ASUHAN KEPERAWATAN PADA

PASIEN DENGAN DISLOKASI

Oleh:
Hana Ariyani
PENGERTIAN
A dislocation of a joint is a condition in
which the articular surfaces of the distal and
proximal bones that form the joint are no longer
in anatomic alignment.
A subluxation is a partial dislocation and does
not cause as much deformity as a complete
dislocation.
In complete dislocation, the bones are literally
out of joint.
 Traumatic dislocations are orthopedic
emergencies because the associated joint
structures, blood supply, and nerves are
displaced and may be entrapped with extensive
pressure on them.
If a dislocation or subluxation is not reduced
immediately, avascular necrosis (AVN) may
develop.
AVN of bone is caused by ischemia, which
leads to necrosis or death of the bone cells.
ETIOLOGI
The cause is often a fall or a blow, sometimes
from playing a contact sport.
You can dislocate your ankles, knees, shoulders,
hips, elbows and jaw. You can also dislocate your
finger and toe joints.
MANIFESTASI KLINIS
Signs and symptoms of a traumatic dislocation
include:
acute pain,
change in positioning of the joint,
shortening of the extremity,
deformity, and
decreased mobility.
PEMERIKSAAN DIAGNOSTIK
X-ray. An X-ray of your joint is used to confirm
the dislocation and may reveal broken bones or
other damage to your joint.
MRI. This can help your doctor assess damage
to the soft tissue structures around a dislocated
joint.
PENATALAKSANAAN
The affected joint needs to be immobilized at the scene
and during transport to the hospital.
The dislocation is promptly reduced and displaced parts
are placed back in proper anatomic position to
preserve joint function.
Analgesia, muscle relaxants, and possibly anesthesia
are used to facilitate closed reduction.
The joint is immobilized by splints, casts, or traction and
is maintained in a stable position.
Neurovascular status is assessed at a minimum of
every 15 minutes until stable.
After reduction, if the joint is stable, gentle, progressive,
active and passive movement is begun to preserve range of
motion (ROM) and restore strength.
 Surgery. You might need surgery if your doctor
can't move your dislocated bones into their
correct positions or if the nearby blood vessels,
nerves or ligaments have been damaged. Surgery
may also be necessary if you have had recurring
dislocations, especially of your shoulder.
 When properly repositioned, a joint will usually
function and move normally again in a few
weeks. Once you dislocate a shoulder or
kneecap, you are more likely to dislocate it
again. Wearing protective gear during sports
may help prevent dislocations.
PENGKAJIAN
Nursing attention is geared to frequent
assessment and evaluation of the injury
including complete neurovascular assessment
with proper documentation and communication
with the physician
PERENCANAAN
The patient and supportive family members are
educated regarding proper exercises and
activities as well as danger signs and symptoms
to look for, such
as increasing pain (even with analgesics),
numbness or tingling,and increased edema in
the extremity. These signs and symptoms may
indicate compartment syndrome, and if this is
not identified and communicated to the treating
physician, the patient may lose the extremity
REHABILITASI
Rest your dislocated joint. Don't repeat the action that caused
your injury, and try to avoid painful movements.
Apply ice and heat. Putting ice on your injured joint helps reduce
inflammation and pain. Use a cold pack for 15 to 20 minutes at a
time. For the first day or two, try to do this every couple of hours
during the day. After two or three days, when the pain and
inflammation have improved, hot packs or a heating pad may help
relax tightened and sore muscles. Limit heat applications to 20
minutes at a time.
Take a pain reliever. Over-the-counter medications, such as
ibuprofen (Advil, Motrin IB, others), naproxen (Aleve) or
acetaminophen (Tylenol, others), can help relieve pain.
Maintain the range of motion in your joint. After one or two
days, do some gentle exercises as directed by your doctor or physical
therapist to help maintain range of motion in your injured joint.
Total inactivity can cause stiff joints.