Nursing Data 29 MU

🔻اهم النقاط من ٨٥ الى ٨٨ جزء Traction

🔻 Skin Traction 🫧 treatment of children’s fractures and adult fractures or dislocations that require only a moderate amount of pulling force for a relatively short period. 🫧 the child’s skin is more able to tolerate this type of traction than the adult’s. 🫧should not be used on fractures which require more than 5 to 7lbs. (2.7 to 3.2kg). 🫧 not recommended for continuous traction 🫧three to four weeks 🫧is not recommended when controlling limb rotation 🔻 Skeletal traction 🫧 applies the force directly to the bone using pins, wires, screws and 🫧in the case of cervical traction, using tongs or halos applied directly to the skull. 🫧 allows the use of up to 20 or 30lbs. (9 or 14kg) 🫧three to four months 🫧fractures of the femoral shaft. 🫧controls rotation عكس skin مكنتش تنفع ف rotation 🔻Straight-Line Traction: Buck’s Traction. 🫧Pulling force in a straight line with the body part resting on the bed 🫧 fixed limp at one point 🫧using one or more pulleys 🫧only one direction 🫧each pound of weight applied 1 pound of force is delivered. 🔻suspension Russell’s Traction. 🫧traction system is attached to the patient in two or more places. 🫧more stationary points on the traction. 🫧directional lines of pull vectors or force are being applied. 🔻The vectors of force principle 🫧The resultant force (R)=10 pounds. 🫧The vertical pull on the knee sling (C) = 5 pounds 🫧actual horizontal pulling force on the extremity is double the amount of applied weight. 🔻Hamilton-Russell’s Traction 🫧accomplishes the same goal as Russell’s Traction, except it uses skeletal methods. 🫧The horizontal traction force is twice the amount of weight applied 🫧the lift force is equal to the actual weight.

🔻اهم النقاط من ٨٥ الى ٨٨ جزء Traction 🔻 Skin Traction 🫧 treatment of children’s fractures and adult fractures or dislocations that require only a moderate amount of pulling force for a relatively short period. 🫧 the child’s skin is more able to tolerate this type of traction than the adult’s. 🫧should not be used on fractures which require more than 5 to 7lbs. (2.7 to 3.2kg). 🫧 not recommended for continuous traction 🫧three to four weeks 🫧is not recommended when controlling limb rotation 🔻 Skeletal traction 🫧 applies the force directly to the bone using pins, wires, screws and 🫧in the case of cervical traction, using tongs or halos applied directly to the skull. 🫧 allows the use of up to 20 or 30lbs. (9 or 14kg) 🫧three to four months 🫧fractures of the femoral shaft. 🫧controls rotation عكس skin مكنتش تنفع ف rotation 🔻Straight-Line Traction: Buck’s Traction. 🫧Pulling force in a straight line with the body part resting on the bed 🫧 fixed limp at one point 🫧using one or more pulleys 🫧only one direction 🫧each pound of weight applied 1 pound of force is delivered. 🔻suspension Russell’s Traction. 🫧traction system is attached to the patient in two or more places. 🫧more stationary points on the traction. 🫧directional lines of pull vectors or force are being applied. 🔻The vectors of force principle 🫧The resultant force (R)=10 pounds. 🫧The vertical pull on the knee sling (C) = 5 pounds 🫧actual horizontal pulling force on the extremity is double the amount of applied weight. 🔻Hamilton-Russell’s Traction 🫧accomplishes the same goal as Russell’s Traction, except it uses skeletal methods. 🫧The horizontal traction force is twice the amount of weight applied 🫧the lift force is equal to the actual weight.

🔻اهم النقاط من ٨٥ الى ٨٨ جزء Traction 🔻 Skin Traction 🫧 treatment of children’s fractures and adult fractures or dislocations that require only a moderate amount of pulling force for a relatively short period. 🫧 the child’s skin is more able to tolerate this type of traction than the adult’s. 🫧should not be used on fractures which require more than 5 to 7lbs. (2.7 to 3.2kg). 🫧 not recommended for continuous traction 🫧three to four weeks 🫧is not recommended when controlling limb rotation 🔻 Skeletal traction 🫧 applies the force directly to the bone using pins, wires, screws and 🫧in the case of cervical traction, using tongs or halos applied directly to the skull. 🫧 allows the use of up to 20 or 30lbs. (9 or 14kg) 🫧three to four months 🫧fractures of the femoral shaft. 🫧controls rotation عكس skin مكنتش تنفع ف rotation 🔻Straight-Line Traction: Buck’s Traction. 🫧Pulling force in a straight line with the body part resting on the bed 🫧 fixed limp at one point 🫧using one or more pulleys 🫧only one direction 🫧each pound of weight applied 1 pound of force is delivered. 🔻suspension Russell’s Traction. 🫧traction system is attached to the patient in two or more places. 🫧more stationary points on the traction. 🫧directional lines of pull vectors or force are being applied. 🔻The vectors of force principle 🫧The resultant force (R)=10 pounds. 🫧The vertical pull on the knee sling (C) = 5 pounds 🫧actual horizontal pulling force on the extremity is double the amount of applied weight. 🔻Hamilton-Russell’s Traction 🫧accomplishes the same goal as Russell’s Traction, except it uses skeletal methods. 🫧The horizontal traction force is twice the amount of weight applied 🫧the lift force is equal to the actual weight.

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🔽Iumber Disc Herniation

🔻Anatomy : 🫧The discs are made of connective tissue. Connective tissue holds the living cells of the body together. Most connective tissue is made of fibers of a material called collagen. These fibers help the disc withstand tension and pressure. A disc is made of two parts. The center, called the nucleus, is spongy It provides most of the disc's ability to absorb shock. The nucleus is held in place by the annulus, a series of strong ligament rings surrounding it. Ligaments are connective tissues that attach bones to other bones. ➖➖➖➖➖➖ √Most common in >> 30- 40 years √Human supine formed by >> 24 spinal bone 📌ناخد بالنا ان عندي 3 type of pain: 1⃣ Sharp pain >> دا ف حاله لو حصل complete disc herniation بيبقي ممتد الي جزء من الرجل او الرجل كامله 2⃣ Throbbing pain >> ودا ف حاله لو حصل inflammation بلاقيه موجود ومنتشر عندي ف : *Low back *Both hip and buttocks 3⃣pins.needles.numbness >> ودا ف حاله لو حصل pressure on nerve 📌عندنا كمان Symptoms of nerve compression الضغط دا لو نزل ع lower limbs هيسببلي 1-Reflex slow 2-Nerve weaken 3-Impaired sensation in the skin 4- Change in bowel and bladder function 📌 Non-Surgical Treatment (conservative treatment) 1- anti-inflammatory drugs >> aspirin+ ibuprofen 2-narcotic drug >> codeine+ morphine ودا بستخدمه ف حاله لو الأعراض عند المريض Severe 3-muscle relaxants >> ف حاله لو عنده spasm 4-Oral steroids >> ف حاله لو pain spread down to the leg 🫧Lying on back can take pressure off sore discs and nerves. 🫧back support belt (حزام الضهر) can help lower pressure inside the problem 🫧Note:Patients are encouraged to gradually discontinue wearing the support belt over a period of two to four days ، their trunk muscles begin to rely on the belt and start to atrophy (shrink). يعنى مينفعش المريض يلبس حزام الضهر ده فتره طويله لان كده مش هيستخدم back muscle بتاعته وهيعتمد على حزام الضهر ومع الوقت هيحصلها atrophy لو لابس الحزام طول الوقت 🫧Some patients who continue to have symptoms are given an epidural steroid injection (ESI). 🫧Note :Lumbar traction may also be used at first to ease symptoms of lumbar disc herniation. 🔻 surgical treatment: laminotomy discectomy microdiscectomy posterior lumbar fusion 🔻 Indication of surgery 🫧weakening in the leg muscles. 🫧 pain that won't ease up. 🫧 problems with the bowels or bladder.

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🚨أي هي ال nursing care اهم حاجه عندي 👻Turn pt head to the side to open airway 👻Loosen any tight clothing , 👻نضع تحت راسه اي حاجه soft, flat 👻نتجنب ندخل اي حاجه فى فم المريض 👻Avoid using tongue blade, spoon during attacks 👻Place a soft object to protect tongue 👻أعطي للمريض anticonvulsants لل prevent ليست لل cure 👻مراقبه  و حمايه المريض من اي injury أثناء نوبه الصرع 👻مدى التزامه بالعلاج سنيتن لعند ما يكون free from fits ♦️ لو المريض حس بال aura اهم حاجة ال safty بتاعتو ♦️ هشوف ال toxic signs زى ال slurred speech , ataxia , lethergy and dizziness ♦️ انصح المريض ياخد ال enough sleep to prevent attacks ♦️ avoid restraining نركز على الأسئلة ف نهاية الباور 👩‍🦯 بالتوفيق يا أحلى دفعة 🥰

💥Epilepsy الصرع 💥 👉Def: central nervous system disorders اضطراب فى الجهاز العصبي نتيجه  ان نشاط الخلايا بيحصل ليها فهتسبب ليا disruptd هتعمل ليا seizures, loss of consciousness ومشكلة فى السلوك والاحساس 👈أسبابها اي 👻Genetic influence هنا بمختلف عن ال stroke فى الجزئية دي 👻Head trauma 👻Brain condition فى حالات ال brain tumors , stroke ايوه السكتة الدماغية تعمل ليا epilepsy فى المرضى إللى المرهم اكتر من 35 👻Infection diseases (Meningitisالتهاب الاغيشه السحاقيه فى المخ ، AIDS ,encephalitis التهاب في المخ ➡️ inflammation in active tissue of the brain ) 👻Prenatal injury بيحصل والطفل لسه جنين نتيجه عدوى عند الأم أو نقص الأكسجين أو التغذيه 👻Development disorders Autism التوحد ، neurofibromatosis مجموعه من الأمراض العصبية ➡️ high risk of tumer formation / بتكون وراثية 👈أي هي risk factors 🧜Age بتحصل فى اي عمر بس بتزيد فى الطفوله المبكرة واللى سنهم فوق 60  🧜Family history 🧜Head injury ➡️ when you riding a car wear seat belts ➡️ bicycling wear helmet 🧜Stroke, vascular disease 🧜Dementia الخرف 🧜Seizures in childhood لو عنده high fever فى مرحله الطفوله بتكون مصاحبة بنوبات صرع 👈اعراض ال seizures اي ☠️Temporary confusion ☠️A staring spell تحديق ☠️Loss of consciousness ☠️Uncontrollable jerking movements ☠️Psychic symptoms 🚨انواعها مهمه عندي 🚨 ♦️ partial seizures: 👻Simple seizures ال awareness مش بتتغير ولا بتتأثر 👻Complex seizures ال awareness بتتأثر عكس إللى فوق ♦️ generalized seizures : 👻Absence seizures (petit mal) More in children بتحصل ليا فجأه بدون warning signs Brief loss of awareness Lasting  less than 15 s Stare without moving تحديق المريض مش بيكون فاكر اي حاجه من الى حصلت بتحصل ليا مرات عديدة فى اليوم بيكتشفها المدرس 👻Tonic - clonic (grand mal ) بتنقسم عندى ل ٣ مراحل 1. Pre ictal ( aura phase ) الحلو فيها انها بمثابة warning sings السىء فيها انها بتقعد 2-3 min وبعدها تحصل ال attack بتحس هنا انك شايف شىء مش موجود سامع حد او حتى ف طعم metal ف فمك 2. Ictal ( attack phase ) تفقد الوعى لمدة 10 min ♦️ Tonic بتاخد ١٠ ثوانى اطتر من كدا المريض هيموت بيحصل انو المريض بيرفع عينو لفوق وبيعض ع سنانو و extention للجسم عامة وركز ف دى عضلات التنفس تنقبض يدخلى ف cyanosis ♦️clonic من 2-3 دقايق بيحصل contraction و relaxation وال micturation ويعض لسانو 3. Post ictal تعبان هلكان مصدع وعاوز ينام وعندو Todd's paralysis ودا شلل مؤقت 👻Myoclonic seizures Super jerking بتأثر ليا على limbs , Jaws When falling sleep or waking in the morning 👻Atonic seizures A static seizures or drop attacks No loss of consciousness وعندي فيها slumping , nodding 👉🏻 complication Falling فيأذى دماغو Drowning فيغرق عشان كدا بمنع انو مريض الصرع يعوم Car accident أصلو هيفقد وعيو Pregnancy مضاعافات للأم وللطفل سواء بسبب الحركات أثناء الصرع او الدوا * مضاعفات تهدد الحياة un common بس ممكن تحصل : 👀Status epilepticus دى نركز فيها شوية النوبة فضلت اكتر من 5 min وكذا نوبة ورا بعض من غير فاصل من رجوع الوعى Sudden death 👈مهم عندي اعرف ال diagnosis زي EEG MRI, CT Neurologic exam 👈ال treatment عندي فى non pharmacological Ketogenic ياخد اكل high in fat Not miss drug وخد بالك انا بعطيه ال drug أصلا عشان اعمل prevent مش cure ال mono therapy هو ال best ال multiple لا يفضل عشان عشان drug interaction منوقفش ال antiepileptic drugs الا بعد سنتين وتكون free من ال fits 👈أي الإجراءات إللى بعملها أثناء seizures 🦄Put the patient in the lateral position 🦄Auxiliary temperature should be  measured 🦄أتجنب أعطيه IV line فى منطقه antecubital area لأن وقت التشنجات هيحصل عند flexion لل arm هتعمل ليا  block off IV site 🦄افضل normal saline أعطيه للمريض عشان نتجنب الترسيب (precipitation )هو IV diazepam 🚨أي هي الاحتياطات اللازمة لل phenytoin infusion 🧜اننا نطهر IV line بمحلول ملح قبل استخدامها 🧜بنحقن الدوا بمعدلات بطيئة not rapid than 50 mg / min 🧜Monitor ECG , BP 🚨اي الإجراءات إللى بعملها بعد ال seizures 👻Put the patient in the side lying position to facilitate drainage of secretions 👻بعمل documents لل events  إللى أدت ليا للنوبه الصرع وأثناء حدوثها برضو

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