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Traction

The document discusses the care of patients undergoing traction therapy. It defines traction, indications for its use, classifications, and potential complications. It outlines the nursing assessment of patients in traction and principles of care, including maintaining alignment, skin care, exercise, and monitoring for complications like infection, DVT, and pressure ulcers. The types of traction are listed and nursing management is described.

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Abdullah Bhatti
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196 views

Traction

The document discusses the care of patients undergoing traction therapy. It defines traction, indications for its use, classifications, and potential complications. It outlines the nursing assessment of patients in traction and principles of care, including maintaining alignment, skin care, exercise, and monitoring for complications like infection, DVT, and pressure ulcers. The types of traction are listed and nursing management is described.

Uploaded by

Abdullah Bhatti
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Adult Health Nursing-II

Care of client with traction


: Facilitator
Miss Ume-Aiman
BSN, RN
:Outlines
 Definition of Traction
 Indication for Traction
 Classification of Traction
 Complications of Traction
 Assessment and Diagnostic Evaluation of Traction
 Principles to follow when caring for the patient in traction
 Types of Traction
 Nursing Management
:Objectives
 At the end of this lecture the students will be able to:
◦ Define the traction
◦ discuss the indication for traction
◦ List the classification of traction
◦ list the complications of traction
◦ Describe the assessment of client with traction
◦ Discuss the Principles to follow when caring for the patient in
traction
◦ List the types of traction
◦ Discuss the nursing management for client with traction
Traction
 Traction is the application of a pulling force to a part of
the body.

 Traction must be applied in the correct direction and


magnitude to obtain its therapeutic effects.
 Indications:

Traction is used to
◦ To minimize muscle spasm.
◦ To reduce align, and immobilize fractures
◦ To reduce deformity .
: Classification of Traction
 Skin Traction : is maintained by direct application
of a pulling force on the client’s skin . It is generally
used as a temporary measure.
 To reduce muscle spasms
 To maintain immobilization before surgery.

 Skeletal Traction : is attaches directly to bone ,


providing a strong steady, continuous pull, and can
be used for prolonged periods .
: Classification of Traction
 The amount of weight used depends on the injury,
pathologic condition, body size, and degree of muscle
spasm.
 Manual Traction :
is applied with hands to temporarily immobilize an injured
part. A firm, smooth, steady pull is maintained . Manual
Traction is used during casting, reduction of a fracture or
dislocated joint.
Complications

Potential complications that may develop include the


following:
 Neurovascular compromise.
 Inadequate fracture alignment..
 Skin breakdown .
 Soft tissue injury.
Complications

Potential complications that may develop include the


:following
 Pin tract infection .

 Osteomyelitis can occur with skeletal traction.


 In additional, complications from immobility can be
encountered , especially with long term traction and in
older adult.
:Assessment

 The nurse must be consider the psychological and


physiological impact of the musculoskeletal problem, traction
device, and immobility.

 The nurse must assess and monitor the patient’s anxiety level
and psychological responses to traction.
:Assessment
 It is important to evaluate the body part to be placed in
traction and its neurovascular status and compare it to the
unaffected extremity.
 As long as the client is in traction, skin integrity must be
assessed and documented, examining especially for redness,
bruises, and lacerations.
: Diagnostic Evaluation
 Radiological Evaluation while the client is in traction
determines the extent of injury, maintenance of bony
alignment, and the progress of healing.
 Additional principles to follow when caring for the
patient in traction:

1. Traction must be continuous to be effective in reducing and


immobilizing fractures.
2. Skeletal traction is never interrupted.
3. weights are not removed unless intermittent traction is
prescribed.
4. Any factor that might reduce the effective pull or alter its
resultant line of pull must be eliminated:
4. The factor that might reduce the effective pull
or alter its resultant line of pull must be
eliminated:
1. The patient must be in good alignment in the center of
the bed when traction is applied.
2. Ropes must be unobstructed.
3. Weights must hang free and not rest on the bed or
floor .
4. Knots in the rope or the footplate must not touch the
pulley or the foot of the bed.
: Types of Traction
• Cervical “ skeletal tongs; Gardner-wells crutch
field vinke “

• Halo vest

• Skin “ chin halter straps “


: Types of Traction
• Lower Extremity “ Bryant’s Traction “

• Buck’s Traction

• Balanced Traction
:Nursing Management
 Alteration in Peripheral Tissue Perfusion:
 Circulatory Care: tissue perfusion is enhanced by client

exercises within the limitations of the traction.


 Exercises, regular deep breathing and coughing, adequate

fluids, and elastic stocking work together to prevent deep


venous thrombosis.
 Teaching the client about anti-coagulant is essential.
:Nursing Interventions
 High risk for peripheral neurovascular dysfunction:
 Peripheral sensation management :
 Accurate assessment of neurovascular status includes
evaluating the client’s pain, sensation, active and passive
ROM, color, temperature, capillary refill time, and pulses.
 Neurologic impairment specific to the location of the

traction should be assessed.


 The client must be instructed to report changes in

sensation.
 Taught the client about the appropriate exercises.
:Nursing Interventions
 Providing pin site care:
The wound at the pin insertion site requires attention .
 The goals to avoid infection and development of osteomyelitis.

Initially :
1. the site is covered with sterile dressing.
2. the nurse must keep the area clean.
3. Slight serous oozing at the pin site is expected.
4. the nurse assess the pin site and drainage for signs of infection.
:Nursing Interventions
 Attaining maximum mobility with traction:
:During traction therapy
The nurse encourage the patient to exercise muscles .1
and joints that are not in traction to guard against
.their deterioration
: During the patient exercises
The nurse ensures that traction forces are .1
maintained and that the patient is properly
positioned to prevent complications resulting from
.poor alignment
:Nursing Interventions
 Maintaining the positioning :
1. The nurse must maintain alignment of the patient’s body
in traction as prescribed to promote an effective line of
pull.
2. The nurse positions the patient’s foot to avoid foot drop ,
inward rotation, and outward rotation.
3. The patient’s foot may be supported in a neutral position
by orthopedics devices.
:Nursing Interventions
 Monitoring and managing potential complications:
Pressure Ulcers
 The nurse examines the patient’s skin frequently for evidence of
pressure or friction.
 It is helpful to reposition the patient frequently and to use
protective devices to relieve pressure.
 If the risk of skin breakdown is high, as in a patient with
multiple trauma or a debilitated elderly patient, use of a
specialized bed is considered to prevent skin breakdown.
 If a pressure ulcer develops, the nurse consults with the
physician and the wound care nurse specialist.
:Monitoring and managing potential complications

Pneumonia
 The nurse auscultate the patient’s lungs every 4 to 8 hours
to determine respiratory status and teaches the patient
deep-breathing and coughing exercises to aid in fully
expanding the lungs and moving pulmonary secretions.
 If the patient history and baseline assessment indicate that
the patient is at high risk for development of respiratory
complications, specific therapies may be indicated.
 If a respiratory problem develops, prompt institution of
prescribed therapy is needed.
:Monitoring and managing potential complications

Venous Stasis and Deep Vein Thrombosis


 Venous stasis occurs with immobility.
 The nurse teaches the patient to perform ankle and foot exercises
within the limits of the traction therapy every 1 to 2 hours when
awake to prevent DVT, which may result from venous stasis.
 The patient is encouraged to drink fluids to prevent dehydration.
 The nurse monitors the patient for signs of DVT, including calf
tenderness, warmth, redness, swelling (increased calf
circumference).

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