contractures quickly if measures are not taken to improve mobility. Complications of contractures are skin breakdown, ulcers, and inability to perform ADLs. Signs and symptoms of contractures: • Painful muscle spasms • Rigid muscles • Shortened muscles/decreased range of motion • Stiffness • Joint deformity/curled up appearance • Skin breakdown

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