Chapter 67 Flashcards
What is a short-arm cast?
Extends from elbow to palmar crease, secured at base of thumb. When the thumb is included, it is a thumb spica or gauntlet cast.
What a cast?
A rigid external immobilizing device.
What is a long-arm cast?
Extends from axilla to palmar crease.
What is a short-leg cast?
Extends from knee to base of toes.
What is a long-leg cast?
Extends from junction of upper and middle thigh to base of toes.
What is a walking cast?
He short or long leg cast reinforced for strength.
What is a body cast?
It encircles the trunk.
What is a shoulder spica cast?
The body jacket that encloses the trunk shoulder and elbow.
What is a hip spica cast?
It encloses the trunk and lower extremities.
What are fiberglass casts?
They are casts that are lighter weight stronger and more durable than plaster casts.
What are plaster casts?
They are cheaper and more easy to mold but are not as durable and take longer to dry.
What are splints used for?
Conditions that don’t require rigid immobilization.
What are braces used for?
Support, control movement and prevent additional injury.
Why should unrelieved pain be reported to the physician immediately?
To avoid paralysis and necrosis.
What is compartment syndrome?
A life-threatening and limb threatening condition, when there is insufficient blood supply to muscles and nerves due to increased pressure within a compartment such as an arm or a leg or any enclosed space within the body.
How can braces or casts cause pressure ulcers?
Tissue anoxia may lead to tissue breakdown and necrosis.
What is disuse syndrome?
Muscle atrophy due to immobilization in a cast.
What are some important components of teaching the patient self-care?
Participation in self-care and safe use of assistive devices. Identifying areas of self-care deficit and participating in plans to improve independence.
How does the nurse help prepare the patient for cast removal?
By teaching the patient about cast removal, and about care or the limb once the cast has been removed and how to gradually resume normal activity level.
How does the nurse help manage a patient with an immobilized upper extremity?
Elevate the arm on pillows when the patient is lying down, and the use of a sling when the patient is ambulating. Frequent neurovascular assessments are done.
How does the nurse help manage a patient with an immobilized lower extremity?
The leg is supported on pillows at heart level to help control swelling. The patient is taught to elevate the immobilized leg while sitting. Frequent neurovascular assessments are done.
How does a nurse manager patient in a body cast or spica cast?
Preparing and positioning the client, assisting with self-care and hygiene, and monitoring for cast syndrome.
How can a patient in a body cast or spica cast assist in their repositioning?
By using a trapeze bar or the side rails.
What does the nurse monitor for when assessing for possible cast syndrome?
Bowel sounds, abdominal distention, nausea and vomiting
What are external fixators?
They areused to manage open fractures with soft tissue damage.
How often does the nurse do neurovascular assessments?
Every 2 to 4 hours.
Who adjusts the clamps on the external fixator frame?
The doctor.
What is traction?
The application of pulling force to a part of the body.
What are some of principles of traction?
▪️ It must be continuous to be effective
▪️ The patient must be in good body alignment in the center of the bed
What are some types of traction?
▪️ skin traction
What are some nursing interventions for Buck’s traction?
Ensuring effective traction by avoiding wrinkling and slippage of the traction bandage, as well as monitoring for potential complications.
What are some complications with Buck’s traction?
▪️ skin breakdown
▪️ nerve damage
▪️ circulatory impairment
What is skeletal traction?
Traction applied directly to the bone.
What are some nursing interventions with skeletal traction?
▪️ maintaining effective traction ▪️ preventing skin breakdown ▪️ monitoring neurovascular status ▪️ providing pin site care ▪️ promoting exercise
What are some important aspects of nursing care for patient with traction?
▪️ assessing anxiety
▪️ assisting with self-care
▪️ monitoring and managing potential complicate
What are some common complications with traction?
▪️ atelectasis and pneumonia
▪️ constipation and anorexia
▪️ urinary stasis and infection
▪️ venous thromboembolism
What is open reduction with internal fixation?
A surgical procedure that involves exposing the bone and using hardware to fix it.
What are some nursing interventions with joint replacement?
▪️ preventing infection
▪️ promoting ambulation
▪️ post-operatively evaluate cardiovascular, respiratory, renal and hepatic function
What are nursing interventions with hip replacement?
▪️ preventing dislocation of the hip prosthesis ▪️ keeping the legs abducted ▪️ monitoring wound drainage ▪️ venting deep vein thrombosis ▪️ preventing infection
What are some nursing interventions with knee replacement surgery?
▪️ neurovascular assessment of the leg
▪️ encourage active every hour flexion when patient is awake
▪️ monitor wound drainage device
What is a continuous passive motion device?
The patient’s leg is placing the device, which increases circulation and range of motion of the knee joint.
What should the nurse focus on when doing the post operative assessment after orthopedic surgery?
Hydration status, medication history and possibility of infection.
What are some priorities of nursing care for the orthopedic post-operative patient?
▪️ pain management
▪️ maintaining adequate neurovascular function
▪️ promoting health
▪️ improving mobility
▪️ helping the patient maintain self-esteem
▪️ monitoring for potential complications
What are some complications in the post-operative orthopedic patient?
▪️ hypovolemic shock ▪️ atelectasis and pneumonia ▪️ urinary retention ▪️ infection ▪️ thromboembolism and DVT ▪️ constipation
