fracture

Question 1

patho of a fracture

Answer 1

A fracture is a break in the bone secondary to trauma or a pathological conditional.

Question 2

complete fracture

Answer 2

when a bone breaks into two separate pieces

Question 3

incomplete fracture

Answer 3

when the bone cracks and bends but does not completely break

Question 4

pathological fracture

Answer 4

occurs to bone that is weak from a disease process (bone cancer or osteoporosis)

Question 5

fatigue fracture

Answer 5

results when excess strain occurs from recreational and athletic activities

Question 6

compression fracture

Answer 6

Produced by a loading force applied to a long axis of cancellous bone

Question 7

stage 1

Answer 7

Occurs within 24-72 hours after injury. Hematoma form at fracture site

Question 8

stage 2

Answer 8

Typically begins on day 3 and lasts 2 weeks. Granulation tissue invades fracture site and fibrocartilage forms.

Question 9

stage 3 `

Answer 9

A callus formation has begun, and bone healing occurs

Question 10

stage 4

Answer 10

the callus is gradually resorbed and transformed into bone.

Question 11

stage 5

Answer 11

Remodeling of bone occurs

Question 12

four major complications of acute fractures

Answer 12

infection
acute compartment syndrome
vte
fat embolism

Question 13

infections cm

Answer 13

fever, high WBC, chills and sweats, SOB, inflammation, swelling

Question 14

acute compartment syndrome

Answer 14

pain due to reduced perfusion: pain severe despite being medicated, which causes further ischemia. Sensory perception deficits and paraesthesia. Pale color due to low perfusion and weak pulses. Cyanosis, tingling, and numbing can occur if not treated.

Question 15

vte cm

Answer 15

SOB, rapid breathing, chest pain upper rib cage, heart rate increases, leg pain or tenderness of the leg or calf, edema to the LE

Question 16

fat embolism cm

Answer 16

Dyspnea, increased RR, decreased o2 sat, tachycardia, confusion, chest pain

Question 17

delayed union

Answer 17

Fracture takes longer than usual to heal (longer than 6 months)

Question 18

nonunion

Answer 18

Fracture that never heals

• Electric bone stimulation and bone grafting can treat
• Low intensity pulsed ultrasound can promote healing to treat
• Can occur more frequently in older adults due to impaired healing process
• Can cause immobilizing deformity of the bone involved

Question 19

malunion

Answer 19

Fracture heals incorrectly

Can cause immobilizing deformity of the bone involved

Question 20

What assessment methods do you need to include as part of this neurovascular assessment and what are your expected normal findings for each assessment?

Answer 20

Color and temperatures
Movement 
Sensation 
Pulses
Cap refill
Pain

Question 21

closed reduction and imbolization

Answer 21

The doctor realigns the bones by use of splints, orthopedic boots or casts

Question 22

open reduction and internal fixation

Answer 22

The doctor cuts open your lower leg to view the broken bones and may put in metal pins, screws, rods or plates

Question 23

The ABG results are available, and an additional set of vitals were just obtained.
Arterial Blood Gases Vital Signs
pH 7.55 BP 150/92 mmHg
PaCO2 24 mmHg HR 110 bpm
HCO3 24 mEq/L RR 28 bpm
Pa02 56 mmHg T 99F
Sa02 86% Room Air

What is your interpretation of the ABG’s? What do you think is happening to M.M.?

Answer 23

Respiratory alkalosis

Pulmonary embolism

Question 24

The chest x-ray shows a small right infiltrate. The physician suspects and embolism, either pat or pulmonary and orders a STAT ventilation/perfusion (VQ) lung scan. The interpretation of the results reads “strongly suggestive of a pulmonary embolism (PE).

10. What are the most likely sources of the embolism?

Answer 24

M.M was bed bound developed dvt or a fat embolism due to fracture , PTT was low, High pH and CO2

Question 25

fiberglass cast

Answer 25

• When it is first applied it feels hot because of chemical reaction on skin then it becomes damp and cool
• It takes 24 hours to dry.
• If tissue integrity is impaired they can cut a window to ventilate.
• Frequent monitor of neurovascular assessment

Question 26

You perform a quick CMS (color, motion, sensitivity) check on the toes, and note that the toes are more swollen than this am, they appear pale, are cool to touch and M.M. reports despite receiving his pain medication his pain is more severe. What do you think is happening to M.M.?

Answer 26

Compartment syndrome

Cast preventing expansion

Question 27

what causes compartment syndrome

Answer 27

Pressure builds up inside the fiberglass cast.

Question 28

if compartment syndrome left untreated, what could happen

Answer 28

cyanosis
necrosis
amputation

Question 29

how to treat compartment syndrome

Answer 29

Fasciotomy- fascia is cut to relieve swelling and pressure in compartment of the body