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Nursing Theory Final Test > Fractures > Flashcards

Fractures Flashcards

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0
Q

What is important to note about Colles’ fracture?

A

It is a fracture of the distal radius, common and adults, especially women over 50, usually results when trying to break the fall with in outstretched hand

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1
Q

What are the types of fractures?

A 
Colles' fracture
Fracture of the humerus
Fracture of the pelvis
For moral shaft fracture
Fracture of the tibia
Vertebral fracture
Facial fractures
Mandibular fracture
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2
Q

What is important to note of the humerus fracture?

A

Fracture of the shaft are common in young and middle-aged adults

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3
Q

What is important to note about the pelvis fracture?

A

It can be life-threatening depending on the mechanism of the injury and association to vascular insult
It has the highest mortality rate of all fractures
Can cause serious intra-abdominal injury
May die from sepsis, may develop a deep vein thrombosis or a fat embolism

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4
Q

What is important to know about the femoral shaft fracture?

A

Common injury and young adults, related to soft tissue injuries maybe more serious than bone fractures

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5
Q

What is important to note about the Fracture of the tibia?

A

Vulnerable injury because it has no anterior muscle covering it, common site for a stress fracture

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6
Q

What is important to know about the vertebrL fracture?

A

Most are due to accidents, most are stable fracture, most common injury is a compression fracture

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7
Q

What is important to note about facial fractures? I have

A

Primary concern is to maintain patent airway, treat all patients as though they have had a cervical injury, until proven otherwise

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8
Q

Important to note about the mandibular fracture?

A

Usually require surgical immobilize a shit, wiring the jaws for up to six weeks

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9
Q

Hip fractures and seniors

A

Almost 70% are related to osteoporosis
10 to 20% of seniors hospitalized for the hip fracture will die within six months
If the percent of seniors admitted to the hospital with a hip fracture will never walk again without assistance, and will need extensive homecare

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10
Q

What is important to note about a hip fracture?

A

Is a fracture of the proximal third of the femur
Fracture occurring with the hip joint capsules are called intracapsular fractures
Usually due to osteoporosis and minor trauma

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11
Q

Cwhat are the clinical manifestations of a hip fracture?

A

External rotation
Muscle spasm
Shortening of the leg
Severe pain and tenderness

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12
Q

What is the diagnostic test done for a hip fracture?

A

X-ray

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13
Q

What is the surgical repair for a hip fracture?

A

It is the preferred method of treating hip fracture
Allows for early mobilization, which decreases the risk of major complications
Intracapsular fractures are paired with an Endo prosthesis to replace the femoral head
Extracapsular fracture or repaired with plates and other devices

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14
Q

what is the total hip replacement?

A

Significantly improved pain and functional use of affected joint
Implants may be cemented in place
Good for less active, older adults who have a less than ideal bone strength, and life expectancy of less than 25 years
Artificial hip components tend to loosen overtime and require revision surgery

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15
Q

What is the collaborative care for an patient elderly patient with a hip fracture?

A

Elderly are most likely to have a hip fracture, that’s need to be aware of full medical history
Ensure patient knows their risk for displacement up to six or eight weeks postoperatively
Teach patient and family to avoid 90° flexion

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16
Q

What is the general assessment of a fracture?

A

Neurovascular assessment of the effect of limb:
Color temperature, capillary refill, distal pulses, edema, sensation, movement, and pain
Cardio respiratory status:
Heart rate, blood pressure, respirations, and laboratory values

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17
Q

What teaching to provide with amputation?

A

The goal is to prevent amputation from happening in the first place, teach the patient to manage risk factors for peripheral vascular disease, diabetes, pressure ulcers and osteomyelitis, and Traumatic injury at home, work and play

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18
Q

What are the indications for amputation?

A

Circulatory impairment related to perform peripheral vascular disease, diabetes, pressure ulcers, osteomyelitis
Traumatic injury, thermal injury, cancer, widespread or uncontrolled infection, congenital disorder

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19
Q

What is a closed amputation?

A

Perform to create a weight bearing residual limb
Anterior skin flap with dissected soft tissue padding covers the bone at the end of the stump and is sutured posteriorly to avoid being on the end

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20
Q

What is an open amputation?

A

Performed when the site is infected or there is potential for the same
It is dressed and dressing changes as ordered
site will be sutured closed for the surgeon is satisfied with the status

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21
Q

What is disarticulation?

A

Amputation perform through a joint

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22
Q

What is the goal for amputation?

A

At the time of the surgery it is to preserve as much length and function as possible when removing all infected, diseased, or ischemic tissue
Postoperatively. It is important to manage pain, heal well, actively engage in rehab in order to restore as much function as possible, adopt a lifestyle changes and effectively cope with altered body image

23
Q

What is The collaborative care for amputation?

A

Patient and family will require much psychological support free and postoperatively, they will go through a grieving process and this is normal
Preoperatively the patient and family need to be informed about the types of prosthesis, postop exercises that will need to be performed there will also need to be aware of phantom limb sensation

24
Q

What is the collaborative care for postop amputation?

A

If it is a traumatic amputation monitor for posttraumatic stress disorder
Be alert to possible hemorrhage
Maybe fitted for a prosthesis during surgery, depending on the location
Avoid flexion contracture, specially hip flexion
Avoid dangling the amputated limb
Teach patient how to transfer from bed to chair
prior to discharge teach patient had a crutch walk

25
Q

What are common joint surgeries?

A

Synovectomy: removal synovial membrane
Ostoteomy: correct deformity and relieve pain, involves removing or adding bone to change bone alignment and shift weight bearing
Debridement: removal of diseased or damaged tissue, bone, cartilage
Arthroplasty: reconstruction or replacement of a joint
Athrodesis: surgical fusion of a joint

26
Q

What is musculoskeletal problems?

A

Most musculoskeletal problems are caused by injury from a traumatic event resulting in a fracture, dislocation, associated soft tissue injury, or some combination
Most of these injuries are preventable
Education about basic principles of safety an accident production is key in reducing MS injuries and

27
Q

Fractures

A

Most fractures are related to dramatic injury, but some are secondary to disease process
Are described and classified according to:
Type
Whether their break exposes the bone to the external environment
Anatomical location of fracture on the involved bone
Weather stable or unstable

28
Q

What are the types of fractures?

A

Complete: Rick across the entire cross-section of the bone, bone is usually displaced from its normal position
Incomplete or greenstick: Break is not completely through
Impacted: bone ends are driven into one another
Simple or closed: no break in the skin
Compound, open, or complex: bone is exposed to the outside environment, maybe inside to out or can be outside to in
Stress: result of repeated bone trauma from athletic activities
Compression: involves compression of the vertebrae, most often due to osteoporosis
Avulsion: is related to strong pulling effects of the tendons or ligaments on the bone
Longitudinal, oblique, spiral, transverse: referred to angle or position of the fracture along the bone

29
Q

What are the clinical manifestations of fractures?

A

Immediate localized pain and decreased function in the affected area
Inability to weight bear or use the affected limb
Guarding and protecting of the affected area
Bone deformity
Abnormal position
bruising, edema, swelling, crepitation, muscle spasm

30
Q

What is the diagnostic test done for fractures?

A

History and physical examination
Any symptoms
Neurovascular assessment which includes skin sensation, color, and temperature
X-ray, CT, MRI

31
Q

If the fracture is suspected what should be done?

A

Immobilize extremity immediately in the position I just found
Is the patient is treated by Dr. the patient might have skeletal or skin traction, cast or splint, crutches, sling,other forms of support, external fixation, internal fixation

32
Q

What is the process of fracture healing?

A

First is fracture hematoma, bleeding at the time of injury
Second is granulation tissue, phagocytosis which absorbs products of necrosis, hematoma converts into granulation tissue
Third is Californication, is composed of cartilage osteoblast, calcium, and potassium
Fourth is ossification, newborn is built up as osteoclasts destroy the dead bone
Fifth is bone remodeling, excess bone is reabsorbed

33
Q

What is important to note during the ossification stage of fracture healing?

A

If on skeletal traction, may be removed and displaced by cast
If in a cast, same may be removed and replaced by crutches

34
Q

What are factors that influence healing time with fractures?

A

Age, initial displacement, and inadequate reduction and immobilization, excessive movement, infection, poor nutrition, presence of other diseases

35
Q

What are the treatment goals with fractures?

A

Anatomical realignment of bone fragment, immobilization to maintain realignment, restoration of normal function of injured parts

36
Q

What are the treatment options for fracture?

A

Closed reduction is nonsurgical, manual realignment of the parts
Open reduction is surgical realignment of bone parts

37
Q

What is traction?

A

Apply a pulling force to the injured part at the same time that counter traction pulls in the opposite direction
More often used in children because want to minimize the damage to the growth plates
Less often used today because of surgical advances

38
Q

Why is traction used?

A

Reduce and immobilize fracture or dislocation
Reduce or eliminate muscle spasm
Regain normal length and realignment of extremity
Prevent joint deformity
Reduced pain
Expand joint space

39
Q

What is skin traction used for?

A

Use for fractures of the hip, femur, knee, and back

Used up to 72 hours, until skeletal traction her surgery can be performed

40
Q

What is skeletal traction?

A

Provide longer-term pull to keep injured bones and joints aligned
Pin or wire is inserted into the bone and weights are attached
Major disadvantage is infection
Other disadvantage is delayed union or nonunion or if excessive weight is applied

41
Q

What is the collaborative care for a patient who has traction?

A

Proper body alignment and physician to promote constant traction forces and avoid external hip rotation
Not interrupt or interfere with the weights applied
Monitor for signs of infection
Bed exercises as patient is able to

42
Q

What are casts?

A

Immobilize and ensure stability
Generally incorporate joints above and below the fracture
Some casts are made of fiberglass

43
Q

Collaborative care for a patient who has a cast?

A

Support The casted extremity by elevating
Encourage active range of motion unaffected joist remote blood flow and reduce stiffness and contractures
Monitors cannot cast edges
Monitor sites distal to the cast for signs of pressure necrosis

44
Q

What is external fixation?

A

And external fixator is a medical device composed of metal pins that are inserted into the bone and attached to the external rods to stabilize the fracture
Can be used to apply traction, compressed fracture fragments, and immobilize

45
Q

What is the collaborative care for external fixation?

A

Monitor for infection
Aseptic technique when cleansing pins
Protect protrusions from getting caught in clothing, bed linens

46
Q

What is the general neurovascular assessment?

A

This is done post traction, cast, external or internal fixation, and is important to regularly assess
It includes skin sensation, color, temperature, and pulses
Ask patient to rate pain on a scale of 1 to 10

47
Q

What is the general collaborative care for fractures?

A

Observed dressing or cast for any signs of bleeding or drainage
Monitor volume and types of drainage
Monitor for pressure ulcers, deep vein thrombosis, and pulmonary emboli
Know the weight-bearing limitations
Teach patient how to reduce risk of falling
Teach patient about moderate exercise and good nutrition

48
Q

What are complications of fractures?

A

If death occurs it is usually the result of damage to an underlying organ or complications of fracture or immobility
Direct complications are osteomyelitis, nonunion a bone fragments, and a vascular necrosis
Indirect complications are blood vessel or nerve related damage, compartment syndrome, fat embolism, venous thrombosis, Trumatic or hypovolemic shock
Majority heal without complication

49
Q

What is compartment syndrome?

A

Upper and lower extremities have 38 mile Fatio compartments, but contain my phone, blood supply and nerves, and are bounded by the fascia
Occurs when the pressure within a confined myofascial compartment they become greater than that of the blood vessels in the same compartment. Blood vessels and nerves become compressed. Circulation and nerve transmission in the affected extremity is affected
This requires immediate attention to prevent tissue death and potential loss of affected limb

50
Q

Acute compartment syndrome

A

Medical emergency
Sudden severe decrease in blood supply to tissue distal to the area of injury
Necrosis of muscle tissue can happen quickly if not treated immediately

51
Q

What are the causes of acute compartment syndrome?

A

Causes are trauma, fractures, severe burns, crush injury, venomous snakebite, extensive soft tissue damage

52
Q

What are the symptoms of compartment syndrome?

A

Assess the extremity using the six P’s:

Paresthesia, pain distal to the injury, poikilothermia, pallor, paralysis, pulselessness

53
Q

What is the treatment for compartment syndrome?

A

Remove, loosen, or split the cast or bandages
Reducing traction wait may be helpful
Usually require surgical decompression
If caught late, usually will require amputation

54
Q

What is fasciotomy?

A

Left open for several days to ensure adequate soft tissue decompression, potential for infection at the site is high

Nursing Theory Final Test (7 decks)

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