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Key points of postoperative nursing of fracture in children

Key points of postoperative nursing of fracture in children. The nursing work of children is quite different from that of adults. In nursing work, we should fully understand the characteristics of children and do a good job in nursing work in order to achieve good results. Let's talk about relevant nursing measures through several nursing problems.

1. Limb pain

It is often caused by bone injury, soft tissue swelling, over tightening of external fixation, infection during open fracture, pressure ulcer, etc. severe pain in limbs should also be considered to be caused by osteofascial compartment syndrome.

Nursing measures:

Because most children can not accurately describe the symptoms of pain, and children who do not have the ability of language expression often take crying as the most significant signal of pain. Therefore, the swelling of the affected limb, skin temperature, limb blood circulation, active and passive movement of the distal limb, traction or external fixation effect and limb placement should be observed and checked in detail.

In case of severe limb swelling, the affected limb should be properly raised and children should be guided to strengthen muscle relaxation and contraction activities, promote venous reflux and accelerate the regression of swelling. For those who cannot cooperate, parents should be instructed to help them complete, or passive limb massage.

Pain caused by too tight external fixation. Release and re fix in case of emergency.

Symptomatic nursing such as drug therapy, cold therapy and hyperthermia were used for normal reactive pain caused by injury.

2 elevated body temperature

Most of them are caused by infection caused by absorbed heat or open injury.

Nursing measures:

Children's high fever is mainly physical cooling. Warm water bath effect is better. Antipyretic suppository can be used.

Drink plenty of water and give high protein, high vitamin, high calorie and digestible diet.

Oral care should be done for high fever.

When sweating heavily, change the clothes in time to keep the skin clean.

3. Functional exercise cannot be completed

In the early stage of injury, due to pain and fear, the patient's self-protection performance is very strong. Even slight activities are often refused, making early exercise difficult. In the later stage of injury, due to the relief of pain, children's active nature began to show. In activities, the awareness of self-protection is weak, which is prone to re injury and affect the normal healing.

In the later stage of injury, due to the disappearance of pain, children do not pay attention to self-protection during the activity of the injured limb, which is easy to cause excessive activity and re injury. Therefore, we should pay attention to: (1) first, ensure the stability and reliability of external fixation( 2) Taboo violent activities( 3) Strengthen protection during activities to prevent re injury.

4 damaged skin integrity

Infants have delicate skin and poor language expression ability. During treatment, skin damage is easy to be caused due to external fixation compression and urine feces immersion.

Nursing measures:

Those who use traction, gypsum and external fixation with board shall strengthen patrol inspection and adjust in time.

Pay attention to children's skin cleanliness and hygiene, and scrub daily, especially at the skin folds such as neck, armpit, elbow and groin.

In summer, pay attention to the prevention of prickly heat, strengthen ventilation, avoid overheating, and loose clothes. In summer, babies should turn over more when sleeping, take a bath often, and wipe prickly heat powder after bathing. During treatment, wash and dry with warm water, and apply prickly heat powder or calamine. Avoid washing and scalding with hot and soapy water. Taboo ointment, paste and oil preparation.

Pay attention to prevent wet dermatitis. Clean the perineum and keep it dry after each defecation.

5 psychological response to stress

Children hospitalized due to injury feel strange and afraid of the hospital environment because of pain, or because external fixation limits their activities. Their emotions are affected, often manifested as crying, refusing to eat, refusing treatment, etc.

According to the psychological characteristics of different ages. Infants have less response, and children around the age of four have more prominent response. They should be more concerned and considerate. They can use stories, toys and other methods to distract their attention. Older children can cooperate with treatment and nursing through patient guidance.

Because children are young and have poor self-care ability, it is necessary to strengthen the guidance to parents and obtain the cooperation of parents in order to better complete the care of children.