蓝色医疗-胫腓骨骨折护理

NURSINGCAREOFFRACTUREOFTIBIAANDFIBULAXXX科室XXX胫腓骨骨折的护理目录/contentsPART

01胫腓骨骨折的相关知识PART

02病情及治疗经过PART

03护理诊断及护理措施PART01胫腓骨骨折的相关知识概述是小腿部支撑体重的主要骨骼，承担约1/6体重胫骨主要供小腿肌肉附着，并加强胫骨的力量，无负重功能腓骨指自胫骨平台以下至踝上的部分发生的骨折。定义很常见，以儿童和青壮年居多。特点概述骨折后易产生成角、短缩、旋转畸形腓骨：骨折较少，较易愈合胫骨的前内侧位于皮下，又有棱角，故骨折端极易穿破皮肤而形成开放性骨折成角侧移旋转短缩分离临床特点010203概述胫骨上1/3骨折时，易造成小腿下段的严重缺血或坏死胫骨钟1/3骨折时，可导致骨筋膜室综合症胫骨钟1/3骨折时，营养动脉损伤，容易发生骨折延迟愈合或不易愈合040506概述直接暴力多为打击、撞击、车轮碾压等间接暴力多由高处坠落、滑倒等所致概述患肢疼痛、肿胀，可有反常活动及畸形开放骨折可见断端外露小儿青枝骨折表现为不敢负重和局部压痛X线可明确诊断临床表现常伴有腓总神经损伤，胫前、胫后动脉损伤，胫前区和腓肠肌区张力增加。临床表现闭合性胫骨骨折1.石膏、支具制动2.外固定架固定3.切开复位内固定4.闭合复位髓内针内固定治疗原则开放性骨折选用上述方法之一固定骨折，并遵循以下原则：清创彻底合理应用抗生素中期闭合伤口中期植骨治疗治疗原则PART02病情及治疗经过患者：李XX，女，55岁否认肝炎、结核病史，否认高血压、心脏病史、“冠心病”、“糖尿病”等病史，否认手术、外伤、输血史，否认药物过敏史。基本信息既往史现病史患者自诉于3小时前骑电动车时被车撞伤后全身，即感左小腿疼痛，活动受限，不能自行站立。当时无昏迷，无头痛头晕、恶心呕吐、胸闷气促、腹痛腹胀等不适，被扶起后，急送至当地医院就诊，经急诊科检查并行X线示：“左胫腓骨粉碎性骨折”，经过输液、止痛等处理后，转入我院就诊，遂以“胫腓骨骨折”收入我科。病程介绍体查患小腿胫前区可见1约18cm伤口，胫前肌肉显露，可见骨折断端，胫骨中上段内侧可见一约4cm伤口，皮肤缺损，有肌肉显露，未见骨折断端，内踝可见一约8*8cm游离皮瓣，未见骨折断端，足背动脉搏动可扪及，患肢趾端血运、感觉及运动可，余肢体未见明显异常。专科检查体温37.0℃呼吸23次/分脉搏88次/分血压93/62mmHg病程介绍入院诊断多发伤：失血性休克左胫腓骨开放性骨折左胫骨平台及内踝骨折左足第三距骨骨折左下肢血管、神经损伤肋骨骨折病程介绍输入日期点击输入相关文字点击输入相关文字点击输入相关文字，点击输入相关文字输入日期点击输入相关文字点击输入相关文字点击输入相关文字，点击输入相关文字输入日期点击输入相关文字点击输入相关文字点击输入相关文字，点击输入相关文字输入日期点击输入相关文字点击输入相关文字点击输入相关文字，点击输入相关文字输入日期点击输入相关文字点击输入相关文字点击输入相关文字，点击输入相关文字病程经过日期专科情况检查结果治疗处理PART03护理问题及护理诊断护理问题及诊断1.疼痛与骨折、手术创伤有关7.躯体移动障碍与疼痛及术后肢体活动受限有关2.营养失调低于机体需要量与食欲降低有关3.潜在并发症下肢深静脉血栓4.潜在并发症骨筋膜室综合征5.有皮肤完整性受损的危险与长期卧床有关6.皮肤完整性受损与左臀部烫伤有关8.焦虑担心疾病预后及费用有关9.知识缺乏缺乏术后功能锻炼及恢复期注意事项的相关知识护理诊断与骨折、手术创伤有关护理目标1.患者及家属可以复述至少两种缓解疼痛的方法。2.自述疼痛减轻，舒适感增加。护理措施1.定时评估患者疼痛分值、性质、部位、起始和持续时间、发作规律、伴随症状及诱发因素。2.左下肢垫软枕，抬高患肢，消除肿胀，减轻因肿胀引起的胀痛不适。3.定时翻身，动作轻柔，避免剧烈搬动患者，减少因长时间仰卧或俯卧引起的腰背肌肉酸痛或不舒适感。应尽量采取健侧卧位，避免压迫伤口。4.指导患者床上使用便器的正确方法，避免随意搬动、拖拽患肢。5.心理护理，教会患者分散注意力的方法，以减轻焦虑与不适。

护理评价1.患者及家属能够复述至少两种缓解疼痛的方法。2.患者疼痛减轻。护理问题及诊断护理诊断营养失调：低于机体需要量护理目标病人营养状况稳定，表现为体重无明显下降。护理措施1.

提供良好的进食氛围：饮食适合患者口味，给予营养丰富易消化的饮食。多食鱼、肉、蛋、蔬菜水果等高蛋白、高维生素等增加抵抗力和组织修复能力的食物。2.加强口腔护理，保持口腔湿润，遵循少量多餐原则，当患者出现恶心、呕吐时，暂停进食3.定期监测体重、血红蛋白、红细胞等指标，随时对症处理。

护理评价患者营养需求基本得到满足。护理问题及诊断护理诊断潜在并发症：下肢深静脉血栓护理目标患者术后未发生深静脉血栓。护理措施1.遵医嘱给与抗凝治疗2.使用间歇充气加压装置，指导患者进行踝泵运动，抬高患肢，适当多饮水3.术后尽早指导患者开始功能锻炼，及下地活动。

护理评价患者术后未发生深静脉血栓。护理问题及诊断感谢观看THANKYOUFORWATCHING医疗护理PPT模板Eventplanningisaneffectivebehaviortoincreasemarketshare.Anactionplanwithexecutable,actionableandcreativeideascaneffectivelyenhancethecompany'sreputationandbrandreputation.适用于工作汇报/会议报告/个人竞聘/述职报告/比赛汇报人：xxx添加相关标题Eventplanningisaneffectivebehaviortoincreasemarketshare.添加相关标题Eventplanningisaneffectivebehaviortoincreasemarketshare.添加相关标题Eventplanningisaneffectivebehaviortoincreasemarketshare.添加相关标题Eventplanningisaneffectivebehaviortoincreasemarketshare.目录CONTENTS此处添加相关标题点击此处添加相关主要内容Eventplanningisaneffectivebehaviortoincreasemarketshare.Anactionplanwithexecutable,actionableandcreativeideascaneffectivelyenhancethecompany'sreputationandbrandreputation.PART

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