musculoskeletal trauma Flashcards
describe joint dislocation
- joint no longer in anatomical alignment
- subluxation = partial dislocation
- orthopedic emergency: trauma dislocations
what are some complications of joint dislocation
- avascular necrosis
- check NV status immediately
describe acute interventions for joint dislocation
- xray
- immobilize and reduce joint
- may need sedation or heavy pain meds (fentanyl)
- please get informed consent before meds
whats some nursing considerations and education for joint dislocation
- NV assessment
- discuss exercises: PRICE
what are some causes of fractures
- direct blows
- crushing forces
- sudden twisting motion
how will the client present for fractures
- pain with movement (lessened when immobilized)
- muscle spasm
- deformity (often)
- eccymosis and edema at site (possible)
what are some diagnostic tests for fractures
- xray
- CT (excessive soft tissue damage)
what are some acute interventions for fractures
- NV assessment
- open: cover with saline gauze; prepare for surgery
- closed: reduction and immobilization, conscious sedation and informed consent
what are some complications of fractures
- complicated fractur: ORIF/external fixation, skeletal traction
- avascular necrosis
- osteomyelitis
- hemorrhage
- fat embolus (femur)
- compartment syndrome
- VTE ( from immobilization)
- DIC (bleed and use up all the clotting factors, treated with hep)
- nonunion (not together) and malunion (together but not right)
how can nurses help with fractures
education
- discuss conscious sedation for reduction
- aid in immobilization
- discuss splinting and casting
- PRICE
- NV assessment
- pain control
- monitor for complications
- discuss home care and follow up
what are some causes of pelvic fractures
- falls from great height; crush injuries
- MVA; vehicle vs pedestrian (ouch)
how will a client with pelvic fractures present
- ecchymosis (bc theres a shot ton of big vessels) and tenderness to A&P pelvis
- edema and NT to pubis, gentials, and thighs
- pain when weight bearing
whats the biggest concern with pelvic fractures
hemorrhage
what are some labs/diagnostics for pelvic fractures
CT and CBC
what are some acute interventions for pelvic fractures
- immobilize until surgery
- blood transfusion
what are some complications of pelvic fractures
- severe back pain (retroperitoneal bleed)
- hemorrhage (open book; rock pelvis)
- fat emboli
- NV compromise to lower extremities
what are some nursing considerations for pelvic fractures
- stable vs unstable
- monitor w bedrest and assess for complications of immobility
- painful to sit/defecate = sitz baths, stool softner
- early mobilization; rehab for full weight bearing in 3 months
- monitor for paralytic ileus (no bowel sounds)
what are some causes of hip fractures
falls
how will a client present with hip fracture
- affected leg shortened w external or internal rotation of foot
- pain in hip/groin/knee (upon slightest movement)
what are some diagnostic tests for hip fractures
- XRAY
- CT if worried about more damage
what are some acute interventions for hip fractures
- immobilize
- surgery (withi 24 hrs)
what are some complications of hip fractures
avascular necrosis
what are some nursing considerations for hip fractures
- standard post op care
- complications of immobility
- abductor pillow; les than 90 degrees; elevated toilet seat
- ambulate first day post op (in most cases)
- LTCF/rehab on floor/rehab at home w PT consult
- delirium on older adults
whats a cause of femur fractures
MVA
