Fractures

Question 1

Spiral fx is common for

Answer 1

abuse

Question 2

pulled out of alignment

Answer 2

displaced

comminuted; oblique

Question 3

normal alignment

Answer 3

non displaced

transverse; spiral; greenstick

Question 4

healing process in order:

Answer 4

Fracture hematoma
Granulation tissue
Callus formation
Ossification
Consolidation
Remodeling

Question 5

Assessment

Answer 5

Immobilize
Impaired mobility
Risk for infection
acute pain

Question 6

Health promotion

Answer 6

Teach safety precautions, Advocate to decrease Injuries.

Encourage moderate exercise, Safe environment to reduce falls , Calcium and vitamin D intake.

Question 7

What is important to assess?

Answer 7

Pain
sensation
skin temperature
pulses 
movement

Question 8

Closed reduction

Answer 8

bone is displaced; we have to reduce it

non surgical; manual realignment

Question 9

fitted for immobility device

Answer 9

preoperative

Question 10

important question to ask when getting them out of bed

Answer 10

how much weight they can bear

Question 11

Skin traction:

Answer 11

short term (48-72 hr)
Tape; boot; splint to reduce muscle spasm
5-10 lbs

Bucks traction

Question 12

Priority of assessment for skin traction

Answer 12

skin assessment

are they having a decrease in pain?

Question 13

Long term pull

Align injured bones and joints or treat joint contractures and congenital hip dysplasia

Answer 13

skeletal traction

5-45 lbs

Question 14

Skeletal traction risk for

Answer 14

delayed union
nonunion
infection

Question 15

Maintain counter-traction

Answer 15

balanced suspension traction

Question 16

Balanced suspension traction to remember

Answer 16

weights not touching floor

Keep the ropes knot free

Question 17

Cleaning pin

Answer 17

1x around each pin

Question 18

Fiberglass casts

Answer 18

Lightweight, stronger, more waterproof
Early weight bearing
Activated by submersion in cool or tepid water, then molded to fit body part

Question 19

DO Nots of casts

Answer 19

get cast wet
Remove any padding
Insert any objects inside cast
Bear weight on new cast for 48 hrs
Cover cast with plastic for prolonged periods

Question 20

Application of cast

Answer 20

Cover affected part with stockinette and padding
Immerse plaster of Paris material in warm water, wrap and mold it
Sets in 15 minutes but need 36 to 72 hours before weight bearing
Do not cover: risk for burn and delayed drying
No direct pressure: petal edges (taping around edges)

Question 21

Peripheral vascular

Answer 21

Color and temperature
Capillary refill
Pulses
Edema

Question 22

Pt & caregiver teaching for cast care

Answer 22

Apply ice for first 24 hours
Elevate above heart for first 48 hours
Exercise joints above and below cast
Use hair dryer on cool setting for itching
Check with health care provider before getting wet

Question 23

Dos of cast care

Answer 23

Dry thoroughly after getting wet
Report increasing pain despite elevation, ice, and analgesia
Report swelling associated with pain and discoloration OR movement
Report burning or tingling under cast
Report sores or foul odor under cast

Question 24

Sling implications

Answer 24

To support and elevate arm
Contraindicated with proximal humerus fracture
Ensure axillary area is well padded
No undue pressure on neck
Encourage movement of fingers and nonimmobilized joints

Question 25

Optimal soft tissue/bone healing for nutrition:

Answer 25

Increase protein (1 g/kg of body weight)
Increase vitamins (B, C, D)
Increase calcium, phosphorus , and magnesium 
Increase fluid (2000 to 3000 mL/day)
Increase fiber

Question 26

Compartment syndrome 6 P’s

Answer 26

Pain
Pressure
Paresthesia
Pallor
Paralysis
Pulselessness

Question 27

Risks of anticoagulant therapy

Answer 27

bleeding in gums

tea colored urine

Question 28

FES symptoms/ treatment

Answer 28

Pallor
PaO2 less than 60
LUNG ASSESSMENT
NEURO STATUS

BED REST
FLUID ADMIN
BLOOD TRANSFUSION
Respiratory support