fraktur

REPORT INTRODUCTION Nursing care TO CLIENTS WITH FRAKTUR CRURIS I. The Fraktur cruris continuity bone dissolution is determined according to the type and extent, occur in the tibia and fibula bones. Fraktur happen if the bones dikenao stress larger than that can diabsorbsinya. (Brunner & Suddart) II. TYPE FRAKTUR a.Fraktur komplet: broken line in the middle of all the bones and is usually a shift. b.Fraktur not complete: only the broken part of the bone diameter c.Fraktur closed: fraktur but does not cause skin robeknya d.Fraktur opens: fraktur with wounds on the skin or membrane mukosa to bone fracture. e.Greenstick: fraktur where one of the broken bones, while the other swell. f.Transversal: fraktur throughout diameter bone g.Kominutif: fraktur with a few broken bones frakmen h.Depresi: fraktur with fracture fragments pushed into i.Kompresi: Fraktur where the bone compression (happens to the spine) j.Patologik: fraktur that occurred in the bone by ligamen or tendo on perlekatannnya area. III. Etiology a. Trauma b. Pintir sudden movement c. Muscle contraction ekstem d. Circumstances patologis: osteoporosis, neoplasma IV. PATYWAYS Trauma Direct trauma does not directly condition patologis FRAKTUR Diskontinuitas bones bones shifting frakmen Perub network around the damaged bone frakmen How frag shift laserasi skin: muscle spasme Tech. What Ssm> dr high capillary vena dropouts / Tech peningk arterial capillary stress reaction client deformitas bleeding discharge histamin release katekolamin gg. function plasma protein lost memobilisai fatty acid loss of fluid volume edema bergab dg trombosit embolism penekn pem. drh clog pemb drh decrease perfusi jar V. Clinical manifestations a. Ongoing pain and increases samapi weight diimobilisasi bone fragments, hematoma, and edema b. Deformitas due to a shift in the broken bone fragments c. Bones abridgment occurs because the actual contraction of muscles attached above and below the fraktur d. Krepitasi due to friction between the fragments with one another e. Swelling and discoloration on the skin local VI. Examination support a. examination of fraktur Radiology image: the location, extent b. The number of full blood examination c. Arteriografi: the damage done when a suspected vaskuler d. Kreatinin: muscle trauma meningkatkanbeban kreatinin for kidney klirens VII. PENATALAKSANAAN a. Reduction fraktur open or closed: action-manipulating fragments of broken bone fragments as much as possible to return such as the location. b. Imobilisasi fraktur Fixation can be done with eksterna or Interna c. Maintain and restore function Reduction and should be maintained in accordance imobilisasi needs  Giving analgetik for pain mengerangi  Neurovaskuler status (eg peredarandarah, pain, palpability of movement) is monitored  Isometrik exercise and muscle arranged for setting meminimalakan atrofi disuse and increase blood peredara  VIII. Complications a. malunion: telahsembuh broken bones in a position that should not. b. Delayed union: the healing process continues berjlan but with a slower speed from normal circumstances. c. Non-union: not the bones that connect back IX. Pengkajian BASIC DATA a. activity / rest loss of function in the yangterkena  Limited mobility  b. Circulation Hypertension (sometimes seen as a response to pain / ansietas)  Hipotensi (response to blood loss)  Tachikardi  The decline in the pulse distal to injury bagiian  Cailary refil slowed  Pale in the affected  The period of hematoma on the side injury  c. Neurosensori Pins  Deformitas, krepitasi, abridgment  weakness  d. comfort sudden pain when injury  spasme / muscle cramps  e. security laserasi skin  bleeding  changes color  local swelling   X. Priority Nursing a. Prevent bone injury / network information b. Eliminate pain c. Prevent complications d. Membeikan information does the condition and needs treatment XI. Nursing Diagnosis a. Damage to physical mobility bd jarinagan sekitasr fraktur injury, damage to the framework of neuromuskuler b. Painful b.d spasme tot, a shifting bone fragments c. Damage the integrity of the network fraktur bd open, surgical repair XII. INTERVENTIONS a. Damage to physical mobility bd jarinagan sekitasr fraktur injury, damage to the framework of neuromuskuler Destination: kerusakn physical mobility can be reduced after the action keperaawatan Criteria results: Increase mobility in the most high level which may  Position fungsinal  Meningkaatkan strength / function ill  Able to demonstrate technical activities  Intervention: a. Pertahankan tirah lie in a position that diprogramkan b. Tinggikan ekstrimutas the sick c. Instruct the client / bantu latian rentanng movement in the ekstrimitas the sick and not sick d. Give it a pain in the ekstrimit above dandibawah fraktur when moving e. Describe the views and limitations in activities f. Give the patient is encouraged to do the AKS in lngkup limitations and give appropriate assistance kebutuhan'Awasi teanan daraaah, pulse with activity g. Change psisi periodically h. Kolabirasi fisioterai / okuasi therapy b.Nyeri bd spasme tot, a shifting bone fragments Objectives; pain decreased after the treatment action Criteria results: Client menyatajkan nyei reduced  Rileks appear, able to participate in activities / sleep / rest with the appropriate  Pressure darahnormal  There is no pulse, and RR eningkatan  Intervention: a. Kaji back on location, intensity and pain tpe b. Pertahankan imobilisasi the sick with tirah lie c. Provide a peaceful environment and give impetus to conduct entertainment activities d. Change positions with the help if tolerated e. Jelaskanprosedu before launch f. Akukan danawasi range of movement exercises passive / active g. Drong use stress management techniques, for example: relasksasi, breath in the exercises, visualization imagination, touch h. Observation vital signs i. Collaboration: the analgetik C. Damage the integrity of the network fraktur bd open, surgical repair Destination: damage the integrity of the network can be overcome after the maintenance action Criteria results: Wound healing time in accordance  No laserasi, good skin integrity  Intervention: a. Kaji integrity back injury and observation of signs of infection or drainae b. Monitor body temperature c. Make skin care, often with broken bones in a prominent d. Alihposisi do with the often, pertahankan kesejajaran body e. Pertahankan bed linen bed remains dry and free of wrinkling f. Masage skin ssekitar end parget with alcohol g. Use tenaat bed foam mattress or air according to the indications h. Collaboration emberian antibiotics. REFERENCES 1. Tucker, Susan Martin (1993). Patient Care Standards, V Edition, Vol 3. Jakarta. EGC 2. Donges Marilynn, E. (1993). Nursing care plan, Issue 3, Jakarta. EGC 3. Suzanne Smeltzer, C (1997). Ajar medical books Surgery, Brunner & Suddart. Issue 8. Vol 3. Jakarta. EGC 4. Sylvia Price, A (1994), Patofisiologi: The concept of process-Clinical disease process. 2 volumes. Issue 4. Jakarta. EGC