1. Types of Traction Skin: Weights attached to patient’sskin to decrease muscle spams and immobilize the extremity before surgery. Ex Bryant traction (for hip dysplasia in children) and Buck ‘s traction for hip fracture in adult patients). Skeletal: Screws are inserted into bone. Used for long bone fracturessuch asfemur, tibia, fibula, humerus, ulna, radius, metacarpals, phalanges and metatarsals. Halo: used for cervical bone fractures. Nurse should make sure wrench to release rods is attached to the vest, so CPR can be performed. Nursing interventions • Assess neurovascular status every hour for the 1st 24hrs and then every 4 hours. • Do not lift or remove weights • Do not let weights rest on floor (make sure they are hanging freely) • Muscle spams are expected and should be treated w/meds, repositioning, heat, or message. Unrelieved muscle spasms should be reported to provider. • For halo traction, move patient as a unit and do not apply pressure to rods. • Monitor for skin breakdown 2. Lupus Autoimmune disorder that causes chronic inflammation in the body. There is no cure. There are 2 types. Systemic – affects the connective tissues in multiple organs. Discoid - affects skin (butterfly rash). Risk factors: Female, ages 20-40, race (Africa American, Asian, Native American) S&S: Fatigue, joint pain, fever, butterfly rash on face, depression, edema, Raynaud’s phenomenon, anemia, pericarditis, lymphadenopathy. Lab: positive ANA titer, decreased serum completement (C3/C4), decreased RBC, WBC, platelets. Increase BUN and creatinine with kidney involvement. Med: NSAIDs, immunosuppressant agents(prednisone, methotrexate), antimalaria drugs (hydroxychloroquine), topical steroid creams for rash. Interventions: Avoid UV/sun exposure, avoid sick people,stress, cold weather, infection, pregnancy, patient should use mild protein shampoo to wash hair. 3. Gout Inflammatory arthritis, resulting in formation of uric acid crystals in joints and body tissues. Risk: obesity, alcohol, high purine diet (meat), cardiovascular disease, starvation dieting. S&S: severe joint pain in the great toe, erythema, swelling, warmth in affected joint, tophi w/chronic gout. Med: colchicine, NSAIDs, Corticosteriods, allopurinol and probenecid. Interventions; Pt should avoid spicy food, balance diet,stop alcohol consumption, and eat 2hrs before bedtime. 4. HIV/AIDS Retrovirusthat targets CD4+ lymphocytes(T-cells), resulting in decreased immune function and susceptibility to infections. AIDS = stage 3 (end-stage) HIV infection. RF: Unprotective sex, multiple sec partners, perinatal exposure, IV drug use, health care workers. S&S: Flu-like symptoms, weakness, night sweats, headache, weight loss and rash Stage 3 (AIDS) • CD4+ count < 200>