What is Intramedullary?
Intramedullary refers to the inside of the bone marrow cavity. In the context of Nursing, it is commonly associated with
intramedullary nailing or rods, which are medical procedures used to treat fractures of the long bones, such as the femur or tibia, by inserting a metal rod into the marrow canal.
Preoperative Nursing Care
Prior to intramedullary nailing, the Nurse's responsibilities include: Conducting a thorough preoperative assessment, including
patient history and physical examination.
Ensuring that all necessary
preoperative tests are completed, such as blood tests, ECG, and imaging studies.
Educating the patient and their family about the procedure, expected outcomes, and potential risks.
Preparing the patient for surgery, which includes fasting protocols, skin preparation, and administering preoperative medications as prescribed.
Intraoperative Nursing Care
During the surgery, the Nurse's role involves: Assisting with patient positioning and ensuring that the
operative field is sterile.
Monitoring the patient’s vital signs and overall condition throughout the procedure.
Providing necessary instruments and supplies to the surgical team.
Documenting intraoperative care and any significant events.
Postoperative Nursing Care
Postoperative care is crucial for recovery and involves: Monitoring vital signs and assessing for complications such as
infections, bleeding, or blood clots.
Managing pain through prescribed medications and non-pharmacological methods.
Providing wound care and ensuring that the surgical site is clean and dry.
Encouraging early
mobilization and physical therapy to prevent stiffness and promote healing.
Educating the patient on signs of complications and the importance of follow-up appointments.
Complications and Nursing Interventions
Complications can arise after intramedullary nailing, and Nurses play a key role in early detection and management. Common complications include: Infection: Nurses should monitor for signs of infection such as redness, swelling, and fever, and report these to the physician.
Non-union or delayed union: Ensuring that the patient complies with weight-bearing restrictions and follows up regularly can help prevent these issues.
Neurovascular compromise: Regular neurovascular assessments should be performed to ensure there is no impairment to blood flow or nerve function.
Deep vein thrombosis (DVT): Nurses should encourage mobilization, use compression devices, and administer anticoagulants as prescribed to prevent DVT.
Patient Education and Discharge Planning
Effective patient education and discharge planning are vital for successful recovery. Nurses should provide information on: Proper wound care techniques and signs of infection.
The importance of adhering to prescribed medications and follow-up appointments.
Guidelines for
activity and weight-bearing to avoid stressing the surgical site.
Exercises and
physical therapy instructions to promote healing and regain strength and mobility.
Conclusion
Intramedullary procedures are vital interventions for managing complex fractures. Nurses play a crucial role in providing comprehensive care from preoperative preparation to postoperative recovery. Through vigilant monitoring, effective pain management, and thorough patient education, Nurses contribute significantly to positive patient outcomes and successful healing.
