“Internal Fixation of the Hip” plus 1 more nursing article(s): NursingCrib.com Updates

Internal Fixation of the Hip

Posted: 23 Feb 2011 10:06 PM PST

Definition

Stabilization of an intracapsular fracture of the femoral neck or an extracapsular fracture of the intertrochanteric region.

Discussion

The procedure is indicated for the patient when early postoperative mobilization may not be feasible.
The procedure could be performed under local anesthesia if necessary because of poor physiologic status.
Fixation can be achieved with a variety of fixation devices, including nails, pins, or compression screws across the fracture site, or sometimes in conjunction with a plate along the femoral shaft.

Position

Supine, either on a fracture table or regular operating table that can accommodate fluoroscopy.

Packs/ Drapes

Total hip extremity pack
Folded towels
Stockinette cuff
Image intensifier drape

Instruments

Basic orthopedic tray
Power drill, cord, drill bits
Fixation device, guide pins

Supplies/Equipment

Basin set
Suction
Blades
Power source for drills
Asepto syringe
Stockinette
Solutions
Medications
Sutures

Procedure

After the patient is asleep, the fracture is reduced and checked by x-ray film.
The incision is made, exposing the fracture site, and the appropriate fixation device is placed after guide wires are inserted temporarily to check alignment.
A drill is used to assist a placement or fixation device, and an x-ray film is taken to reaffirm placement.
The wound is irrigated with antibiotic solution and closed.

Perioperative Nursing Considerations

Have x-ray capabilities in the room.
Notify x-ray department when patient is being positioned on the table. Observe radiologic precautions.
The extremity may be supported postoperatively in a cast, depending on the location/ severity of the fracture.

image by: davelowe.blogspot.com

Pathophysiology, Disease and Etiology

Posted: 23 Feb 2011 10:00 PM PST

Overview

Before discussing about the specifics of a certain disease, its causes and its signs and symptoms, it is essential to establish core fundamentals on pathophysiology, disease and etiology. These provide the context in which all the subsequent information from different publications is presented. Aside from that, it introduces some essential terminology that is widely used by health care professionals.

Pathophysiology versus Pathology

The terms pathology and pathophysiology are most of the time misused and interchanged. Both terms refer to the study of disease, but pathology and pathophysiology are different. PATHOLOGY is applied to the work of pathologist and physicians whose focus is on the PHYSICAL CHANGES present in diseased organs and tissues. These physical changes are studied by obtaining specimens. Such specimens are obtained post-mortem or following after death.

PATHOPHYSIOLOGY, on the other hand, focuses on the ABNORMAL FUNCTIONING of diseased organs with application to medical procedures and patient care. It studies the changes of normal mechanical, physical and biochemical functions which are either caused by a disease or from an abnormal syndrome.

The study of pathology and pathophysiology often overlap in diseases and processes. However, pathology emphasizes direct observations while pathophysiology emphasizes quantifiable measurements. Pathophysiology looks at the specific malfunctioning that comes from or causes of the disease. In pathology, abnormalities may be grossly visible from the obtained specimens. Meaning to say, the abnormalities can be seen with the naked eye or may be observed microscopically.

Disease and Etiology

When can we tell that a person has a disease? Most people consider themselves healthy when their physical and mental capacities can be fully utilized. When impairment is present then we can hear them say that a disease is present. What is the exact definition of disease?

Any disruption in the homeostatic balance required for an optimal cellular function that is expressed at the somatic (whole body) level is recognized as disease. Broadly, it refers to any abnormally condition that impairs normal function. It is associated with specific signs and symptoms that a person clinical manifests.

The word etiology refers to the cause of a certain disease. It is the study of disease causation or origination. Frequently, common usages equate the terms etiology and causes. When the etiology of a disease is unknown, it is said to be idiopathic. In general, there are three categories of etiology. Diseases could be described as genetic (the individual's genes are responsible for the defect), congenital (factors in the embryo's intrauterine environment interfere with normal development) or acquired (other factors encountered later in life produce the disease).