Fractures Flashcards
Plastic Deformation (bend)
Bone is bent no more than 45 degrees w/out breakage
Buckle (torus)
Compression of bone resulting in a bulge or raised area at fracture site
Greenstick
Incomplete fracture of bone
Transverse
Break is straight across bone
Oblique
Break is diagonal across bone
Spiral
Break spirals around bone
abuse
Epiphyseal (growth plate)
Injury to the end of the long bone on growth plate
Stress
Small fractures/cracks in bone due to repeated muscle contractions
Complete
Bone fragments are separated
Incomplete
Bone fragments are still attached
Closed or Simple
The fracture occurs w/out a break in skin
Open or Compound
Fracture occurs w/ an open wound & bone protruding
Complicated Fracture
Fracture results in injury to other organs & tissues
Comminuted
Fracture includes small fragments of bone tht lie in surrounding tissue
Bone Healing & Remodeling
-
Typically rapid healing in children
> from neonatal to early childhood to later childhood to adolescence - School-age: most broken bones
-
Infants: uncommon to have broken bones, but heal quickly
> collar bone most common from birth -
Most common in peds:
> collar bone
> forearm
Fractures - Diagnostics
-
Radiographs
> x-ray - Hx taking
- Suspicion of fracture in a young child who refuses to walk or bear weight
Goals of Fracture Management
- Reduction & immobilization
- Restoring function
-
Preventing deformity
> at risk: malnutrition
Fractures - Neurovascular Assessment
6
- Pain & point of tenderness
- Pallor
- Pulselessness
- Paresthesia: sensation distal to fracture site
- Paralysis: movement distal to fracture site
- Pressure
Osteomyelitis
At risk for infection after broken bone
caused by staph
Osteomyelitis - Manifestations
- Irritability
- Fever
- Tachycardia
- Edema
- Pain is constant but incrs w/ movement
- Not wanting to use affected extremity
- Site of infection tender, swollen, & warm
Osteomyelitis - Nursing Actions
-
Assist in diagnostic procedures
> obtaining skin, blood, & bone cultures - Assist w/ joint or bone biopsy
- Admin IV & oral antibiotics
- Monitor hepatic, hemtologic, & renal function
-
Monitor for development of superinfection
> candidiasis, c diff - Immobilize & elevate
- Admin pain meds
- Consult w/ parents & provider regarding home care
Osteomyelitis - Education
- Length of treatment tht can be needed & long-term antibiotics
- Monitor hearing due to ototoxicity of some antibiotics
- Limit movement of affected limb & avoid bearing any weight until cleared
- Provide diversional activities consistent w/ pt’s lvl of development
- Ensure proper nutrition
Caring for Fractures
-
Cast appliation techniques
> plaster vs fiberglass - Care management
-
Cast care at home
> red flags: Ps
> itchy -
Cast removal
> scary - Skin care
