Musculoskeletal 2

Question 1

Fracture treatment

Answer 1

Reduction 
Traction
Immobilisation
Maintaining and restoring function 
Preventing infection
Drug therapy 
Nutritional therapy

Question 2

Reduction

Answer 2

Closed traction realignment

Open reduction internal fixation - metallic pins, wires, screws, playes , nails and rods

Question 3

Immobilisation

Answer 3

Casts braves splints immobilisers

External and internal fixation device’s

Question 4

Internal fixation

Answer 4

Cannulated screw fixation
Compression hip screw and side plate
Blade plate fixation

Question 5

External fixation

Answer 5

Metal pins inserted in the bone

Attached to external rods to stanilose fracture while it heals

Question 6

Fractures : nursing problems (diagnosis)

Answer 6

Impaired mobility
Risk of neurovascular
Acute pain

Question 7

Impaired mobility

Answer 7

Loss of integrity of bone structure
Movement of bone fragment
Prescribed movement restrictions

Question 8

Risk for peripheral neurovascular dysfunction

Answer 8

Vascular insufficiency

Nerve compression

Question 9

Acute pain

Answer 9

Oedema
movement of bone fragments
Muscle spasms

Question 10

Acute interventions in perioperative nursing management

Answer 10

Skin preparations
 Neuro vascular observation
Analgesia
Drain care
Prevention and monitoring of complications
Cast care needed
Mobility training
Education
Rehabilitation

Question 11

Neurovascular assessment

Answer 11

Circulation
Motion
Sensation

Question 12

Circulation

Answer 12

Colour
Temperature
Capillary refill

Question 13

Motion

Answer 13

Weakness

Paralysis

Question 14

Sensation

Answer 14

Paraesthesia
Unrelenting pain
Pain on passive stretch
Absence kf feeling

Question 15

Cast therapy and nursing care

Answer 15

Acute management
Teaching patient self care
Fibre glass
Plaster

Question 16

Acute management

Answer 16

Assess and monitor neurovascular status
Relieve pain
Monitor and management potential complications

Question 17

Teaching patient self-care

Answer 17

Move about as normally as possible and perform prescribed exercises
Do not scratch skin under cast
Keep cast dry
Report : persistent pain , swelling , changes in sensation, paralysis
Note odour, stained areas hot spots
Report broken cast

Question 18

Fibreglass

Answer 18

Light

Strong durable and water resistant

Question 19

Plaster

Answer 19

Heavy slower in drying

Loses strength when becomes wet

Question 20

Traction

Answer 20

The mechanism bu which a steady pull is exerted to a part or parts of the body

Question 21

Traction principles

Answer 21

The line of pull must be maintained
The pull must be continuous
Ropes, pulleys and weights must be free of friction
There must be adequate counter-traction

Question 22

Type of traction

Answer 22

Skin

Skeletal

Question 23

Patient with traction nursing process

Answer 23

Diagnosis: acute pain
Impaired mobility 
Impaired skin integrity
Risk for ineffective coping
Risk of impaired urinary elimination 

Potential complications 
Haemorrhage
Peripheral neuromuscular
Deep  vein thrombosis 
Pressure ulcer
Infection

Question 24

Nursing process: nursing process

Answer 24

Pain relief- handle traction gently, provide pain relief, positioning for comfort
Monitor neurovascular status
- monitor every hour then drop to 4/24 hrly, patient to report any changes in sensation
Dvt prevention
Compression stockings, compression devices , anticoagulant therapy
Pressure area prevention
Provide back care, keep bee dry, and free of wrinkles and crumbs
Pin site care
Keep pin sites clean and dry, and sites to be covered by sterile dressings

Question 25

Direct Complicationsof fractures

Answer 25

Bone infection ( osteomyelitis)
Bone union problems
Avascular necrosis

Question 26

Indirect complications

Answer 26

Associated with blood vessel and nerve damage resilting in conditions
Compartment syndrome
Venous thromboembolism 
Fat embolism syndrome 
Rhabdomyolysis
Hypovolaemic shock