Fractures Flashcards
Spiral fx is common for
abuse
pulled out of alignment
displaced
comminuted; oblique
normal alignment
non displaced
transverse; spiral; greenstick
healing process in order:
Fracture hematoma Granulation tissue Callus formation Ossification Consolidation Remodeling
Assessment
Immobilize
Impaired mobility
Risk for infection
acute pain
Health promotion
Teach safety precautions, Advocate to decrease Injuries.
Encourage moderate exercise, Safe environment to reduce falls , Calcium and vitamin D intake.
What is important to assess?
Pain sensation skin temperature pulses movement
Closed reduction
bone is displaced; we have to reduce it
non surgical; manual realignment
fitted for immobility device
preoperative
important question to ask when getting them out of bed
how much weight they can bear
Skin traction:
short term (48-72 hr) Tape; boot; splint to reduce muscle spasm 5-10 lbs
Bucks traction
Priority of assessment for skin traction
skin assessment
are they having a decrease in pain?
Long term pull
Align injured bones and joints or treat joint contractures and congenital hip dysplasia
skeletal traction
5-45 lbs
Skeletal traction risk for
delayed union
nonunion
infection
Maintain counter-traction
balanced suspension traction
Balanced suspension traction to remember
weights not touching floor
Keep the ropes knot free
Cleaning pin
1x around each pin
Fiberglass casts
Lightweight, stronger, more waterproof
Early weight bearing
Activated by submersion in cool or tepid water, then molded to fit body part
DO Nots of casts
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
Application of cast
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)
Peripheral vascular
Color and temperature
Capillary refill
Pulses
Edema
Pt & caregiver teaching for cast care
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
Dos of cast care
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
Sling implications
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
Optimal soft tissue/bone healing for nutrition:
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
Compartment syndrome 6 P’s
Pain Pressure Paresthesia Pallor Paralysis Pulselessness
Risks of anticoagulant therapy
bleeding in gums
tea colored urine
FES symptoms/ treatment
Pallor
PaO2 less than 60
LUNG ASSESSMENT
NEURO STATUS
BED REST
FLUID ADMIN
BLOOD TRANSFUSION
Respiratory support
