Fractures Flashcards
what is a spiral fracture?
a twisting break that is most usually associated with abuse
What is a greenstick fracture?
kind of just at one edge and often seen in children and can also be associated with abuse
What are manifestations of a fracture?
- muscle spams due to pulling forces of bone when not aligned
- crepitus
- edema
- ecchymosis
How can the nurse help treat an open fracture?
- STOP bleeding by covering with sterile dressing until patient can get to surgery
- antibiotics
- tetanus shot if patient has not had one in previous 10 years
What are nursing care priorities when treating a patient with a fracture?
- still always assess ABCs
- do not move the injured area
- keep patient warm
- neurovascular checks should be done every hour
- assess pain frequently
when is an external fixation done on a patient?
external fixation is done when a patient is too unstable for surgery or they have other priorities such as internal bleeding
What is the priority action when caring for a patient with an external fixation?
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
what is a closed reduction procedure?
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
what are two types of tractions?
skin and skeletal tractions
what is a skin traction?
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
What is a skeletal traction?
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
What is important nursing actions to provide safety for patients with tractions?
- it is important to NOT touch the weights EVER
2. weights should not be rested on the floor
What medications are given for treatment of fractures?
- FLUIDS!
- antibiotics
- pain medication
- muscle relaxers (if spasms are present)
- anticoagulants are used as a prophylaxis
what type of fractures are the most dangerous?
long bone fractures are at risk for PE or fat embolus
how much blood can be lost from a pelvic fracture?
2 L of blood can be lost from pelvic fractures
how much blood can be lost from a femur fracture?
1.5 L can be lost from a femur fracture
how can the nurse prevent embolisms from occurring after a fracture?
- administer anticoagulants
2. do range of motion exercises
how does a fat embolism occur?
bone marrow breaks off and gets stuck in the capillary
what is the hallmark sign of a fat embolism?
petechial hemorrhage on chest/abdomen and this is a very ate sign
what nursing interventions can the nurse perform to help treat a fat embolus?
there is no real treatment but nurse can assess ABCs, give oxygen, steroids, and vasopressors
How does the fat embolus go away in a patient?
patient will die or absorb the embolus because there is no real treatment
when should the neurovascular assessment be done if a patient comes in with a fracture?
NV assessment should be done every hour for the first 24 hours, and every 1-4 hours thereafter
What are nursing interventions that should be done for patients with casts?
- neuro assessments
- elevate about level of heart for the first 24-48 hours
- monitor for skin breakdown
