Disease and s/s

Nurses LPN/LVN

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Hey there. I'm an Student Practical Nurse in training. In my course, as I'm sure in others, it is required for us to know some of the common diseases and the s/s associated with it. Now, in testing, I can identity the disease and the s/s; but for some reason, when I am asked later on about a disease, I can't remeber it's s/s. How do you guys learn and retain the information for all the diseases? (it sure is a lot!) thank you. :):):nurse:

anybody heard of Buck's skin traction? thank u

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Specializes in med/surg, telemetry, IV therapy, mgmt.
anybody heard of buck's skin traction?

the proper name for this in most texts is "buck's extension skin traction". it is a skin traction that exerts a pulling force on a part of the body (usually the spine, pelvis or a long bone of the arm or leg) to reduce a fracture, treat a dislocation, correct a deformity, improve or correct contractures or decrease muscle spasms. it is used when a light, temporary, intermittent or noncontinuous pulling force is required. an adhesive or non adhesive tape is used. sometimes a special velcro boot appliance is used. the traction force is normally 5 to 10 pounds. the foot of the bed can be elevated to help provide traction as well. you hang the weight slowly and carefully to avoid jerking the affected extremity. make sure the patient's extremity isn't itself tangled in the traction rope. when applying buck's traction, make sure the line of pull is always parallel to the mattress of the bed and not angled downward to prevent pressure on the heel. placing a flat pillow under the extremity may help as long as it doesn't alter the line of pull.

you document the amount of traction weight that is used and that you have made equipment inspections. document routine neurovascular checks on the involved extremity, the skin condition, respiratory status, and elimination pattern (bms).

while buck's (extension) specifically is a skin traction that uses tape or a special velcro boot appliance, there are two other types of skin traction: pelvic traction that uses a pelvic belt and cervical traction that uses a head halter. the whole idea of this skin traction is to give the patient comfort from their pain, give them some mobility within the confine of their injury, and allow maximum tissue perfusion and pulses to distal areas to the fracture. buck's traction is contraindicated for use if the patient has severe open wounds in the area where the tape or boot appliance would be placed, has an allergy to tape or any of the other skin traction equipment that would be used, has peripheral circulatory problems, dermatitis, or severe varicose veins. complications include:

  • pressure ulcers
  • muscle atrophy
  • weakness
  • constipation
  • stasis of respiratory secretions
  • contractures
  • osteoporosis
  • urinary stasis and calculi
  • pneumonia
  • thrombophlebitis
  • osteomyelitis
  • nonunion or delayed union of the bone
  • complications of immobility
  • depression

i most often saw buck's traction on patients with hip fractures. when the patient was admitted we would wrap the lower leg of the fractured limb in a moleskin type adhesive tape if it hadn't already been done in the er incorporating the metal bar that we would attach the traction to. we would then hang about 5 or 10 pounds of a traction sandbag over the end of the bed which would put the fractured hip in extension. the patient's were then able to turn a little easier in the bed until they went to surgery for the fracture repair the next day or so. they also had less pain if they would stay in the traction. the traction could be easily removed if necessary.

references:

  • nurse's 5-minute clinical consult: treatments by lippincott williams & wilkins, page 376.
  • saunders comprehensive review for the nclex-rn examination, 3rd edition, by linda anne silvestri, page 1002.
  • nurse's 5-minute clinical consult: procedures by lippincott williams & wilkins, page 312-313.

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thank u soo much.. wow that is a lot of useful information. It was on my ATI test in nursing. but I have a question. Is Buck's extension skin traction an effective method to use? It it one of those weights that he pt has their broken leg (usually) on? You said that it was velcro boot application? So you just apply this to the pt's limb and then apply presure?? Plus, I don't understand how u could help alievate pain if you're exerting pressure....:(

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Specializes in LTC.
thank u soo much.. wow that is a lot of useful information. It was on my ATI test in nursing. but I have a question. Is Buck's extension skin traction an effective method to use? It it one of those weights that he pt has their broken leg (usually) on? You said that it was velcro boot application? So you just apply this to the pt's limb and then apply presure?? Plus, I don't understand how u could help alievate pain if you're exerting pressure....:(

NOT pressure, pulling. It relieves muscle spasm, aligns bones, and maintains immobiliaztion.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

buck's traction is effective as a temporary measure to keep a fracture reduced and decrease the pain until the docs can repair it. the traction is applied to the broken leg--not the good leg. i have only seen it used in the acute hospital for people with hip fractures and these people are sent to surgery asap unless they have some critical medical problem preventing them from undergoing anesthesia right away. i wouldn't know about it's use with chronic contractures or muscles spasms, but i can surmise that since it is temporary, the patient can be taken on and off the traction in order to be able to do things. when we had patients in pelvic traction we would disconnect them so they could get up and go to the bathroom--no problem. with muscle spasms you always want to s-t-r-e-t-c-h the muscle that is spasming. any physical trainer will tell you that. some people get muscle spasms all the time due to pinched nerves. traction will work to help with that. the type of traction you use depends on what muscles are spasming and where they are located.

the velcro boots i've seen are just that, like a lower leg boot that fits onto the foot and leg and there are a couple of wide velcro straps that you tape down to hold the boot in place rather than shoe laces (i found a website with a picture of one and listed it below so you can look at one). they have a metal bar attached to the sole of the boot that accommodates the traction rope.

a bone breaks and there are, in the simple cases, two halves (segments). a lot of things happen when a bone breaks. the blood vessels, bone marrow and surrounding soft tissues are also damaged and disrupted--not just the bone itself. bleeding can occur into the surrounding soft tissues because of tearing of blood vessels. some bone tissue, particularly at the actual site of the fracture, dies and this stimulates the body to begin an inflammatory response (remember the cardinal signs of inflammation in order of occurrence are redness, heat, swelling, pain). when a bone fractures, there will be deformity (due to the misalignment of the bone fragments), swelling (due to the inflammatory response), muscle spasm (due to the natural tendency for a muscle to shorten), tenderness (due to trauma), pain (due to trauma, inflammation and muscle spasm) and impaired sensation (due to damaged or pinched off nerves). the position of the bone segments is determined by the pull of the muscles that are attached to that particular bone, which are in spasm, and by the forces that caused the fracture in the first place.

what the traction does is p-u-l-l and the distal segment of a broken bone away from the proximal segment. this does two things:

  • stops the bones from overriding against each other
  • reduces muscle spasms

thus, pain is reduced.

a picture is worth a thousand words:

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buck's traction is effective as a temporary measure to keep a fracture reduced and decrease the pain until the docs can repair it. the traction is applied to the broken leg--not the good leg. i have only seen it used in the acute hospital for people with hip fractures and these people are sent to surgery asap unless they have some critical medical problem preventing them from undergoing anesthesia right away. i wouldn't know about it's use with chronic contractures or muscles spasms, but i can surmise that since it is temporary, the patient can be taken on and off the traction in order to be able to do things. when we had patients in pelvic traction we would disconnect them so they could get up and go to the bathroom--no problem. with muscle spasms you always want to s-t-r-e-t-c-h the muscle that is spasming. any physical trainer will tell you that. some people get muscle spasms all the time due to pinched nerves. traction will work to help with that. the type of traction you use depends on what muscles are spasming and where they are located.

the velcro boots i've seen are just that, like a lower leg boot that fits onto the foot and leg and there are a couple of wide velcro straps that you tape down to hold the boot in place rather than shoe laces (i found a website with a picture of one and listed it below so you can look at one). they have a metal bar attached to the sole of the boot that accommodates the traction rope.

a bone breaks and there are, in the simple cases, two halves (segments). a lot of things happen when a bone breaks. the blood vessels, bone marrow and surrounding soft tissues are also damaged and disrupted--not just the bone itself. bleeding can occur into the surrounding soft tissues because of tearing of blood vessels. some bone tissue, particularly at the actual site of the fracture, dies and this stimulates the body to begin an inflammatory response (remember the cardinal signs of inflammation in order of occurrence are redness, heat, swelling, pain). when a bone fractures, there will be deformity (due to the misalignment of the bone fragments), swelling (due to the inflammatory response), muscle spasm (due to the natural tendency for a muscle to shorten), tenderness (due to trauma), pain (due to trauma, inflammation and muscle spasm) and impaired sensation (due to damaged or pinched off nerves). the position of the bone segments is determined by the pull of the muscles that are attached to that particular bone, which are in spasm, and by the forces that caused the fracture in the first place.

what the traction does is p-u-l-l and the distal segment of a broken bone away from the proximal segment. this does two things:

  • stops the bones from overriding against each other
  • reduces muscle spasms

thus, pain is reduced.

a picture is worth a thousand words:

thank u so much for this information. so lemme c if i understand this correctly. the purpose of buck's traction is to stretch and pull the muscle that is spamsing. when the pt is on it, it is temporary. the traction help to realign the bones and prevent the rubbing of the two bones against one another, thus reducing inflammation. this type of traction also keeps the pt's fractured bone immbolized as possible, but it allows them to get up ad lib. once again, i thank u for you're information. i can't wait to share this with my classmates. :tku::):nurse:

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thank you Daytonite. the pics are great! I understand know. and it all makes sense. Because of this type of traction, it requires the nurse to montior the pt for vs and also do nuerovasuclar checks.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

No, you are not understanding all the information correctly. Re-read my two posts or print them out and highlight portions of them. There is a lot of information there to assimilate.

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ok, I'll re read them.

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Does anybody here have any advice on how to conquer all those "select all the apply" questions. I got some of those questions on a test (ATI) and I didn't do soo well. thank you.

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also, for the SATA (select all that apply) questions I heard that there is a possiblilty the only 1 answer is right out of the 5 possible choices. Is this true? :idea:

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I wanted to thank all of you have replied to my original post. I really appreciate it. I was wondering though, does anyone know a good way to remember the s/s for all electrolyte imbalances such as HYPOmagnesia, hypermagnesia, hypernatremia/ hyponatremia,hyperkalemia /hypokalemia etc. thank u.. :yeah::):typing:nurse:

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