Fractures

Question 1

What is a fracture?

Answer 1

Any break in a bone

Question 2

What occurs during bone Healing?

Answer 2

Hematoma

Osteoblasts form new bone, Osteoclasts destroy damaged bone

Question 3

Complications of Bone Fractures

Answer 3

Hemorrhage
DVT
Fat Emboli Syndrome
Infection
Skeletal Integrity
Compartment Syndrome
Malunion
Nonunion

Question 4

Fat Emboli Syndrome

Answer 4

Fat from bone marrow enters bloodstream blocks the lungs

s/s: Change of Mental Status, petechaie rash, snow storm on Xray, bloody frothy sputum

Question 5

Compartment Syndrome

Answer 5

Edema releases histamines, causes dead cells to release myoglobin that blocks the kidneys which leads to kidney failure.
Can lead to loss of function in 6 hrs
NC: monitor for pain, swelling, sensation and paralysis

Question 6

Malunion/Nonunion

Answer 6

Failure to heal/ Delayed Healing
NC: monitor nutritional status, use of meds like corticosteriods
Dx: X-ray
Tx: Pain management, electrical stimulation

Question 7

Emergency Care of Fractures

Answer 7

Immobilize fracture
Maintain Perfusion
Cover all wounds with sterile dressings
Cover bleeding with pressure dressings
Splint extremity: relieve pain, prevent further damage

Question 8

Traction

Answer 8

strengthens and pulls muscles, maintains alignment and anatomical postition

Question 9

Skin Traction

Answer 9

Used as a treatment before surgery
Pulley system with weights
Pt wears foam boot 
Helps with comfort 
NC: keep weights off the floor, frequent repositioning, monitor skin and perfusion

Question 10

Skeletal Traction

Answer 10

Pins are inserted with anesthetic
Allows for more weight
Increased risk of infection, anxiety and discomfort
NC: Never remove weights, never wedge foot, protect pressure points, neuro vascular assessment, pin care, assess skin

Question 11

Casts

Answer 11

Immobilizes fractures
NC: allow cast to dry completely, neuro vascular assessment, palpate for “Hotspots”, report all drainage, dont place anything inside of cast, don’t get cast wet dry with blow dryer, assess temp, color and sensation on extremity

Question 12

5 P’s

Answer 12

Pulse Pain Paralysis Pallor Paresthesiae

Question 13

Electric Bone Stimulation

Answer 13

Electric current promotes healing
Invasive: lead wire is inserted and electricity is deliver 24/7
Noninvasive: wire wrapped around cast delivered at night for 3-10 hours