手的护理和治疗PDF文件-2007.PDF

Hand Care and Treatment Madeline Weiner, RN EB Nurse Educator Goals Maintain and/or reclaim: • maximum mobility of the hands • ability to use the hands in daily life * Very high maintenance * Requires time commitment * Causes pain and discomfort in an already maxed-out environment * affected individual must want to do this!! Intervention Best if done for prevention Necessary to maintain post-op correction – Evaluation by OT / PT – Follow individualized therapy regime (exercise program) – Custom splints – Hand wrapping to prevent webbing challenges are… • webbing and curling (or contractures) of fingers • wrist contractures Abduction and Extension of thumb and fingers • Abduction - pulls a structure away from the midline of the body (spreading the fingers apart, away from the centerline of the hand). • Extension – brings the members of a limb into or toward a straight position. Extension and Flexion of the wrist Prevent contractures of the wrist Prevent contractures of the wrist extension of the palm of the hand • Plan exercises around other activities to help you remember to do them – diaper change or mealtimes Special attention to the thumb Goal: Maintain the thumb web space opposing thumb helps the hand manipulate tools and the environment maintain independence with ADLs (eating, grooming, bathroom) Splints • Recommend night time use • Cover with soft sock to prevent injury to the face or other skin Splints • Maintain separation of