Fractures

Question 1

what is a spiral fracture?

Answer 1

a twisting break that is most usually associated with abuse

Question 2

What is a greenstick fracture?

Answer 2

kind of just at one edge and often seen in children and can also be associated with abuse

Question 3

What are manifestations of a fracture?

Answer 3

1. muscle spams due to pulling forces of bone when not aligned
2. crepitus
3. edema
4. ecchymosis

Question 4

How can the nurse help treat an open fracture?

Answer 4

1. STOP bleeding by covering with sterile dressing until patient can get to surgery
2. antibiotics
3. tetanus shot if patient has not had one in previous 10 years

Question 5

What are nursing care priorities when treating a patient with a fracture?

Answer 5

1. still always assess ABCs
2. do not move the injured area
3. keep patient warm
4. neurovascular checks should be done every hour
5. assess pain frequently

Question 6

when is an external fixation done on a patient?

Answer 6

external fixation is done when a patient is too unstable for surgery or they have other priorities such as internal bleeding

Question 7

What is the priority action when caring for a patient with an external fixation?

Answer 7

pins are drilled into the bone so there is a HIGH risk for infection so it is important for the nurse to clean pin sites every shift

Question 8

what is a closed reduction procedure?

Answer 8

this is a procedure to reduce a broken bone without cutting the skin open (surgery). The broken bone is put back into place which allows it to grow back together

Question 9

what are two types of tractions?

Answer 9

skin and skeletal tractions

Question 10

what is a skin traction?

Answer 10

a skin traction weighs no more than 10 pounds and the weight is attached by rope to the patient’s skin, and it is almost important to monitor for skin breakdown

Question 11

What is a skeletal traction?

Answer 11

skeletal traction is 15-30 pounds and this is where rods/screws are inserted into the bone so it is important to monitor for signs of infection

Question 12

What is important nursing actions to provide safety for patients with tractions?

Answer 12

1. it is important to NOT touch the weights EVER

2. weights should not be rested on the floor

Question 13

What medications are given for treatment of fractures?

Answer 13

1. FLUIDS!
2. antibiotics
3. pain medication
4. muscle relaxers (if spasms are present)
5. anticoagulants are used as a prophylaxis

Question 14

what type of fractures are the most dangerous?

Answer 14

long bone fractures are at risk for PE or fat embolus

Question 15

how much blood can be lost from a pelvic fracture?

Answer 15

2 L of blood can be lost from pelvic fractures

Question 16

how much blood can be lost from a femur fracture?

Answer 16

1.5 L can be lost from a femur fracture

Question 17

how can the nurse prevent embolisms from occurring after a fracture?

Answer 17

1. administer anticoagulants

2. do range of motion exercises

Question 18

how does a fat embolism occur?

Answer 18

bone marrow breaks off and gets stuck in the capillary

Question 19

what is the hallmark sign of a fat embolism?

Answer 19

petechial hemorrhage on chest/abdomen and this is a very ate sign

Question 20

what nursing interventions can the nurse perform to help treat a fat embolus?

Answer 20

there is no real treatment but nurse can assess ABCs, give oxygen, steroids, and vasopressors

Question 21

How does the fat embolus go away in a patient?

Answer 21

patient will die or absorb the embolus because there is no real treatment

Question 22

when should the neurovascular assessment be done if a patient comes in with a fracture?

Answer 22

NV assessment should be done every hour for the first 24 hours, and every 1-4 hours thereafter

Question 23

What are nursing interventions that should be done for patients with casts?

Answer 23

1. neuro assessments
2. elevate about level of heart for the first 24-48 hours
3. monitor for skin breakdown