Manifestations of Fractures

Question 1

What are typical manifestations of fractures?

Answer 1

1. Edema and Swelling
2. Pain and tenderness
3. Muscle Spasm
4. Deformity
5. Ecchymosis
6. Loss of Function
7. Crepitation

Question 2

Significance and NUR Dx Edema/Swelling

Answer 2

Unchecked swelling in closed space can occlude circulation and damage nerves.

Risk for periperal neurovascular dysfunction

Question 3

Significance and NUR Dx for Pain and Tenderness

Answer 3

Pain and tenderness encourage splinting of fracture with reduction in motion of injured area.

Acute Pain

Question 4

Significance and Nur dx for muscle spasm

Answer 4

Muscle spasms may displace nondisplaced fracture or prevent it from reducing spontaneously

Acute Pain

Question 5

Significance and nur dx for deformity

Answer 5

Deformity is a cardinal sign of fracture; if uncorrected, it may result in problems with bony union and proper restoration of function of injured part.

Impaired physical mobility

Question 6

Significance and nur dx for ecchymosis

Answer 6

Usually appears several days after injury and may appear distal to injury. The nurse should reassure patient that process is normal.

Body Image Disturbance

Question 7

Significance and nur dx for loss of function

Answer 7

Fracture must be managed properly to ensure restoration of function

Impaired physical mobility

Question 8

Significance and nur dx for crepitation

Answer 8

Crepitation may increase chance for nonunion if bone ends are allowed to move excessively.

Impaired physical mobility

Question 9

TNI Edema/Swelling

Answer 9

Ice

Elevate

CMS checks

Question 10

TNI Pain and Tenderness

Answer 10

NSAIDs

Narcotics

Antispasmodics

Question 11

TNI Muscle Spasm

Answer 11

NSAIDs

Narcotics

Antispasmodics

Question 12

TNI Deformity

Answer 12

ADLs

Immobility

Question 13

TNI Ecchymosis

Answer 13

Ice

Question 14

TNI Loss of function

Answer 14

ADL

Question 15

TNI Crepitation

Answer 15

ADL

Question 16

Emergency Management for a Suspected Fracture

Answer 16

1. Treat life threatening injury
2. Ensure ABC
3. Control bleeding with direct pressure
4. Splint joint above and below fracture
5. Check neurovascular status
6. Do not attempt to straighten
7. Elevate injured limb (if possible)
8. Do not manipulate bone ends
9. Apply ice
10. Anticipate need for x-rays and tetanus prophylaxis
11. Continue to monitor: VS, LOC, O2 sat, CMS, pain