limb fractures Flashcards
What are the assessment findings of a limb fracture?
Excruciating pain, swelling, warmth, tenderness, bruising, crepitus, deformity, protruding bone (if open), loss of function/sensation, muscle spasms/atrophy, inability to bear weight, guarding of limb.
What is included in the initial nursing management of a limb fracture?
Assess ABCs, control bleeding, perform neurovascular assessment (5 P’s + poikilothermia), immobilize limb, elevate, apply ice, obtain X-ray, administer tetanus if open fracture, mark pulses, monitor vitals, LOC, and pain.
What are the 5 P’s of neurovascular assessment (plus 1)?
Pain, Pallor, Pulses, Paresthesia, Paralysis, Poikilothermia (temp regulation).
What is the purpose of casting in fracture management?
To immobilize the limb for healing and alignment.
What are key nursing considerations for casting?
Ongoing neurovascular checks, assess capillary refill if pulses not palpable, skin checks around cast, no objects inside cast, use hairdryer on cool for itching, don’t add padding, avoid water if not waterproof.
What are cast care education tips for patients/families?
Elevate extremity above heart for 48 hrs, ice with towel barrier, coordinate PT/OT, follow mobility orders.
What is skeletal traction and its purpose?
Long-term traction (5–45 lbs) to align bones/joints.
What are nursing considerations for skeletal traction?
Weights must hang freely, support weights during movement, aseptic pin care, monitor for infection, maintain alignment, coordinate PT/OT.
What is halo traction used for?
Cervical spine immobilization with pins and weights.
What are nursing considerations for halo traction?
Sleep sitting up, keep vest dry (blow-dry if wet), aseptic pin care, avoid dislodging, keep wrenches nearby, use sheepskin/cotton under vest, coordinate PT/OT.
What is skin traction and what is it used for?
Noninvasive traction (e.g., Buck’s boot) for spasms, contractures, pain relief, or immobilization.
What are nursing considerations for skin traction?
Monitor skin for breakdown and infection regularly.
What is compartment syndrome?
Increased pressure within a muscle compartment leading to compromised blood flow and nerve function.
What are assessment findings of compartment syndrome?
Increased swelling and pain, tingling, faint/absent pulse, cool/pale skin, loss of function.
What are nursing interventions for compartment syndrome?
Notify HCP immediately, do not elevate limb, do not apply cold, assist with fasciotomy, maintain aseptic wound care, ongoing neurovascular checks.
What is fat embolism syndrome?
Fat globules from a broken bone enter circulation and can obstruct blood vessels, particularly in lungs.
What are assessment findings of fat embolism syndrome?
Chest pain, tachypnea, cyanosis, dyspnea, tachycardia, decreased LOC, hypoxemia, petechiae (neck/axilla).
What are nursing interventions for fat embolism syndrome?
Administer oxygen, IV fluids/meds to support heart/lungs, anticipate EKG & X-ray, call Rapid Response/ICU team.
What is open reduction and internal fixation (ORIF)?
Surgical procedure to correct bone alignment using internal devices like rods, plates, screws, etc.
What are common complications of ORIF?
Constipation, renal stones, cardiopulmonary issues, osteomyelitis (infection).
What are nursing interventions for ORIF?
Prophylactic antibiotics, pain meds before PT/OT, increase protein & fiber intake, increase fluids, ambulate as tolerated, stool softeners, infection monitoring, aseptic dressing changes.
