NURSING CLIENT Fracture

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NURSING CLIENT Fracture

NURSING CLIENT fracture

Fraktur is a disconnection or rupture of the continuity of the bone structure. Injury is a major cause of fractures, although some fractures are the result of a process of disease (pathological fractures).
Fractures can dklasifikasikan by:
Type
Are not related or associated with the outside world.
Fault location

Type of fracture:
closed fracture (simple fracture), which is incomplete fracture in which the skin remains intact on bgaian of fractures, bone does not damage the skin.
Open fracture (compound fracture), skin damage ditas adsanya a broken bone. Injuries that occur associated with bone fracture. Therefore relate to the outside world it will be a potential infection.


Complete fracture (complete fracture), a fault line extends the entire substance of bone. So perioteum broken on both sides of the bone.
Incomplete (partial) fracture, a fault line extends only to the most bone. Bone fracture is not perfect. This species is also called a willow, greenstick, or hickory-stick fracture.
Displaced fracture, broken bone fragments on a fault line.
Momminuted fracture, more than one fault line, and fragemen bone fracture into several mutually destructive.
Impacted fracture (telescoped fracture) or a compression fracture, a bone fragment with its power driven into the various fragments of the adjacent bone.
Pathologic fractures, fractures occur due to bone disorders such as osteoporosis or tumor.
Greenstick fracture, this fracture where one side of a broken bone and the other side to be bent.

Fracture can be a combination of circumstances. If there fgraktur divided into two fragments of the proximal and distal fragments. Proximal fragment is part of the bone close to the body.
Another limitation that is according to a fault line:

Linear fracture, fracture lines parallel to the length of bone.
Oblique fracture, oblique fault line membentuksudut
Longitudinal fracture, a fault line stretching.
Transverse fracture, fracture lines intersect in the bone
Spiral fracture, a fault line forming a spiral around the bone.
Stellate, central point of fracture with some fissures spread out.

Incident:
The incidence of fracture vary. Rib fractures are common in adults. Femor fractures often occur in adolescents or middle age. And in the elderly often suffer from hip and wrist fractures.
Cause:
Fractures are often caused by direct trauma to the bone. Accidents due to driving and fall is the major mechanism of bone cedera.Penyakit such as osteoporosis or metastatic bone cancer can weaken the bone structure and fracture occurs.
Fractures can occur lansgung or indirect and influenced by biological factors and behavior. Direct pressure causes the movement of objects in contact with the bone .. indirectly caused by strong muscle contractions on bone.
Pathophysiology:
When a broken bone, the periosteum and blood vessels in kosteks, marrow, and surrounding soft tissue is lost. Bleeding will occur due to damaged by the end of the bone in soft tissue close to the bone (muscle). Hematoma will form within the spinal canal between the ends of the bones that poatah and under the periosteum. Bone tissue immediately connected on a broken bone. Mekrotis tissue stimulates the inflammatory response is continuously characterized by vasodilatation, exudation of plasma and leucocytes, and infiltration of leucocytes.
Bone healing:
Bone has the ability of generations, unlike in certain body tissues. Penyembuahn bone caused by the formation of new bone tissue. Fractures usually heal over 6 weeks through stages:

Phase I; hematoma formation: in 24 hours, began an organized blood clot. Blood in the hematoma (coagulation), lost, interlocked due to the formation of fibrin disetar bone.
Phase II: Cellular Proliferation: This stage is in place of fractures, where the tip of the periosteum, endosteum, and bone marrow cells proliferate supply and turn into fibrocartilago, hyalin cartilago, and fibrous connective tissue nOnce few days, the combination increased the periosteum and formation of granulation tissue surrounding the ends of each fragment. Cause the bones have fused and formed a bridge over the fracture site.
Phase III: Formation callus: 6 to 10 days after injury, changes in granulation tissue and callus formation ..
Stage IV: Ossification: permanent Kallus, bones become hard and even form of calcium salt deposits, where the ends of the bones knit. The formation of bone is healing perfectly.
Phase V: Consolidation and Remodeling: At one time formed the original bone, formed by the activity kallus osteolastosis and osteoklast.

Healing time:
Soft bones heal faster than the bone hard because rich in blood supply. Impakta fractures healed in a few weeks, but on the shifting fracture takes months or bertahn.
In the cast arm will heal in 3 months, where the tibia and femur of 6 months or longer. Part of the bone surface ore speedy recovery.
Its function will be back in 6 months after bone grafting
Clinical manifestations:
Many factors influence the clinical manifestations may fracture as a result of such location, severity, type of fracture, the amount of damage from the existing structure. Some of the fractures showed little clinical manifestations and is not detected by X-ray.
The signs and symptoms associated with fractures:

deformity: Encouragement muscle strength can cause bone riding each other
Pembengkakanà quickly apparent edema.
Bleeding / hematoma.
Muscle spasm (muscle contraction in involuntari close to the area of ​​fracture)
Pain.
Impaired sensation (numbness)
Loss of normal function
movements are not normal mobility
À crepitus due to the fracture tip
Hipovolrmia doubt.

Complications:
Possible early complications is damage to blood vessels, fat embolism, infection, shock.
Long-term complications:

Delayed union
Nonunion
malunion

Medical Treatment:
The main purpose penanaganan fracture to restore the position to the maximum extent possible, prevent complications and get the body shape best.
Action taken:

Traction
Closed reduction (manipulation)
Open reduction

Nursing:
Assessment:
When admitted to hospital, the client usually weighed before being transported to the bed. Comprehensive assessment conducted including assessment abrasions or injured while climbing.
Nursing Diagnosis:

Barriers to physical mobility R / T restrictions on movement and pain
Risk of injury (dislocation) R / T emphasis on joints that are not appropriate and also the surrounding tissue.
The risk of injury (syndrome compartemn R / T leg edema and bleeding.
Pain R / T trauma and surgery
Constipation R / T side effect of narcotics and immobilita

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