Chapter 32 Part 4 Flashcards
Provide support for fractures that has been reduced
It can be easily removed for assessment and care of the skin then reapplied
Brace and splint
What type of braces use for the elbows and knee
Hinge brace
A fresh plaster cast should never be
Should never be covered air circulation speeds up drying
Is the application of mechanical pull to a part of the body for the purpose of extending and holding the part in a certain position during immobilization
Traction
What are the two types of traction
Skeletal and skin traction
The surgeon inserts pins, wires, or tongs directly through the bone at a point distal to the fracture so that the force of the pull from the weight is it exerted directly on the bone
Skeletal traction
A bandage or foam traction boot is applied to the limb below the site of fracture and pull is exerted on the limb
Skin traction
What is the difference between skin and skeletal traction
Skeletal use 10lb or more
Skin 7 to 10 lbs
Open comminuted fracture should be surgically addressed w/in
What is given one hour before the surgery and after the surgery
Six hours to decrease the chance of infection
Cefazolin one hour before and 2 doses after
What should the nurse monitor if the pt had a fracture. Levels
WBC
Temp
Appearance
Redness and swelling
Heat and purulent
Is a bacterial infection of the bone
Osteomyelitis
The most causative organism to cause osteomyelitis is
Staphylococcus aureus
Enters the bloodstream from a distant focus of infection
Such as boil or furuncle or open wound
Staphylococcus aureus
Where is osteomyelitis usually found
Tibia or fibula
Vertebrae
Or at the site of joint prosthesis
S/s of osteomyelitis
Severe pain
Tenderness at site
High fever with chill
Swelling of adjacent soft parts
Headache
Malaise
Pt with diabetes or with chronic renal failure or on long term steroids are all at risk of
Infection and osteomyelitis
How is osteomyelitis diagnosed
Laboratory findings indicating acute infection which = high wbc
Radiograph which shows bones destruction 7 to 10 days after onset of the disease
History of injury to the part, open fracture, boil, FURUNCLES, and other infections
Biopsy in which the bones sample exhibit signs of necrosis
What type of treatment is needed or earlier osteomyelitis
Intervenous antibiotics which are prescribed 4 to 6 weeks
Debridement
The abscess is incised and drained
A simple skin traction that is used to treat muscle spasms from fractures of the hip or femur, preoperatively, and for dislocation of the hip
Bucks extension
the use of tongs inserted into the skull, the use of a halo device, or a head halter
Cervical traction
Failure to heal
Nonunion
A fraction that fail to heal how can it be treated
Why do use this
By electrical bone growth stimulating device =growth of bone cells (osteogenesis )
It can prevent further surgery and bone grafting
Is rare but serious complication of fractures of the bone that has an
Abundance of Morrow fat
Example include
Fat embolism
Long bone, pelvis, and rib
Sign and symptoms of fat embolism
Change in mental status
Respiratory distress
tachypnea
Crackles and wheezes
On auscultating the lungs
Rapid pulse
Fever
Petechiae
A fine rash over the chest, neck, upper arms, or abdomen
Petechiae
What should the nurse to when the patient has a fat embolism
Stay with the patient
Put them in high Fowler position
Use a nonrebreather mask and give high flow of oxygen
Establish a peripheral IV line
Intubation or mechanical ventilation may be needed
When should you get the provider when a patient has a fat embolism
Immediately because there is a proximately 80% mortality rate from this complication since it’s very rare
Anticipate hydration what IV fluids and correction of acidosis
Who are at high risk for a fat embolism
Older adults with fractured hip
What are vulnerable to thrombus formation
The veins of the pelvis and lower extremities
What are used when you have a Venous
Thrombosis on the unaffected lower extremities
Compression stockings
Sequential compression device and range of motion
What are you look for when a patient has a VENOUS thrombosis
If the patient is on any prophylactic anti-coagulant
Aspirin warfarin heparin
It is a restriction of blood flow that occurs in one or more muscle compartment of the extremities
Compartment syndrome
Is caused by the external or internal pressure
Compartment syndrome
Occur from the dressing or casts that are too tight
External pressure
Occurs from IV fluid infiltration, inflammation and Edema
Internal pressure
What is key to preventing swelling and compartment syndrome
Toes and fingers should be higher than
Elevation
The truck
Sign and symptoms of compartment syndrome is
Severe unrelenting pain
And unrelieved by narcotics
Decrease sensation
Numbness and tingling
Paleness of the skin
Weakness of extremities are other signs
What are the six things that you assess for when dealing with compartments syndrome
What are you doing when you see those type of symptoms
Pain
Pallor
Paresthesia
Pulselessness
Paralysis
Poikilothermia
Notify the provider immediately
Cold to touch
Poikilothermia
Split through all the layers of material
Bivalved
Linear incision in the fascia down the extremities
Fasciotomy
What is done for post treatment of a factor
Rice
Elevating the limb
Pain medication
If pain is not relieved within 30 minutes notify their healthcare provider
Every immobilized patient should be routinely assess for the various problems of
Skin breakdown
UTI
Constipation
Atelectasis
DVT
Adequate nutrition and fluids are needed to promote healing
