Question

1. in what ways does an activity affect circulation?

2. To perform a neurovascular assessment on an in mobilized extremity you would:

3. What is the standard of practice for bed rest care?

4. Charles Lee just had a left long leg cast applied. Describe the care of this cast during the drying period?

5. Describe the emotional support that is important in providing nursing care for non-alert or comatose patient.

6. What are some ways to decrease itching inside a cast.

7. Five pressure relief devices used to help prevent skin injury for immobilized patients are:

8. When applying an elastic or a roller bandage you would follow which guidelines?

chapter 39 promoting musculoskeletal function

Answer 1

1. Ways does an activity affect circulation :-

The heart is a muscle which becomes more efficient with activities. When we do an activity our muscles help to circulate blood through the body taking some of the strain and effort off the heart. Not as much work is needed to pump blood and the heart becomes stronger over a period of time

When we begin to do an activity , our heart will contract faster and circulation will increase, which gets oxygenated blood to your muscles quicker. As the demand for blood increases, the heart is going to try to meet the demand by increasing the heart rate and also by increasing the force at which it contracts. The increase in oxygen delivery is twofold: our heart will have more beats per minute, and a more forceful contraction each time it beats so it can pump a greater amount of blood throughout the body.

2.To perform a neurovascular assessment on an in mobilized extremity

Assessing for the changes in circulation and oxygenation in a immobilized extremity to assess the threat to neurologic function .

- Evaluate neurovascular status every 1-2 hours

- Note the size of the fingers and toes to detect any edema

- Palpate the distal pusle of the limb and note the strength .

- Observe the colour of the nail beds

- Ask the patient to describe any sensations if any .

- Compare the temperature by simultaneouse feeling in affected and unaffected extremities.

- Assess the capillary refill.

3.The standard of practice for bed rest care.

Performing active or passive ROM exercises to maintain joint mobility and muscle integrity .

Range of motion exercises are also called "ROM" exercises. There are three types of ROM exercises:

passive, active, and active assists.

Passive range of motion is movement applied to a joint solely by another person or persons or a passive motion machine. When passive range of motion is applied, the joint of an individual receiving exercise is completely relaxed while the outside force moves the body part, such as a leg or arm, throughout the available range. Injury, surgery, or immobilization of a joint may affect the normal joint range of motion.

· Example : -

· Head and neck exercises

· Shoulder and elbow exercises

· Forearm and wrist exercises

· Hand and finger exercises

· Hip and knee exercises

· Ankle and foot exercises

Active range of motion is movement of a joint provided entirely by the individual performing the exercise. In this case, there is no outside force aiding in the movement. Active assist range of motion is described as a joint receiving partial assistance from an outside force. This range of motion may result from the majority of motion applied by an exerciser or by the person or persons assisting the individual. It also may be a half-and-half effort on the joint from each source.

4. Care of the cast during the drying period

Cast or splint will be dry in about one hour. During this drying period, do not want to put any constant pressure or weight on cast until it is hard and dry. It could easily bend and lose its shape.

- Sit for about 10 minutes after application to let it harden.

- Only minimal walking is permitted within the first hour of application.

-Do not put weight on your newly casted leg for 48 hours, which is the appropriate time needed for the plaster to dry.

-Elevate your casted extremity (preferably above heart level) for 12 hours after it is applied.

-Place your wet cast on a pillow or soft pad. Hard surfaces may dent wet plaster.

-Do not use anything to scratch under the cast, as this may cause a sore.

-Do not allow any small objects to fall down inside the cast, as this will irritate your skin.

-Do not attempt to shorten or loosen your cast in any way, as this can cause serious problems.

6.Ways to decrease itching inside a cast

- Keep it dry: If you get your cast wet, your limb may become itchy or irritated. Take extra precautions to keep your cast dry around water, such as during a shower or bath. Exposure to water can damage the cast.

-Don't put anything in the cast: Don't stick items - such as hangers - in your cast in an attempt to ease the itchiness. This can cause soreness.

- Keep the cast clean: Stay away from dirt, sand, and powders, which can make itching or skin irritation worse. If have a waterproof cast, rinsing the area with clean, cool water after excessive sweating can prevent sores and itchiness from developing. Allow the water to drain once the area is soothed.

-Blow-dry it: Don't use hangers, butter knives, and other thin objects to scratch your skin within your cast. This can break your skin and cause irritation. Instead, use a blow dryer on the cool setting and aim it at the cast opening to relieve your itching. An alternative to the blow dryer is placing the casted limb in front of a fan.