Orthopaedic common disease care plan doc
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(1) Brake of the affected limb and fixation of the corrective shoes: When the affected limb is braked, a pillow is placed between the legs to make the affected limb assume a neutral abduction position; it can be fixed by wearing anti-rotation orthopedic shoes to prevent external rotation of the hip joint or Dislocation; the lower limb support and skin traction are used to connect the affected limbs appropriately.
(2) Lying on a hard bed: Resting on a hard bed, lying on the affected side with the permission of the physician; avoiding adduction, external rotation, or hip flexion of the affected limb when changing positions to prevent displacement of the fracture.
(3) Accurately carry the patient: Try to avoid carrying or moving the patient. When it is necessary to carry and move, pay attention to taking the entire hip joint out of the affected limb to prevent dislocation of the joint or the formation of new damage to the fractured end.
(1) Isometric contraction of the quadriceps: Point the patient to perform isometric contraction of the quadriceps of the affected limb, flexion and extension of the calf joint, and foot program. Multiple times a day, 5-20 minutes each time, to prevent deep vein thrombosis of the lower limbs, muscle atrophy and joint stiffness. Before and after training, pay attention to assess the feeling, movement, temperature, color, and pain, edema of the affected limb.
(3) Hip function training: After performing total hip arthroplasty for 1 week, help the patient sit on the bedside to perform hip function training. The action should be slow, the program range from small to large, program range and strength Gradually increase; instruct the patient to change the position by using the bed rail.
(4) Transfer and walking exercise: Evaluate whether the patient needs assistive equipment to complete daily life, and point out the way the patient sits, moves to a wheelchair, and walks. Non-surgical patients can gradually sit up in bed after 8 weeks. When sitting up, their legs cannot be crossed. After 3 months, they can use the cane gradually. The affected limb is walking in a non-sinking environment and abandoned after 6 months. walk. Patients undergoing artificial total hip arthroplasty agreed to get out of bed after 2 to 3 weeks, and the patient was instructed to walk with a walker or walking stick while being accompanied by an accurate person; the affected limbs should not be sunk until the fracture was healed.
(2) Control accurate training opportunities and methods. The affected limbs should undergo quadriceps isometric contraction, patella passive program, ankle flexion and extension program, and foot program.
(1) The connecting bed is soft, clean, dry, and flat. Change the position on time, massage the pressured part, and often wipe the body with warm water to prevent pressure ulcers.
(2) Encourage the patient to expand the chest, take a deep breath, and cough to exercise lung function. Connected to oral hygiene, the indoor air is refreshing and the temperature is appropriate to prevent lung infection.
Partially fix the patient with a figure 8 bandage or double-circle fixation. The connection is invalid and the armpit is not too tight. Partially immobilized patients are advised not to change their lying position casually.
(1) After the partial fixation, connect the chest and shoulders, and perform various programs on the hands, wrists, and elbows, shoulder abduction, and back extension, such as doing chest lifts and hands with waists. Taboo flexion, adduction and other actions.
(2) After lifting the external fixation, start a comprehensive shoulder joint program. At first, the purpose of each target of the shoulder joint is changed. The program range is from small to large, and the number of times is small to large. Then perform the analysis of each target's purpose, such as the shoulder joint rotation program, the arms to do the boat movement and so on.
(1) Pay attention to see if the affected limb can show severe pain, pale skin, cold hands, painful sadness of passive extension of the fingers, weakened or disappeared radial artery pulsation, and notify the physician as soon as it is found.
(2) Check whether the splints and plaster bandages are properly tightened on time, and timely adjust them when necessary to avoid nerve and blood vessel compression and maintain invalid tissue perfusion.
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