Med surg test 2 part 6

Question 1

Immobilization secures the injured extremity in order to:

Answer 1

Prevent further injury.
Promote healing/circulation.
Reduce pain.
Correct a deformity.

Question 2

__ __ is when a pulling force (traction) is applied manually to realign the displaced fractured
bone fragments

Answer 2

Closed reduction

Question 3

Once the fracture is reduced, immobilization is used to allow the

Answer 3

bone to heal

Question 4

__ __ is when a surgical incision is made and the bone is manually aligned and kept in place
with plates and screws

Answer 4

open reduction

Question 5

Open reduction is when a surgical incision is made and the bone is manually aligned and kept in place
with plates and screws. This is known as an

Answer 5

open reduction and internal fixation (ORIF) procedure.

Question 6

Traction: Check the temperature of the affected extremity. The extremity should be

Answer 6

warm, not cool, to touch.

Question 7

Traction: Cool skin may indicate decreased

Answer 7

arterial perfusion

Question 8

Nail beds that are cyanotic may indicate

Answer 8

venous congestion

Question 9

Casts are more effective than splints or immobilizers because they cannot be

Answer 9

removed by the client.

Question 10

type of cast that is heavy, not water resistant, and can take 24 to 72 hr to dry

Answer 10

Plaster of Paris

Question 11

___ __ casts are light, stronger, water resistant, and dry very quickly (in 30 min).

Answer 11

Synthetic fiberglass

Question 12

If the swelling continues after cast application and causes unrelieved pain, the cast can be

Answer 12

split on one side (univalve) or on both sides (bivalved).

Question 13

___ is used over any rough area of the cast that may rub against the client’s skin

Answer 13

Moleskin

Question 14

Prior to casting, the area is cleaned and dried. ___ ___ __ roll is placed over the
affected area to maintain skin integrity

Answer 14

Tubular cotton web

Question 15

After cast application, position the client so that warm, dry air circulates around and under
the cast (support the casted area without \_\_\_\_\_\_\_\_\_\_\_)

Answer 15

pressure under or directly on the cast

Question 16

Elevate the cast above the level of the heart during the first 24 to 48 hr to prevent

Answer 16

edema

Question 17

If any drainage is seen on the cast, it should be

Answer 17

outlined, dated, and timed, so it can be

monitored for any additional drainage

Question 18

Cast education: Clients are instructed not to place

Answer 18

any foreign objects under the cast to avoid trauma to the skin

Question 19

___ ___ over the cast can be used to avoid soiling from urine or feces

Answer 19

Plastic coverings

Question 20

Traction uses a pulling force to promote and maintain

Answer 20

alignment of the injured area

Question 21

Goals of traction include: Prevent __ __ injury

Answer 21

soft tissue

Question 22

Goals of traction include: ___ of bone fragments

Answer 22

Realignment

Question 23

Goals of traction include: Decrease

Answer 23

muscle spasms and pain

Question 24

Goals of traction include: Correct or prevent further

Answer 24

deformities

Question 25

Traction prescriptions should include: amount of

Answer 25

weight

Question 26

Traction prescriptions should include: whether | traction can be

Answer 26

removed for nursing care

Question 27

Classification of Traction: Straight or running: The countertraction is provided by

Answer 27

the client’s body

Question 28

Classification of Traction: The countertraction is provided by the client’s body by applying a pulling force in a

Answer 28

straight line

Question 29

Classification of Traction: Movement of the client’s body can alter the traction provided.

Answer 29

Straight or running

Question 30

Classification of Traction: Balanced suspension: The countertraction is produced by

Answer 30

devices such as slings or splints

Question 31

Classification of Traction: Balanced suspension: The client’s body can be moved without

Answer 31

altering the traction.

Question 32

traction used preoperatively for hip fractures for | immobilization in adult clients

Answer 32

Bucks

Question 33

Traction: Ensure that weights hang

Answer 33

freely and are not resting on the floor.

Question 34

If the weights are accidentally displaced,

Answer 34

replace the weights. If the problem is not corrected, | notify the provider

Question 35

Move the client in halo traction as a unit, without

Answer 35

applying pressure to the rods

Question 36

to treat muscle spasms, use

Answer 36

heat/massage

Question 37

Loosening of pins could indicate

Answer 37

infection

Question 38

Crusting at the pin site

Answer 38

should not be removed as this provides a natural barrier to bacteria.

Question 39

____ antibiotics prevent infection when fracture immobilization is achieved

Answer 39

Prophylactic

Question 40

Splints are ___ and allow for monitoring of skin swelling or integrity

Answer 40

removable

Question 41

Splints can be used to support fractured/injured areas until

Answer 41

casting occurs and swelling is | decreased

Question 42

involves fracture immobilization using percutaneous pins and wires that are attached to a rigid external frame

Answer 42

External fixation

Question 43

Used to treat: Comminuted fracture

Answer 43

External Fixation

Question 44

Used to treat: nonunion fractures with extensive soft tissue damage

Answer 44

External Fixation

Question 45

Used to treat: Leg length discrepancies from congenital defects

Answer 45

External Fixation

Question 46

Used to treat: Bone loss related to tumors or osteomyelitis

Answer 46

External Fixation

Question 47

External Fixation advantages include: Minimal blood loss occurring in comparison with

Answer 47

internal fixation

Question 48

External Fixation advantages include: Allowing for early

Answer 48

mobilization

Question 49

External Fixation advantages include: Permitting

Answer 49

wound care with open fractures

Question 50

Nursing Actions for external fixation

Answer 50

Provide antiembolism stockings and sequential compression device to prevent DVT

Question 51

Open Reduction and Internal Fixation (ORIF) nursing actions: ensure that heels are

Answer 51

off the bed at all times

Question 52

Open Reduction and Internal Fixation (ORIF) nursing actions: Position for comfort and with __ on the surgical site

Answer 52

ice

Question 53

Open Reduction and Internal Fixation (ORIF) nursing actions: Have the client get out of bed from the ____ side

Answer 53

unaffected

Question 54

Open Reduction and Internal Fixation (ORIF) nursing actions: ensure increased intake of __ and __

Answer 54

calories and calcium

Question 55

Open Reduction and Internal Fixation (ORIF) nursing actions: meals should be

Answer 55

small, frequent meals with snacks

Question 56

Open Reduction and Internal Fixation (ORIF) nursing actions: what do you monitor pertaining to the GI system

Answer 56

constipation

Question 57

Compartment syndrome described in one sentence

Answer 57

pressure that disrupts circulation

Question 58

Compartment syndrome (ACS) is assessed by using

Answer 58

the five P’s

Question 59

Compartment syndrome: Increased pain unrelieved with

Answer 59

elevation or by pain medication

Question 60

Compartment syndrome: Intense pain when ___ moved

Answer 60

passively

Question 61

____ is a late sign of compartment syndrome

Answer 61

Pulselessness

Question 62

Compartment syndrome: Palpated muscles are ___ and swollen from edema.

Answer 62

hard

Question 63

Fat embolism: most common fractures are

Answer 63

hip and pelvis

Question 64

in addition to hip and pelvis fracture, fat embolism can occur with long bone fractures or with

Answer 64

total joint arthroplasty

Question 65

difference between PE and fat embolism

Answer 65

FE has petechiae

Question 66

prevention of fat embolism is

Answer 66

immobilize the area so that the fat doesn't get out of the bone

Question 67

fat embolism Tx

Answer 67

O2 corticosteroids (for edema) fluid replacement pain/anxiety meds

Question 68

Osteomyelitis: Bone pain that is constant, pulsating, localized, and worse with

Answer 68

movement

Question 69

Who might not have a fever despite having osteomyelitis

Answer 69

older adults

Question 70

A fracture that has not healed within 6 months of injury is considered to be experiencing ___ ___

Answer 70

“delayed union.”

Question 71

Electrical bone stimulation and bone grafting can be used to treat

Answer 71

nonunion (which is when the bones havent healed in 6 months)

Question 72

which of the 6 p's is an early sign of compartment syndrome

Answer 72

Paresthesia

Question 73

Buck’s traction is a temporary immobilization device applied to diminish muscle spasms and

Answer 73

immobilize the affected extremity until surgery is performed