Browsing Category: "Nursing care procedures"
EXTERNAL FIXATION
In external fixation, a physician inserts metal pins through skin and muscle layers into the broken bones and affixes them to an adjustable external frame that maintains their proper alignment. (See Types of external fixation.) This procedure is used most commonly to treat open, unstable fractures with extensive soft tissue damage, comminuted closed fractures, and septic, nonunion fractures and to facilitate surgical immobilization of a joint. Specialized types of external fixators may be used to lengthen leg bones or immobilize the cervical spine.
An advantage of external fixation over other immobilization techniques is that it stabilizes the fracture while allowing full visualization and access to open wounds. It also facilitates early ambulation, thus reducing the risk of complications from immobilization.
The Ilizarov fixator is a special type of external fixation device. This device is a combination of rings and tensioned transosseous wires used primarily in limb lengthening, bone transport, and limb salvage. Highly complex, it provides gradual distraction resulting in good-quality bone formation with a minimum of complications.
Equipment
PROCEDURE FOR DRESSING CHANGE FOR CENTRAL LINES AND PERIPHERAL ARTERIAL LINES
Equipment Required:
1. 1 sterile green towel
2. 2- Chorhexidine 2% and 70% alcohol swabs
3. Suitable dressing (eg.Tegaderm, gauze and tape)
4. Steri-strips if required
5. Non-sterile gloves
Procedure and rationale
Tags: sterile gloves, site, alcohol swabs, line, sterile towel, PERIPHERAL ARTERIAL LINES, vertical pattern, skin integrity, gauzeNormal heart sounds auscultation
Normal Heart Sounds
With the aid of a stethoscope you can hear the characteristic sounds of the normal heartbeat, typically described as a “lub-dub.” These sounds are produced by the closure of the heart valves. The first heart sound or “lub” results from closure of the tricuspid and mitral valves. It is a rather low-pitched and a relatively long sound which, as indicated in, represents the beginning of ventricular systole.
The second heart sound, or “dub,” marks the beginning of ventricular diastole. It is produced by closure of the aortic and pulmonary (pulmonic) semilunar vanes when the intraventricular pressure begins to fall. This “dub” sound is typically heard as a sharp snap because the semilunar valves tend to close much more rapidly than the AV valves. Because diastole occupies more time than systole, a brief pause occurs after the second heart sound when the heart is beating at a normal rate. Therefore, the pattern that one hears is one of: “lub-dub” pause, “lub-dub” pause, and so on.
Sometimes, especially in young normal individuals, a third heart sound can be heard. This sound is produced by the very rapid influx of blood into the partially filled ventricle. It is typically very faint and as such difficult to hear.
you can see the videos normal heart sounds auscultation
Tags: rapid influx, diastole, normal heart, nursing, ventricular, Nursing care procedures, heart, third heart sound, lub dub, systolePERIPHERAL I.V. THERAPY PREPARATION
PERIPHERAL I.V. THERAPY PREPARATION
Selection and preparation of appropriate equipment are essential for accurate delivery of an I.V. solution. Selection of an I.V. administration set depends on the rate and type of infusion desired and the type of I.V. solution container used.
Two types of drip sets are available: the macrodrip and the microdrip.
The macrodrip set can deliver a solution in large quantities at rapid rates because it delivers a larger amount with each drop than the microdrip set. The microdrip set, used for pediatric patients and certain adult patients who require small or closely regulated amounts of I.V. solution, delivers a smaller quantity with each drop.
Administration tubing with a secondary injection port permits separate or simultaneous infusion of two solutions; tubing with a piggyback port and a backcheck valve permits intermittent infusion of a secondary solution and, on its completion, a return to infusion of the primary solution.
Vented I.V. tubing is selected for solutions in nonvented bottles; nonvented tubing is selected for solutions in bags or vented bottles. Assembly of I.V. equipment requires sterile technique to prevent contamination, which can cause local or systemic infection.
Equipment
