YOUR WEEKEND NCLEX TIP
After hip replacement surgery, the patient should avoid these three positions until fully recovered:
- Bending more than 90 degrees at the waist (for example, bending over to pick something up)
- Internally rotating the leg
- Adducting the legs (including crossing one’s legs)
The device seen above helps to prevent the latter two positions from occurring during sleep
CELEBRITY SATURDAY
A halo brace is a traction device used to stabilize the head and neck after a cervical fracture or dislocation. It is comprised of a circular piece adhered to the skull with four pins, which is attached with rods to a vest. It is the nurse’s responsibility to ensure that the device doesn’t become loosened so that stability isn’t compromised. One major objective of nursing care for a patient with a halo is promotion of skin integrity. The pin sites should be carefully monitored and some hospitals’ policies include prophylactic use of betadine or antibiotic ointment application to the sites. The interior of the vest has a removable sheep skin liner which should be changed once a week or as needed. The skin inside the vest should be kept clean and dry to prevent pressure ulcers from forming. Respiratory function should be monitored every 2-4 hours due to pressure on the diaphragm and the patient may prefer small, frequent meals to reduce pressure on the stomach.
Patients in a halo traction can’t move their head from side to side, often a hand mirror is provided to increase peripheral vision. A wrench must be taped to the vest at all times in case the device must be removed to perform CPR.
Rachel McAdams wears a (modified) halo brace as the character Regina George in the movie Mean Girls.
