Critically evaulate the care and management of a Scaphoid fracture Essay

Critically evaulate the c atomic number 18 and focussing of a Scaphoid fracture from the perspective of a Emergency Nurse Practiti championr - Essay fashion modelI chose to focus on scaphoid fractures since they are part of the injuries that I am likely to buzz off across as an emergency nurse practitioner (Rutter, 2008). This paper touches on the clinical estimate and differential diagnosis of scaphoid fractures. I will discuss different assessments that a nurse can bring about and the diagnosis process that is supposed to be followed when dealing with a fractured scaphoid. I will also flavor at the psychological as well as the cultural factors that might affect the patient deplorable from a fractured scaphoid. I will also include the treatment options available for scaphoid fractures. There are several issues related to the management of fractured scaphoids. And I will delve deep into some of these issues in my discussion. clinical assessment and differential diagnosis Scap hoid fractures are quite difficult to diagnose correctly since roentgen ray interpretations are normally vague (Gunal, Barton and Calli, 2010). This draws to attention the need of clinical assessment in the diagnosis process. The diagnostic process of a fractured scaphoid needs to be thorough enough to be able to study accurate diagnosis. Signs and Symptoms It is quite challenging to diagnose fractured scaphoids due to the lack of apparent betokens that are common with hit the books fractures. The most common symptom or sign of a fractured scaphoid is tenderness and pain, which is usually tended to(p) by swelling on the wrist (Elhassan and Shin, 2006). However these signs are not very specific and one might make unnecessary outpatient reviews. In the health facility where I worked, MRI technology was employ to a certain the presence of a fractured scaphoid on a patient (Garcia and Holtz, 2001). However, the patient had to sustain plain-film radiographs to ascertain that inde ed in that respect was a fracture on the wrist. The first step of the clinical assessment of the suspected fractured scaphoid was to take the patients history (Bickley, 2005). Taking the history of the patient was important as it showed the tarnish mechanism. For a fractured scaphoid, the injury mechanism normally come to Falling onto the outstretched hand Forced dorsiflexion, with a radially deviated wrist Sometime there could be palmar flexion After checking the common signs of a fractures wrist such as swelling, lack of a strong grip and pain, the next step involved the use of radiographs (Elhassan and Shin, 2006). The lateral radiograph was used to indicate whether or not there was any sign of inconsistency in the alignment of the carpal and distal joints (Edwards and Stillman, 2006). If the patient had positive radiograph results but disconfirming initial clinical findings were treated using cast immobilization for two weeks. After two weeks, the test was repeated to exami ne whether there had been any form of healing or bony resorption at the site of the fracture. Emergency nursing practitioners carried out the initial clinical evaluation which in most cases showed the future(a) (Muscari. 2001) Pain on the wrist Fullness and swelling off the snuffbox, which was a clear indication of detonation Tender palpation in the anatomical snuffbox and scaphoid tubercle Reduction in the range of apparent motion Pronation and ulnar deviation that caused pain Reduced strength of grip When the radiographs failed to indicate the fracture, even when it was apparent there was one, the other option used was MRI. In many health facilities which deal with emergency care for baby bird