Decreased efficiency of orthostatic NV reflexes and decreased vasopressor
mechanism, altered distribution of blood volume and venous statis.
Leads to inability to adapt to upright position, pooling of blood in extremities, exercise
intolerance, emboli, tissue breakdown and risk for infection
Nursing Considerations for Immobilized Patients
Ongoing multisystem assessment
Allow child to be as active as physically possible
Encourage adequate nutrition
Maintain skin integrity
Provide entertainment/stimulation
Provide opportunities for play
Support to child and family
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Traumatic Injury Treatment
RICE:
Rest, Ice immediately, Compression, Elevation of the extremity (above heart)
Alleviate repetitive stress Usually means reduced activity and alternative exercises,
not bedrest
Immobilization and support (casts or splints as appropriate to injury)
, Fractures in Children
Rare in infants, except with motor vehicle crashes (or abuse)
Clavicle is the most frequently broken bone in childhood, especially in those <10
years old
School age: bike, sports injuries
Where should fractures NOT take place?
Epiphyseal (growth) plate:
Weakest point of long bones is the cartilage growth plate (epiphyseal plate), can
affect future bone growth
Fractures-Manifestations
Generalized swelling
Pain or tenderness
Diminished functional use
May have bruising, severe muscular rigidity, crepitus
Muscle spasms are trying to hold bone in place.
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