The procedure for setting up traction is as follows: The neurological condition of the areas of traction must be frequently assessed and inspected, the skin should be assessed and cared for, and the client should be repositioned as much as possible in a frequent manner, typically every 2 to 4 hours. Note if urinary incontinence is occurring due to the inability of the patient to reach the restroom in time.[1]. Compression stockings, or antiembolism stockings or hose, and automatic sequential compression devices are used to promote venous return and prevent emboli, both of which can occur as the result of patient immobilization and other causes such as deep vein thrombosis. They should be applied upon awakening because edema is usually at its lowest point after lying in bed overnight. Some of these preventive techniques include: The Braden Scale for Predicting Pressure Ulcers and the Norton Pressure Ulcer Scale are two of the most popular standardized screening tools that are used to screen and assess clients in order to determine if they are at risk for skin breakdown. In fact, many insurance companies do not reimburse health care agencies for complications resulting from immobility, like pressure injuries, because they are viewed as avoidable with the proper care. To prevent a decrease in lung function, reduce the build-up of fluids in the airways, and prevent pneumonia, clients are often prescribed incentive spirometry to keep their bronchioles open. For example, a client who has had limited mobility for several years may have a joint that can only be moved a few inches, but it is important to maintain that mobility, no matter how small. The fabric should be completely over the toes, or completely at the base of the toes, to prevent skin breakdown or blockage of circulation to the toes. Some of the advantages associated with chemical debridement include its relatively rapid, action and its ability to be selective and not damage healthy surrounding tissue. The plan is tailored to the needs of the individual and will include the specific joints to move. See Table 9.4 for potential complications of immobility by body system and additional preventative measures that will keep clients as healthy as possible.
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