![]() ![]() Nursing AssessmentĪssessment of the fractured area includes the following: Nursing management for close and open fractures should be differentiated. Fracture reduction refers to the restoration of the fracture fragments to anatomic alignment and positioning and can be open or closed depending on the type of fracture.In an open fracture, the wound should be covered with a sterile dressing to prevent contamination of the deeper tissues.Adequate splinting is essential to prevent the movement of fracture fragments.Immediately after injury, if a fracture is suspected, it is important to immobilize the body part before the patient is moved. ![]() Management of a patient with a fracture can belong to either emergent or post-emergent. Coagulation profile: Alterations may occur because of blood loss, multiple transfusions, or liver injury.Urine creatinine (Cr) clearance: Muscle trauma increases the load of Cr for renal clearance.Increased white blood cell (WBC) count is a normal stress response after trauma. Complete blood count (CBC): Hematocrit (Hct) may be increased (hemoconcentration) or decreased (signifying hemorrhage at the fracture site or at distant organs in multiple trauma).Arteriograms: May be done when occult vascular damage is suspected.Bone scans, tomograms, computed tomography (CT)/magnetic resonance imaging (MRI) scans: Visualizes fractures, bleeding, and soft-tissue damage differentiates between stress/trauma fractures and bone neoplasms.X-ray examinations: Determines location and extent of fractures/trauma, may reveal preexisting and yet undiagnosed fracture(s). ![]() To determine the presence of fracture, the following diagnostic tools are used. Compartment syndrome in an extremity is a limb-threatening condition that occurs when perfusion pressure falls below tissue pressure within a closed anatomic compartment. After fracture of long bones and or pelvic bones, or crush injuries, fat emboli may develop.
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