Nursing 213

N213: Health Differences Across the Lifespan 3 Study Guide • Pin care is very important; clean per surgeon instructions and monitor for infection. Regularly check placement and notify surgeon if alignment does not appear right. • Monitor distal extremity with the 5 Ps: pain, paresthesia, paralysis, pulse, and pallor • Provide proper nutrition for healing; increase protein intake and vitamins • Encourage increased fluids Expected outcomes for soft tissue injuries and fractures: • Patient remains free from infection and injury • Verbalizes increased comfort and pain relief • Patient maintains proper body alignment for healing • Skin remains free from breakdown • Patient is compliant with rehabilitation and treatment plan Traumatic Amputations This injury is the result of both a soft tissue injury and a fracture that results in the loss of a limb or other body part. The force is so strong that it completely separates toes, fingers, legs, hands, or arms from the body. It is very common inmotor vehicle accidents, farm accidents, factory worker accidents, and with power tool accidents. Rapid emergency response is critical in these situations to possible re- attach the limb to the body surgically. If that is not possible, flap closure is necessary to prevent profuse bleeding and possible infection. With re-attachment or transplantation, the only limitation seems to be the regeneration of the nerves. Medical and surgical techniques have improved the outcomes of these injuries and with rehabilitation, prosthesis, and occupational therapy these patients can go on to live very normal lives. There are two types of traumatic amputations: • Partial: The bone is completely fractured, but the body part is held on by attached tissue. • Complete: The body part is completely separated from the body. Nursing assessment for traumatic amputations: • Take vital signs, assess respiratory, and circulatory system; watch for hypovolemia and shock; patient will be hypotensive and tachycardic • Take a thorough history on the nature of the accident • Check injury for clean amputation or a crushing amputation; look for clean or jaggededges • Ask patient about recent tetanus immunization • Check for peripheral pulses if partial amputation • Review radiology reports: ultrasound, ateriography, and x-ray

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