Med-Surg Chp 61 Caring for Clients Requiring Orthopedic Treatment

Question 1

Surgical reconstruction of a joint using an artificial joint that restores previously lost function and relieves pain

Answer 1

arthroplasty

Question 2

death of bone from an insufficient blood supply

Answer 2

avascular necrosis

Question 3

supports made of plastic materials, canvas, leather, or metal that are custom fit to each client, provide controlled movement and prevent additional injury

Answer 3

braces

Question 4

deposits of minerals that break loose from the walls of renal tubules

Answer 4

cast

Question 5

procedure in which a fractured bone is restored to its normal position by external manipulation and then immobilized with a bandage, cast, or traction

Answer 5

closed reduction

Question 6

procedure in which metal pins are inserted into a fractured bone or bones from outside the skin surface and then attached to a compression device

Answer 6

external fixation

Question 7

surgical procedure to repair fractures with wire, nails, plate, and/or an intramedullary rod (a rod inserted into the center of the bone with wires around the bone for stabilization); done to hold bone fragments in place until bone healing is complete

Answer 7

internal fixation

Question 8

surgical procedure in which a fractured bone is exposed and realigned

Answer 8

open reduction

Question 9

an artificial device to replace a body part such as a joint

Answer 9

prosthesis

Question 10

a thin piece of wood or strip that immobilizes and supports an injured body part in a functional position

Answer 10

splint

Question 11

partial dislocation

Answer 11

subluxation

Question 12

method of pulling structures of the musculoskeletal system to relieve muscle spasms, align bones, and maintain immobilization

Answer 12

traction

Question 13

What are the three different cast types

Answer 13

cylinder cast
body cast
hip spica cast

Question 14

Cast Composition

Answer 14

Fiberglass
Plaster

Question 15

Managing the Care of the Client in Traction

Answer 15

Assess neurovascular status frequently. Compare assessment findings in the affected limb with those in the unaffected limb.

Check traction equipment for the following:

Proper alignment (position client so that the body is in an opposite line to the pull of traction)

Correct attachment

Prescribed amount of weight

Freely hanging weights and freely moving ropes over unobstructed pulleys

Maintenance of countertraction

Monitor client for signs of pressure areas.

Encourage client to be as mobile as possible and to perform exercises as indicated.

If traction is applied to the lower extremity, observe foot position and prevent foot drop.

If skeletal traction is applied, follow agency procedure for pin care.

Cover tips of any protruding metal pins or rods with corks or other protective material.

Question 16

Care for Clients AFTER Orthopedic Surgery

Answer 16

The head of bed will be less than 45 degrees, especially with the hip replacement patient, to keep hip flexion less than 90 degrees.

client with a total hip replacement needs to have legs abducted with pillows or abductor cushion and extended because the opposite positions of adduction and flexion beyond 90° can dislocate the prosthetic femoral head from the acetabulum.

Clients with a total hip replacement need to sit in an elevated chair or on a seat raised by pillows, so that the flexion remains less than 90°.

Ice packs help reduce pain and inflammation to the incisional site (particularly after knee surgery)

Question 17

Avoiding Hip Dislocation After Conventional Replacement Surgery

Answer 17

Keep the knees apart at all times.

Put a pillow between the legs when sleeping.

Never cross the legs when seated.

Avoid bending forward when seated in a chair.

Avoid bending forward to pick up an object on the floor.

Use a raised toilet seat.

Do not flex the hip to put on clothing such as pants, stockings, socks, or shoes.