initial assessment of a fracture & traction

Question 1

what is a fracture?

Answer 1

broken bone

Question 2

notes
closed fractures
- does not break skin

open fracture “compound”
- skin surface broken

complete fracture
( infection risk )

incomplete fracture “greenstick”

spiral fracture
- twisting motion
- child abuse

oblique fracture - angel

compression fracture “impact”
- high fall or jump

crush, compression fracture
- dropping a heavy item on their bone
- causes them a massive risk for dvt/ fat embolism

Question 3

what are some causes for patients to get a fracture?

Answer 3

bed rest
osteoporosis
steroids
trauma

Question 4

what are some signs and symptoms of fractures? (3)

Answer 4

pain & swelling
crepitus ( grinding sound )
muscle spams

Question 5

what is the biggest and or priority finding that we have to worry about when patents have a fracture?

Answer 5

internal bleeding

Question 6

if a patient with a fracture has internal bleeding, what are we going to see as a nurse on their vitals and assessment ? (3)

Answer 6

hypotension
tachycardia
hematuria

Question 7

what is the type of traction that we typically will use before surgery to help keep the leg in alignment?

Answer 7

bucks traction

Question 8

what do we do for a bucks traction?

Answer 8

we use tap on the legs or a premed boot and connect it tup to the machine

then we use free hanging weights, remember FREE HANGING, to pull the bone back into place

Question 9

tractions
weight should be?
tractions ropes must be?
when repositioning the patient we should do what?

what position should the limb be in?

what are we always assessing for the patient ? (2)

Answer 9

free hanging at all times
TIGHT!!
( not resting, or loose )
hold weights
neutral position

skin break down and neuro checks on limb

Question 10

what is the neuro check that we do on the limb?

Answer 10

pulse
motor
sensation
capillary refill

Question 11

in a bucks traction, do we elevate the head of the beda ? why or why not

Answer 11

no!
we want to remain flat

Question 12

what are the prioritize ordered that we want to worry about after the patient has surgery ? (3)

Answer 12

1. bleeding
2. infection
3. position education

Question 13

if your patient is bleeding, what are we looking for?
(2 vitals signs ?)
( labs?)

Answer 13

hypotension
tachycardia

hemoglobin less than 11
( below 7, patient in heaven )

Question 14

what’s normal abc count?
what if the patient has an elevated wbc?

Answer 14

5,000-10,000

infection! - sepsis - shock

Question 15

how do we perform pin care for a patient ?

how many times a day?

Answer 15

we use sterile solution
3x a day

Question 16

notes

total hip arthroplasty
- abducted legs : place a pillow between the legs
- keep the legs wide open
- no crossing legs
- no leaning forward
- no sitting in chair

Question 17

notes
fat embolism risk
1. mental status changes !!!
( confusion, restlessness, altered mental status )
2. dyspnea and chest pain
3. low pulse ox
4. petechaise over neck and chest ( small red dots )

intervention
- minimize movement of the fracture
- dont give compression devices
- dont give blood thinners either

Question 18

what are the 6ps ?

Answer 18

pain !!
paresthesia !!
polikthermia
pulselessness
pallor
paralysis

Question 19

the cast care
C
A
S
T

stand for?

Answer 19

clean and dry
- never wet or cover cast with plastic bag for bathing

above the heart
- first 48 hours, decrease swelling and prevent compartment syndrome

scratch an itch
- hair dryers ( cool setting )
- never put anything to scratch inside

take it easy
- no bearing weight
- no finger indentation
- no hard surfaces