• Non-invasive stimulators use direct current or pulsed electromagnetic fields (PEMFs) to generate a weak electrical current. Electrodes are typically in a band applied over the patient’s skin or cast and worn 10 to 12 hours each day, usually while the patient is sleeping. • Semi-invasive or percutaneous bone growth stimulators use an external power supply and electrodes that are inserted through the skin and into the bone. • Invasive bone growth stimulators require surgical implantation of a current generator in an IM or subcutaneous space. An electrode is implanted in the bone fragments. • Case Study • What type of medication would you expect the health care provider to order for L.G. postoperatively? • What vaccination should he have received in the ED if he were not up-to-date?
• Drug Therapy • Central and peripheral muscle relaxants • Carisoprodol (Soma) • Cyclobenzaprine (Flexeril) • Methocarbamol (Robaxin) • Patients with fractures experience varying degrees of pain associated with muscle spasms. Central and peripheral muscle relaxants, such as carisoprodol (Soma), cyclobenzaprine (Flexeril), or methocarbamol (Robaxin), may be prescribed for management of pain associated with muscle spasms. • Tetanus and diphtheria toxoid • The threat of tetanus from an open fracture can be reduced by administering tetanus and diphtheria toxoid or tetanus immunoglobulin for the patient who has not been previously immunized or whose immunization is expired. • Bone-penetrating antibiotics • cephalosporin (e.g., cefazolin [Kefzol, Ancef]), are used prophylactically before surgery. • Case Study • What will you teach L.G. about his nutritional needs related to bone healing? • Nutritional Therapy • ↑ Protein (1 g/kg of body weight) • ↑ Vitamins (B, C, D) • ↑ Calcium, phosphorus , and magnesium • ↑ Fluid (2000-3000 mL/day) • ↑ Fiber • Body jacket and hip spica cast patients: six small meals a day • An adequate energy source is needed to promote muscle strength and tone, build endurance, and provide energy for ambulation and gait-training skills. • The patient’s dietary requirements must include adequate protein (e.g., 1 g/kg of body weight), vitamins (especially B, C, and D), and calcium, phosphorus, and magnesium to ensure optimal soft tissue and bone healing. • Low serum protein and vitamin C deficiencies interfere with tissue healing. • Immobility and bone healing increase calcium needs. • Three well-balanced meals a day usually provide the necessary nutrients. A well- balanced meal should be supplemented by a fluid intake of 2000 to 3000 mL/day to promote optimal bladder and bowel function. • Adequate fluid and a high-fiber diet with fruits and vegetables will prevent constipation.
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- Fall '16
- Bone fracture