Download - Chapter 53 Bandages and Binders
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Chapter 53
Bandages and Binders
Chapter 53
Bandages and Binders
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
BandagesBandages• Purposes and therapeutic benefits
– *To support a limb or joint, a wound or incision
– *To support a wound or incision
– *To hold dressings, splint, cold pack or warm pack in place, or to hold a pad to absorb drainage
– *To immobilize a joint or limb or maintain a limb in a specific position
– *To provide compression, to promote venous return or prevent edema or prevent contractures
– To shape a stump before fitting a prosthesis
– *Wrapped around a clients limbs to provide muscle or joint support or to increase or support circulation
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Wrapping of BandagesWrapping of Bandages
• Type of application
– Figure eight
– Spiral
– Spiral-reverse
– Circular
– Recurrent
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Peripheral Neurovascular Assessment (PNA) Peripheral Neurovascular Assessment (PNA)
• Peripheral neurovascular assessment (PNA)
• Observations (CMS-ET)
– Color of toes or fingers
– Motion or mobility
– Sensitivity or sensation
– Edema and swelling
– Temperature
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In Practice: The Client’s Circulation When Using BandagesIn Practice: The Client’s Circulation When Using Bandages
Refer to Data Gathering in Nursing 53-1
CMS-ET
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Types of BandagesTypes of Bandages• Roller bandages
– All cotton elastic (ACE) bandage
• Usually provides support
• Hold a dressing in place
• Exert pressure over a bleeding point
• Kerlix-stretchy gauze
• Stretch-net bandages-tube gauze
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Antiembolism stockingsAntiembolism stockings
– Thromboembolic disease (TED) stockings
– To promote adequate return circulation and prevent clots
– Remove the stockings at least once every 4-8 hours ad examine the leg carefully for redness, pitting edema, or skin discoloration
– Nursing procedure 53-1
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Nursing Care Guideline 53-1Nursing Care Guideline 53-1
• Applying roller bandage
– Use correct size
– Elevate extremity to be wrapped just above the level of the clients body
– Overlap each layer about ½ the width of the previous strip
– Check the clients peripheral neurovascular status at least every 2 hours
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The PCD MachineThe PCD Machine
• To provide alternating pressure to the legs
– Pneumatic compression device (PCD)
– Sequential compression device (SCD)
– Intermittent sequential compression device (ISCD)
• These machines support circulation and are used primarily for clients immediately after surgery and for those with circulatory disorders.
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The PCD MachineThe PCD Machine
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BindersBinders• Binder
– Wide, flat piece of fabric that is applied to support a specific body part or to hold a dressing in place.
– Arm sling
– T-binder
• Used to hold rectal or perineal dressings in place
– Breast binder
– Abdominal binder
• Flat piece of fabric that is secured around the trunk of the clients body to support the abdomen or dressings on the abdomen
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Applying a binderApplying a binder
• Nursing care guidelines 53-3
– Apply firmly but not to tight
– Fasten the binder from the bottom up
– Rewrap binder every 2-4 hours and check the dressing
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Hypoallergenic TapeHypoallergenic Tape
• Holds a client’s dressings in place
• Supports sprained ankles, fractured ribs, or fractured toes
• Allows ventilation and helps to prevent skin maceration (skin breakdown)
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Montgomery StrapsMontgomery Straps
• May be used if frequent dressing changes are needed
• Helps prevent skin irritation
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Montgomery StrapsMontgomery Straps