hip fractures Flashcards
What are the assessment findings of a hip fracture?
Uneven leg length, severe pain and tenderness, muscle spasm, external rotation, possible impaired blood flow (pallor, weak/no pulses, paresthesia, paralysis).
What imaging is used to confirm a hip fracture?
X-ray.
What nursing assessments are prioritized for hip fractures?
Ongoing neurovascular and skin assessments.
How is pain managed for a hip fracture?
Use pain scale to assess and administer appropriate pain medications.
What are key preoperative preparations for hip fracture surgery?
Witnessed consent (procedure + blood), type and crossmatch, CHG wipe bath, NPO 8 hrs before (or midnight).
What should clients expect post-op for hip fracture surgery?
Pain, the need for assistive devices, and limited mobility.
What mobility aids are important after hip surgery?
Trapeze bar for repositioning, elevated toilet/shower chair, abductor pillowwhen lying down.
What activity restrictions should clients follow post-op?
No standing for long periods, do not bend hip past 90° for 4–6 weeks.
What therapy support is needed for hip fracture recovery?
Coordinate PT/OT for safe ambulation and adapted ADLs, follow all mobility orders.
What are the assessment findings for a mandibular fracture?
Severe facial pain, tooth fractures, bleeding, limited jaw motion, extensive bone and tissue loss.
What are priority nursing assessments for mandibular fractures?
ABCs (airway, breathing, circulation), assess for bleeding, airway obstruction, aspiration risk.
How is oral hygiene maintained in a patient with a mandibular fracture?
Use oral swabs frequently due to high-sugar liquid diet; maintain oral hygiene to prevent infection.
What tools should be at the bedside for a patient with a wired jaw?
Yankauer suction, wire cutters or scissors, tracheostomy tray in case of airway emergency.
What nutrition care is needed for mandibular fracture patients?
Liquid diet with a straw; insert NG tube if ordered for gastric decompression.
How should communication be managed with patients who cannot speak?
Provide a communication board or whiteboard to communicate.
What patient education is important after mandibular fracture surgery?
Reassure ability to breathe/swallow liquids, teach feeding and hygiene adaptations, teach management of secretions, educate on when and how to use wire cutters, and when to notify HCP.
What are two serious complications of mandibular fractures?
Airway obstruction and vomit aspiration.
What are common indications for limb amputation?
Infection/osteomyelitis, necrosis, gangrene, compartment syndrome, trauma, osteosarcoma, diabetes-related ulcers, peripheral vascular disease.
What assessments are important pre- and post-op for amputation patients?
Neurovascular assessments, mental health screening, skin assessments.
What neurovascular assessments are specific to limb amputation?
Popliteal pulse for BKA, Doppler for AKA, assess for pulse, pallor, paresthesia, paralysis, and poikilothermia.
What is important to monitor regarding the surgical site?
Assess dressings for drainage, use sterile technique for dressing changes, check for redness, swelling, or drainage daily.
What emergency equipment should be at the bedside post-amputation?
Tourniquet for excessive bleeding.
How should the residual limb be positioned and why?
Lay prone 30 minutes, 3-4x/day to extend hip and prevent contractures and skin breakdown.
How often should the stump be bandaged initially?
24/7, except during PT and bathing.
When can the bandage be worn only when not wearing the prosthesis?
After the residual limb is healed.
What should patients be taught before and after an amputation?
Educate on the procedure and recovery expectations, teach upper extremity exercises, show how to apply dressings and bandages, and educate on phantom limb sensation and therapies (VR, mirror therapy, pain management).
