Four Types & Definitions

Four types & definitions (in my own words): ●​ Four-point gait – Each crutch and each leg move separately (slow but stable, like walking on four legs).​ ●​ Three-point gait – Both crutches and the affected leg move forward together, then the unaffected leg steps through.​ ●​ Two-point gait – Opposite crutch and opposite leg move at the same time (similar to normal walking).​ ●​ Swing-through gait – Both crutches move forward, then both legs swing past the crutches.​ Cane Use ●​ Patient holds cane on the stronger/unaffected side.​ ●​ Move cane forward, then the weaker leg, then the stronger leg follows.​ Traction Purpose: Keeps fractured bones in correct alignment, decreases muscle spasms, and relieves pain.​ Who/why: Used for patients with fractures, contractures, or dislocations. Types of Traction ●​ Skin traction – Uses straps/boots applied to skin; short-term, less weight.​ ●​ Skeletal traction – Pins or wires inserted into bone; longer-term, heavier weights.​ ●​ Manual traction – Hands used to pull bone into place, usually temporary.​ ●​ Balanced suspension traction – Allows patient movement while keeping bone aligned.​ Halo Fixator Why used: Stabilizes cervical spine after fracture or surgery.​ Emergency equipment: Wrench (to remove halo in case of emergency CPR). External Fixators Advantages: 1.​ Allows early mobility.​ 2.​ Easy access to wound care.​ Disadvantages:​ 3.​ High infection risk at pin sites.​ 4.​ Heavy and uncomfortable.​ Cast Care Purpose: Immobilize bone for healing.​ Cast care: Keep dry, don’t put objects inside, monitor circulation.​ Complications: Pressure sores, infection, compartment syndrome. IV Therapy Complications 1.​ Infiltration​ 2.​ Phlebitis​ 3.​ Extravasation​ 4.​ Infection​ 5.​ Air embolism​ 6.​ Fluid overload​ Electrolytes Table Electrolyte Normal Range High (Hyper-) Low (Hypo-) Potassium 3.5–5.0 mEq/L Dysrhythmias, muscle weakness Dysrhythmias, muscle cramps Sodium 135–145 mEq/L Confusion, seizures Confusion, muscle cramps Magnesiu m 1.5–2.5 mEq/L Hypotension, lethargy Tetany, seizures Calcium 9–10.5 mg/dL Constipation, kidney stones Tetany, numbness/tingling Lab Values Table Lab Value Normal Range Body System AST/ALT 10–40 units/L Liver Amylase, Lipase Amylase 30–220, Lipase 0–160 Pancreas Ammonia 15–45 mcg/dL Liver CKMB <5% of CK Heart Troponin <0.03 ng/mL Heart BNP <100 pg/mL Heart failure Creatinine 0.6–1.3 mg/dL Kidneys TSH 0.4–4.2 uIU/mL Thyroid Non-Medication Pain Management 1.​ Heat/cold therapy​ 2.​ Massage​ 3.​ Relaxation techniques​ 4.​ Distraction (music, TV)​ 5.​ Positioning​ 6.​ Guided imagery​ Acute vs. Chronic Pain ●​ Acute: Short-term, sudden onset, resolves with healing.​ ●​ Chronic: Lasts >6 months, continues after healing, impacts daily life.​ Adapting Care: Hearing Loss ●​ Face the patient, speak slowly, use simple words.​ ●​ Write down instructions if needed.​ ●​ Ensure hearing aids are in working order.​ Adapting Care: Vision Loss ●​ Announce presence before touching.​ ●​ Keep items in consistent location.​ ●​ Provide large print or audio materials.​ Positioning Uses ●​ Prone: Improves oxygenation in ARDS.​ ●​ Left lateral sims: Enemas, rectal exams.​ ●​ Semi-Fowler’s: NG tube insertion, promotes lung expansion.​ ●​ Supine: Most surgeries, resting position.​ ●​ Trendelenburg: Hypotension, venous return.​ ●​ Reverse Trendelenburg: Promotes gastric emptying, prevents reflux.​ Risk Factors for Skin Breakdown 1.​ Immobility​ 2.​ Incontinence​ 3.​ Poor nutrition​ 4.​ Poor circulation​ 5.​ Decreased sensation​ Parenteral vs Enteral Feeding ●​ Enteral: Through GI tract (NG, PEG). Risks – aspiration, diarrhea. Nursing: HOB ↑, check residuals.​ ●​ Parenteral: IV (TPN). Risks – infection, hyperglycemia. Nursing: Monitor blood glucose, use sterile technique.​ Diets Table (short version) Diet Prescribed For Allowed Restricted Clear liquid Post-op, GI rest Broth, tea, gelatin Solid foods, milk Full liquid Transition diet Milk, pudding, soup Solid foods Mechanical soft Chewing/swallowing issues Mashed potatoes, soft meat Tough meat, raw veggies Sodium restricted HTN, HF Fruits, unsalted foods Processed foods Renal diet Kidney disease Low K/Phos foods Bananas, nuts High protein/high carb Wound healing Eggs, lean meat High-fat foods Low purine Gout Rice, fruit, veg Organ meats, seafood Carb restricted Diabetes Lean meat, non-starchy veg Bread, sugar Acid ash Kidney stones Meat, eggs, cheese Milk, fruits High fiber Constipation Whole grains, beans Processed foods Low residue Bowel rest White bread, rice Nuts, seeds, raw veggies Hospitalization & Sleep ●​ Noises, frequent vital checks, anxiety.​ ●​ Nurses should cluster care, dim lights, reduce noise at night.​ Factors Influencing Teaching/Learning ●​ Readiness, culture, education level, language, motivation.​ Learning Domains ●​ Cognitive: Knowledge (ex: teaching about diabetes management).​ ●​ Affective: Attitudes/feelings (ex: support group for acceptance).​ ●​ Psychomotor: Hands-on skills (ex: teaching insulin injection).​ Allergies Beyond Medications ●​ Food allergies: Adjust diet orders.​ ●​ Latex allergy: Use latex-free supplies.​ ●​ Environmental allergies: Minimize exposure.