Hip Fracture/ Replacement

Question 1

What does Bucks traction do?

Answer 1

Relieve painful muscle spasm and is used for up to 24-48 hours

Question 2

The type of surgery depends on

Answer 2

Location and severity of the fracture and the persons age

Question 3

Surgical options include

Answer 3

1. Repair wit internal fixation devices
2. Replacement of part of the femur with a prosthesis / hip replacement
3. Total hip replacement both femur and acetabulum

Question 4

How do most hip fractures occur

Answer 4

Older adults falling

Question 5

In people older than 65 who is more likely to fracture a hip, men or women?

Answer 5

Women

Question 6

What to consider when planning treatment?

Answer 6

Chronic health problems. Surgery may be delayed until the pt is stable

Question 7

How can muscle spasms be managed?

Answer 7

Appropriate analgesics or muscle relaxers

Comfortable positioning

Traction

Question 8

How to teach exercise for a hip fracture pt

Answer 8

A method of using unaffected leg and both arms. Use the trapeze above the bed and opposite rail to help get in and out of bed

Question 9

Post op hip replacement managemnt: Early post op period

Answer 9

Asses: vitals, I and O,
Monitor: respiratory function
Deep breathe and cough
Administer pain mess
Observe dressing and incision for flood and infection
Asses extremity for: color, temp, cap refill, distal pulses, edema, sensation, motor function and pain

Question 10

Non drug post op edema and pain management?

Answer 10

Edema - elevate the leg when the patient is in a chair

Pain when resulting from poor alignment - use pillows

Question 11

Prosthesis with a posterior approach interventions

Answer 11

Take measures to prevent dislocation
Teach pt about positions and activities that can cause dislocation (crossing legs at ankles, addiction across midline, more that 90 degree flexion)

Question 12

Hip replacement do’s

Answer 12

Use elevated toiled seat
Place chair inside shower or tub and remain seated while washing
Keep hip in neutral, straight positing when sitting walking or lying
Notify surgeon if sever pain, deformity or function loss occurs
Inform dentist of presence of prosthesis before dental work sot prophylactic antibiotics an be given if need be

Question 13

Hip replacement don’t***

Answer 13

Don’t:
Force hip greater than 90 degrees of flexion (sit in low chairs)
Force hip into abbduction or internal rotation
Cross legs ant knees and ankles
Put on own shoes or stockings without adaptive devices
Sit on chairs without arms
Avoid internal rotation

Question 14

What exercises are designated to restore strength and muscle tone

Answer 14

Quadriceps setting - tightening the knee cap
Gluteal muscle setting - tightening the butt
Leg raises in supine and prone positions
Abduction exercise from supine and standing position
Continue for months

Question 15

Gerontological considerations: risk of hip fracture include

Answer 15

Tendency to fall
Inability to correct a postural imbalance
Inadequacy of local tissue shock absorbers
Reduced skeletal strength

Question 16

Gerontological considerations: what increases the risk of falls?

Answer 16

Faith and balance problems
Decreased vision and hearing
Slowed reflexes
Orthographic hypotension
Medication use
Large rugs and slippery or uneven surfaces
Getting in or out of a chair or bed
Falls to the side** most likely result in hip fracture than forward fall

Question 17

Gerontological considerations: what reduces the likelihood of fractures?

Answer 17

External hip protectors
Calcium and vit d supp
Estrogen replacement
Bisphosphonate drug therapy

Question 18

Initially the effected extremity may be

Answer 18

Temporarily immobilized by bucks traction until physical condition is stabilized

Question 19

Clinical manifestations of a pt with hip dislocation**

Answer 19

Sudden pain
Dislocated limb shorter than the other
Lump in the butt
NPO