Page 2488 - Saunders Comprehensive Review For NCLEX-RN

f. Assess skin integrity to ensure that the
jacket or cast is not causing pressure.
g. Provide sterile pin site care as
prescribed.

5. Client education for halo traction device (Box

69-24)
a. Initiate interventions in support of the
client’s self-image.
b. Teach the client and family pin care,
care of the vest, and signs and
symptoms of infection to report to her
or his PHCP.
R. Interventions for thoracic, lumbar, and sacral injuries
1. Bed rest
2. Immobilization with a body cast if prescribed

3. Assess for respiratory impairment and

paralytic ileus, possible complications of the body
cast.
4. Use of a brace or corset when the client is out of bed
S. Surgical interventions for thoracic, lumbar, and sacral injuries
1. Decompressive laminectomy
a. Removal of 1 or more laminae
b. Allows for cord expansion from edema;
performed if conventional methods fail
to prevent neurological deterioration
2. Spinal fusion
a. Spinal fusion is used for thoracic spinal
injuries.
b. Bone is grafted between the vertebrae
for support and to strengthen the back.

3. Postoperative interventions

a. Monitor for respiratory impairment.
b. Monitor vital signs, motor function,
sensation, and circulatory status in the
lower extremities.
c. Encourage breathing exercises.
d. Assess for signs of fluid and electrolyte
imbalances.
e. Observe for complications of
immobility.
f. Keep the client in a flat position as
prescribed.
g. Provide cast care if the client is in a full
body cast.

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