Musculoskelatal Flashcards
Antiresorptive drugs
Estrogen
Raloxifene
Biphosphonates
Calcitonin
Denusumab
Raloxifene
Hormone drug therapy
Similiar to estrogen and binds to estrogen receptors
Reduces bone resorption
Fractures
Break of a bone
Class to external enviroment -Open fracture-
Skin broken; bone exposed
Class according to external -closed fracture
Skin intact
Classes based on direction of fracture line
Transverse
Spiral
Green stick
Comminuted
Oblique
Pathological
Stress
Other-linear and longitudinal
Displaced fracture
Two ends separated from one another (comminuted or oblique)
Non displaced fracture
Periosteum is intact and bone is aligned
Usually transverse,spiral or green stick
What do we want to control when a pt comes in with a fracture
Swelling
S/s of fracture
Edema/swelling
Pain and tenderness
Muscle spasms
Deformity
Confusion
Loss of function
Crepitation
Guarding
Crepitation
It’s a sound or feeling crackling sensation when two end bones are rubbing together
Nursing assessment -objective
Apprehension
Guarding
Skin laceration, color changes
Hematoma, edema
Decrease or absent pulse
Decrease skin temp
Delayed capillary refill
Parenthesis
Absent or decrease or increase sensation
Restricted or loss of function
Deformities; abnormal angular ion
Shortening, rotation or Crepitation
Muscle weakness
Image finding
What image findings do we look at for a fracture?
CT scan , xray and mri
Apprehension
If its painful moving the extremity
Hematoma formation
Blood bringing nutrients to assist in healing to bone
Organizes into fibrous network and converts to granulation tissue
Callous formation
New bone is built up as osteoclast destroys dead bone
Ossification
Of the callus occurs (3 weeks to 6 months
Consolidation
Callus continues to develop, closing the distance between bone fragments (up to 1 year after injury )
Remodeling
Is accomplished as excess callus is reabsorbed and trabecular bone is laid down
Traction
Skin(bucks) and skelatal
Helps relieve tension and pressure
Bucks traction
A type of traction that can be used with a hip knee or femur fracture
Patients with a broken hip
Typically need to get into surgery fast. But in case they can’t you can use a buck traction in case they have bp out of wack , heart condition
Skelatal traction
Long term
Pin or wire inserted in bone
Weights 5-45 pounds
Risk for infection
Higher risk later in life complications
Nursing interventions for skelatal traction
Maintain counter traction by elevating end of bed ( 15- 20 degrees per physician orders)
Maintain continuous traction
We need to make sure we keep weights off the floor to avoid kicking them because they are attached to her leg
Why is it important to elevate leg especially after a cast
Can cause the cast to be too tight because of the swelling an also if its a plastered or fibrous cast and you leave it in a dependent position it will stretch off the cast
Elevate above the heart for at least 24 hours but would even encourage 48
Watch for compartment syndrome
6 ps
Pain
Pressure
Parenthesis
Pallor
Paralysis
Pulselessness
Extrernal fixation
Metal pins and rods more functional than skelatal traction
Mostly for long bones
External fixation nursing interventions /teaching
Assess for pin loosening an infection
P in site care
Patient teaching watch for drainage redness prulence o. Excessive bleeding on dressing
Also teach not to mess with them
Magnesium can help
Relax the muscles
Complications of immobility for renal calculi
Kidney stones - pt fluid level may not be as high so they are at risk
Complications of immobility prevention cardiopulmonary reconditioning
Dvt risk, pulmonary embolism, pressure ulcer, pneumonia, interventions turn cough and deep breath and spirometer up in a chair 3x a day for meals, ted hose, SCD foot pumps
Dietary requirements for fractures
Adequate protien 1g per kg
Vitamin b c d
Calcium
Magnesium
Fluid intake 2-3,000
High fiber diet with fruits and veggies
Direct complications of fractures
Infection
Incorrect union
Necrosis
Indirect complications of fractures
Compartment syndrome
Venous, thromboembolism
Fat embolism
Rhabdomyolysis
Hypovolemic shock
Which fracture requires prophylactic treatment
Open fracture
I& D
Go in with saline and clean it out anything with infection on it they scrape it out and often leave wound back or antibiotic beads
Don’t want it to turn into osteomyelitis
