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NUR 211 Krissa > Fractures > Flashcards

Fractures Flashcards

1
Q

A disruption or break in the continuity of bone

A

A Fracture

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2
Q

Fractures are most common in patients with what comorbidities?

A
  • Cushings
  • Osteoporosis
  • Osteogenesis imperfecta
  • cancers
  • anorexia
  • Paget’s disease
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3
Q
  • A genetic disorder that prevents the body from building strong bones
  • Also known as brittle bones
A

Osteogensis Imperfecta

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4
Q

Chronic Disorder that causes bones to grow larger and become weaker than normal

A

Paget’s disease

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5
Q

What kind of fracture is this?

A

Complete fracture

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6
Q

What kind of fracture is this?

A

Incomplete fracture

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7
Q

What kind of fracture is this?

A

Closed, Simple non-displaced

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8
Q

What type of fracture is this?

A

Closed simple displaced

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9
Q

What type of fracture is this?

A

Open Compound

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10
Q

What type of fracture is this?

A

Avulsion

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11
Q

What type of fracture is this?

A

Comminuted

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12
Q

What type of fracture is this?

A

Compression fracture

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13
Q

What type of fracture is this?

A

Depressed

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14
Q

What type of fracture is this?

A

Greenstick fracture

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15
Q

What type of fracture is this?

A

Oblique fracture

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16
Q

What type of fracture is this?

A

Spiral fracture

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17
Q

What type of fracture is this?

A

Impacted fracture

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18
Q

What type of fracture is this?

Disruption that spans across the width of the bone; causing bone fragments

A

Complete

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19
Q

What type of fracture is this?

Disruption occurs through part of the bone cortex; no displacement of bone fragments

A

Incomplete fracture

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20
Q

What type of fracture is this?

Fracture is contained within the skin

A

Closed simple

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21
Q

What type of fracture is this?

Fracture that is contained within the skin and the bone is still in proper alignment

A

Closed, simple, non-displaced

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22
Q

What type of fracture is this?

Fracture that is contained within the skin but the bone is not properly aligned

A

Closed, simple, displaced

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23
Q

What type of fracture is this?

Disruption where pieces of bone protrude through the skin, creating an external wound that exposes the fracture site. These fractures are graded based on severity

A

Open Compound

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24
Q

What Grade of compound fracture is this?

Presence of puncture wound, minimal soft tissue injury, vasculature remains intact

A

Grade I Compound fracture

Or Open

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25
Q

What grade of compound fracture is this

Puncture wound, fragments of broken bone, moderate skin and muscle contusions, significant wound contamination

A

Grade II compound fracture

Or Open

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26
Q

What grade of Compound fracture is this?

Severe damage to soft tissues, nerves, muscles, and blood vessels. Open fracture site is extremely contaminated. Contains numerous comminuted fractures

A

Grade III Compound Fracture

Or open

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27
Q

What type of fracture is this?

Caused by over stretching and tearing of a tendon or ligament, separating a small segment of bone at the insertion site

A

Avulsion Fracture

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28
Q

What type of fracture is this?

Shattered bone fragments at the site of disruption

A

Comminuted Fracture

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29
Q

What type of fracture is this?

Caused by excessive force along the axis of spongy bone, making the bone collapse on itself

A

Compression Fracture

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30
Q

What type of fracture is this?

Disruptions where bone fragments are forced inward, associated with blunt force trauma to facial and skull fractures

A

Depressed Fracture

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31
Q

What type of fracture is this?

Bone fragments not in proper alignment

A

Displaced fracture

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32
Q

What type of fracture is this?

  • Incomplete disruption where one side of the bone is bent and the other is fractured
  • Typical in children d/t bone flexibility
A

Greenstick fracture

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33
Q

What type of fracture is this?

  • Bone fragments are well approximated at the site of disruption
  • Bone pieces are lined up
A

Non-displaced fracture

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34
Q

What type of fracture is this?

Break occurs at a 45-degree angle across the bone

A

Oblique Fracture

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35
Q

What type of fracture is this?

Fracture wraps around the shaft of the bone

A

Spiral fracture

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36
Q

What type of fracture is this?

Segments of bone are wedged into eachother at the fracture line

A

Impacted fracture

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37
Q

Medications used to treat Fractures

A
  • Opioids and NSAIDs - the manage and relieve pain
  • ABX for open fractures with contaminated wounds to prevent OM and other infections
38
Q

Name the 6 P’s

Neurovascular assessment

A
  • Pain
  • Pressure
  • Paralysis
  • Pallor
  • Paresthesia
  • Pulselessness
39
Q

Nursing assessment of a fracture

A
  • Inspect site of injury
  • Palpate extremity noting 6 P’s
  • Verify correct positioning, application, and stability of imobilization devices
  • Assess vital signs - includes pain!
40
Q

The presence of one or more of the 6 P’s can indicate what?

A

Neurovascular compromise

41
Q

Neurovascular compromise can lead to what?

A
  • Hemorrhage
  • Compartment syndrome
  • Infection
  • Permanent loss of function
42
Q

Absence of 6 P’s indicate what?

A

Proper treatment is being provided and there is no neurovascular compromise

43
Q

The following vital signs can indicate what in fracture patients?

Low BP
Tachycardia
Tachypnea

A

Hemmoragic Shock d/t excessive bleeding

44
Q

An elevated temperature can indicate what in a fracture patient?

45
Q

The following vital signs indicate what in a fracture patient?

  • Tachycardia
  • Tachypnea
  • Decreased O2
A

Pulmonary Embolus

46
Q

The following are clinical manifestations of what?

  • Pain
  • Deformity
  • Sometimes an open wound
47
Q

This is released from damaged muscle and may indicate the presence of rhabdomylosis, which may lead to renal compromise or failure

48
Q

This is released with any muscle breakdown, and with rhabdomyolysis the levels are very high.

A

Creatine Phosphokinase
or
CPK

49
Q

Type of blood test

used to detect signs of infection (WBCs) and blood loss (Hgb & Hct)

A

Complete Blood Count
or
CBC

50
Q

A type of blood test

checks for electrolyte imbalances, which can indicate renal failure

51
Q

A type of blood test

checks for proper kidney functioning and can lead to renal failure

A

Renal panel

52
Q

Hematuria or tea colored urine can indicate what?

A

Rhabdomylosis

53
Q

Lab tests for fractures

A
  • Myoglobin
  • Creatine Phosphokinase
  • CBC
  • CMP
  • Renal panel
  • Urinalysis
54
Q

Non-Surgical Treatment of fractures

A
  • Closed reduction
  • Traction
55
Q
  • Manual manipulation of bone fragments to put in proper alignment
  • Uses anesthesia
  • After realignment, bone is placed in cast or splint

A type if non-surgical treatment for a fracture

A

Closed reduction

56
Q

Surgical Treatment of fractures

A
  • Open Reduction External Fixation or OREF
  • Open Reduction Internal Fixation or ORIF
57
Q

Plates, screws rods into fracture

Surgical tx for fx

A

Open reduction Internal Fixation

58
Q

Rods and pins around fracture to stabilize it

A

Open reduction external fixation

59
Q

Types of anesthesia used on patients with a fracture

A
  • Conscious sedation
  • General Anesthesia
  • Nerve block
  • Spinal block
60
Q

Non-ridgid immobilization to maintain alignment

A

Splint or sling

61
Q

Rigid immobilization to maintain alignment; made of fiberglass or plaster for use on weight bearing extremities

62
Q
  • Pins, tongs, screws, and wires are surgically screwed to the bone weight is then applied to provide alignment
  • i.e. Halo device
A

Skeletal traction

63
Q
  • Uses flexible harness, boot, or belt to secure the extremity while 5-10 lbs of weight is applied to relieve muscle spasms and maintain the length of the bone
  • i.e. Bucks traction
A

Skin traction

64
Q
A

External Fixator

65
Q
A

Traction Device

66
Q

Nursing dx for patients with a fx

A
  • Acute pain r/t muscle spasms and trauma
  • Activity intolerance r/t immobility
  • Impaired mobility r/t limb immobilization
  • Impaired skin integrity r/t presence of cast, splint, and traction
67
Q

Patient teaching for fx patients to maintain pulmponary hygiene

A
  • Incentive spirometry to prevent post-op PNA
  • Coughing and deep breathing to promote expansion of aveoli
68
Q

The following indicate what complication associated with a fx

  • Decreased blood flow & oxygen to tissues
  • Severed vessels or nerves by bone fragments
A

Neurovascular Compromise

69
Q

How to correct NV compromise

A
  • Elevation
  • remove cast/splint
70
Q

The following are all risk factors for what?

  • Immobility
  • trauma
  • cardiac disease
  • long surgery
  • obesity
  • smoking
  • BCP use
71
Q

How to prevent VTE in a fracture patient

A
  • Early ambulation
  • Anticoag therapy
72
Q

The following indicate what complication associated with a fx

  • Occurs in long bone fractures, very frequent in fx of the arms and legs (radius, ulnar, humerus, femur, tibia, fibula)
  • Fatty bone marrow migrate into systemic circulation and clog smaller blood vessels
A

Fat Embolism

73
Q

The following are S/S of what?

  • Respiratory distress
  • Acute confusion
  • Generalized petechiae
  • Restlessness potentially leading to respiratory failure and death
A

Fat Embolism

74
Q

The following are S/S of what?

  • Severe flank pain
  • Dark, tea-colored urine
  • Elevated serum myoglobin level
A

Rhabdomylosis

75
Q
  • Compression & tissue ischemia -> restricted blood flow to muscle -> myoglobin spills into circulation -> nephrons are clogged -> Renal failure
  • Could also see multiple electrolyte imbalances
A

Rhabdomylosis

76
Q

How to correct rhabdomylosis

A

IV fluids to flush kidneys

77
Q

Complication associated with a fx

Fracture fails to heal in correct alignment, or fails to heal all together.

A

Malunion and nonunion

78
Q

How to prevent malunion and nonunion

A

Frequently check the positioning of the immobilization device

79
Q

Name this complication associated with a fx

  • Increased edema and hemorrhage in the area of the fracture, causing compression of nerves and blood vessels
  • Can be caused by a cast, immediate removal is necessary
A

Compartment syndrome

80
Q

All of the following are S/S of what?

  • Pain out of proportion to the injury
  • Passive pain at rest of the affected limb, hurts worse when moved
  • All of the 6 P’s are present
  • Pallor, paralysis, and pulselessness are considered late findings
A

Compartment Syndrome

81
Q

Late findings of compartment syndrome

A
  • Pallor
  • Paralysis
  • Pulselessness
82
Q

How to fix compartment syndrome

A

*Remove cast
* Immediate Fasciotomy – incisions are made through the fascia over the affected compartment to relieve pressure
* NOTIFY PROVIDER IMMEDIATELY!!

83
Q

Blood clot that breaks off and travels through the heart into the lungs

A complication associated with a fracture

A

Pulmonary Embolus

84
Q

The following are S/S of what?

Sudden, intense dyspnea
Pleuritic chest pain
Tachypnea
Tachycardia
Crackles
Cough
Hemoptysis

A complication associated with a fx

A

Pulmonary Embolism

85
Q

Dietary teaching for patients with a fracture

A

Metabolic demands increase during bone and wound healing. Extra protein, carbohydrates, calcium, and vitamins A/D/C are needed for adequate bone repair. Vitamin D supplementation promotes bone healing. Extra fiber and fluids are needed to avoid constipation caused by narcotic analgesics.

86
Q

To foster bone healing and minimize complications that can cause malunion or nonunion the nurse must teach what?

A

proper use of slings, splints, and traction devices

87
Q

What technique should be used for wound care?

88
Q

What before PT can help client get the most out of PT?

89
Q

Complications associated with fractures

A
  • PE
  • Compartment Syndrome
  • Rhabdomylosis
  • Infection
  • Malunion and nonunion
  • Hypovolemia
  • Fat Embolism
  • VTE
  • NV Compromise
90
Q

If a crushing injury is suspected what should be avoided and why?

A

Elevation because it reduces arterial pressure

91
Q

Nursing Interventions for a fracture

A
  • Maintain pulmonary hygiene
  • Administer pain meds as ordered
  • Administer other meds as ordered
  • Provide wound/pin care
  • Elevation*
  • Apply Ice
  • Perform ROM exercises
  • Reposition as needed
  • Provide hydration and nutrition
  • Give positive feedback and encouragement

NUR 211 Krissa (16 decks)

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