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Nursing > Musculoskeletal TRAUMA > Flashcards

Musculoskeletal TRAUMA Flashcards

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1
Q

Strain

A

stretching or tearing of a muscle or tendon

muscle to bone

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2
Q

Sprain

A

stretching or tearing of a ligament

bone to bone

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3
Q

Contusion

A

injury to soft tissue that results in a hematoma

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4
Q

1st Degree Strain

A
  • mild edema, pain, and muscle spasms
  • ROM NOT affected
  • may last 3-5 days
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5
Q

2nd Degree Strain

A
  • Moderate
  • Edema/bruising
  • Pain/muscle spasms
  • Loss of strength
  • 2-3 weeks
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6
Q

3rd Degree Strain

A
  • Complete Tearing
  • Internal bleeding w/ bruising
  • Severe pain, edema, muscle spasms
  • Complete loss of function
  • May need surgery
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7
Q

1st Degree Sprain

A
  • stretching or minimal tearing
  • edema/mild discomfort
  • function unaffected
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8
Q

2nd Degree Sprain

A
  • Moderate incomplete tearing
  • Edema, redness, pain w/ moving
  • Discomfort evident w/ weight bearing
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9
Q

3rd Degree Sprain

A
  • Complete tearing
  • Ambulation not possible
  • Severe pain, redness, edema
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10
Q

Diagnostic Tests for Strains/Sprains

A
  • X-rays
  • CT Scans
  • MRI
  • Ultrasounds
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11
Q

Treatment for 1st-2nd Degree

A 
R- rest
I- ice (30 mins 5x a day)
C- compression 
E- elevate
NSAID's 
Splinting
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12
Q

3rd Degree Treatment

A

Surgery

  • Arthroscopic
  • Reconstructive
  • Recovery is 4-6 weeks of immobilization and therapy
  • Percocet/Norco
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13
Q

Complications of Sprains and Strains

A
  • Joint instability
  • Higher Risk for repeated injury
  • Bursitis/ Tendonitis
  • Limited Mobility
  • Compartment Syndrome
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14
Q

Joint Dislocation

A

Articular surfaces of bone are no longer aligned

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15
Q

5 Types of Dislocation

A
  • Total or Partial
  • Congenital
  • Spontaneous
  • Traumatic
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16
Q

S/S of Dislocation

A
  • Abnormal appearance of joint
  • Shortening of affected limb
  • Loss of normal mobility
  • Confirmed w/ x-ray
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17
Q

Treatment for Dislocation

A
  • Immediate immobilization
  • Reduction ASAP
  • Re-immobilize
  • Neurovascular checks q 1-2 hours
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18
Q

When can the patient begin to move their extremity again after dislocation?

A

-Begin slowly progressing movement IF joint is stable

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19
Q

When may surgery be necessary?

A

If no stability can be attained

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20
Q

When is treatment considered emergent for a dislocation?

A

When it is traumatic and is to prevent Avascular Necrosis

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21
Q

Fractures

A

A disruption or break in the continuity of a bone

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22
Q

What might cause an elderly person’s bones to fracture?

A
  • Weakened bones secondary to osteoporosis
  • Loss of bone density due to aging
  • Falls
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23
Q

What are the most common causes of fractures for teens-young adults?

A
  • Motor vehicle accidents

- Sports injuries

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24
Q

Where do fractures in young children often occur?

A

Growth plates

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25
Q

Complete Fracture

A

Bones break into 2 or more parts and may involve displacement

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26
Q

Incomplete Fracture

A

Break does not go all the way through the bone

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27
Q

Oblique Fracture

A

Break runs across the bone diagonally

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28
Q

Comminuted Fracture

A

Produces bone fragments

  • may have missing pieces
  • hardest to heal
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29
Q

Impacted Fractures

A

Ends of the bones are driven into each other

-often w/ falls

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30
Q

Closed (Simple) Fracture

A

Does NOT break the skin

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31
Q

Open (Compound) Fracture

A

Bone protrudes through the skin

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32
Q

Stress Fractures

A

Repeated bone trauma

-Athletes

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33
Q

Compression Fracture

A

Compression of vertebrae

-May be pathological (osteoporosis)

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34
Q

Avulsion Fracture

A

tendon/ligament is pulled away and takes the bone w/ it

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35
Q

Depression Pattern Fracture

A

Inward fracture from blunt force trauma

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36
Q

Green stick Fracture

A

One side is broken and the other is bent

-Children

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37
Q

Spiral Fracture

A

Twisting of the bone

-Child abuse

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38
Q

S/S of a Fracture

A
  • Pain
  • Loss of Function
  • Deformity
  • Shortening
  • Crepitus
  • Swelling
  • Discoloration
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39
Q

What are the non-surgical treatments for a fracture?

A
  • Immobilization (splints/casts)
  • Pain Meds
  • Closed Reduction
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40
Q

What pain meds are used for fractures?

A

Narcotics: Percocet, Norco
NSAIDs: Motrin, Advil, Aleve

41
Q

Closed Reduction

A

Bones are realigned through manual manipulation and traction while the patient is under conscious sedation

  • Cast/splint used for immobilization
  • X-rays used to verify realignment
42
Q

Surgical Treatment for Fractures

A
  • Open reduction w/ internal fixation
  • Closed reduction w/ internal fixation
  • Open reduction w/ external fixation
43
Q

Open Reduction w/ Internal Fixation

A

Plates, screws, and rods are used internally to stabilize the fracture

44
Q

Closed Reduction w/ Internal Fixation

A

Bones aligned manually, but small incisions are made to place plates and screws

45
Q

Open Reduction w/ External Fixation

A

Rods and pins create a frame externally to support the fracture

46
Q

What should be done for an Open Fracture?

A
  • Irrigation and debridement of wounds
  • Reduction and stabilization
  • Antibiotics w/in 6 hours of trauma
  • Sterile dressing/wound VAC/debridement
  • Closure w/ patients skin or secondary intention
47
Q

Reactions to Internal Fixations

A

May be the result of mechanical or material failure, allergic reaction, or device corrosion
-causes pain and decreased mobility

48
Q

How can you treat a reaction to internal fixation devices?

A

Removal may be possible if bone strength and functioning can be adequately maintained
-Must treat infection 1st

49
Q

Reactions to External Fixation Devices

A

Infection typically common w/ pins and pin sights

  • Erythema
  • Drainage
  • Warmth of infected extremity
  • Fever
  • Increased WBC’s
50
Q

Treatment and Prevention for reactions to external fixation devices

A

Pin care and antibiotics

51
Q

Complex Regional Pain Syndrome

A

Constant intense limb pain associated w/ limb fractures

52
Q

S/S of Complex Regional Pain Syndrome

A
  • *Severe burning pain
  • Swelling
  • Excessive sensitivity (hyperesthesia)
  • Discoloration
  • Limited ROM
53
Q

What should be done for a patient w/ Complex Regional Pain?

A
  • Avoid prolonged contact w/ affected extremity
  • Vitamin C supplements
  • Early Mobilization
  • Elevation
  • Physical Therapy
  • Pain reduction
54
Q

What medications can be used fir Complex Regional Pain?

A
  • NSAIDs
  • Corticosteroids
  • Nerve blocks
  • Muscle relaxants
  • Opioids
55
Q

Fat Embolism

A

usually occurs when there is trauma to a long bone or the PELVIS

  • A piece of fat from the marrow breaks away and obstructs smaller vessels
  • multiple fractures, CRUSH injuries, ortho surgery, pelvic/long bone fractures
56
Q

S/S of Fat Embolisms

A
  • Disorientation
  • Agitation
  • Acute HA
  • Hypoxia
  • Tachypnea
  • Tachycardia
  • Dyspnea/crackles/wheezing
  • Petechia
57
Q

How are fat embolisms diagnosed?

A

CT San of lungs and Cerebral MRI

58
Q

What can happen if a fat embolism is NOT treated?

A
  • pulmonary edema
  • heart failure
  • stroke
  • death
59
Q

Prevention and Treatment of Fat Embolism

A
  • Immediate immobilization
  • Minimal manipulation and support
  • Strict fluid and electrolyte balance
  • Respiratory support
  • Corticosteroids
  • Vasopressors
60
Q

Delayed Union

A

prolonged healing/realignment

61
Q

Malunion

A

fractures do not heal in correct alignment causing deformities

62
Q

Nonunion

A

Fractures do NOT heal

  • Internal fixations
  • Bone grafting
  • Electrical bone stimulation
63
Q

Treatment for the Unions

A
  • Smoking cessation
  • Limit alcohol
  • Proper nutrition
  • Avoid NSAID’s
64
Q

Venous Thromboemboli VTE

A

clots develop in the large vessels of the extremities

-can break away and move to the lungs resulting in pulmonary embolism

65
Q

What should you monitor for w/ VTE?

A
  • sudden SOB and chest pain
  • restlessness
  • tachypnea
  • tachycardia
  • acute persistent cough
  • blood-tinged sputum
66
Q

What can prevent/treat VTE?

A
  • Early ambulation
  • ROM daily
  • Prophylactic anticoagulants
67
Q

Hypovolemia/Hypovolemic Shock

A

Secondary to blood loss that may occur

  • pelvic, femur, and open fractures
  • agitation, confusion, low urine output, clammy hands, hypotension, tachycardia, tachypnea, weak pulse
68
Q

How to treat Hypovolemia/Hypovolemic Shock

A
  • Rapid stabilization
  • Transfusion of PRBC’s
  • Pain meds
69
Q

Disseminated Intravascular Coagulation (DIC)

A
  • Clotting proteins in the blood are consumed leading to widespread hemorrhaging
  • *Plasma Transfusions
  • Clotting proteins become abnormally active resulting in widespread clots
  • *Anti-coagulants
70
Q

Avascular Necrosis

A

bone loses its blood supply and dies

71
Q

5 P’s for Neurovascular Assessment

A 
Pain
Pulse
Pallor
Paresthesia 
Paralysis
72
Q

Compartment Syndrome

A

Swelling w/in a limited space, such as muscle compartment or cast that does not easily expand

  • Compresses blood vessels, compromising circulation, and nerves affecting motor function
  • Damage can be irreversible and permanent after only 3 hours
73
Q

Late S/S of Compartment Syndrome

A
  • Loss of sensation
  • Cool skin
  • Weak pulse
  • Paresthesia
  • Decreased mobility
  • Sudden increase in pain
74
Q

Treatment for Compartment Syndrome

A

CALL PROVIDOR ASAP

  • loosen or remove bandage
  • Bi-valve cast
  • Fasciotomy
75
Q

Fasciotomy

A

a surgical procedure where the fascia is cut to relieve tension or pressure
-closed surgically or w/ wound vac

76
Q

Pressure Ulcers

A
  • Assess for drainage/foul odor
  • Remove bandage
  • Bi-valve cast or cut window
77
Q

Disuse Syndrome

A

Muscle Atrophy

  • loss of size and strength in a muscle that has been inactive for a long period of time
  • muscle contraction exercises, fist squeezes, PT
78
Q

Buck’s Traction

A

Used for immobilization of femur and hip fractures prior to surgical repair

  • Free hanging weights
  • Extremity remains in proper alignment
  • Check for slipping
79
Q

Skeletal Traction

A

Used to maintain alignment/prevent limb shortening

  • tibia, femur, and cervical fractures
  • attached directly to the bone
  • Weights attached to rods
80
Q

External Fixator

A
  • used to maintain alignment and immobilization in stable, complicated fractures
  • pins and screws are inserted directly in the bone and secured w/ metal frame
  • clamps used to change tension
81
Q

Traction Care

A
  • Assess weights and ropes q 2 hours
  • Ensure proper alignment
  • Feet remain in neutral position
  • Inspect for pressure ulcers
  • Apply to trapeze
  • Pressure mattress
  • Pin care
  • Inspect pin sites daily
82
Q

Joint Replacement

A

A surgical procedure in which parts of an arthritic or damaged joint are removed and replaced w/ a metal, plastic, or ceramic device (prosthesis)
-Knees, hips, shoulders

83
Q

Diagnosis of need for Joint Replacement

A

-Observation/Assessment
Deformity, limitations, pain
-X-ray/MRI

84
Q

Conservative treatment for joint injury

A
  • Exercise
  • Weight loss
  • NSAID’s (stop 1 week before surgery)
  • Joint Supplements
85
Q

Surgery for Joint Replacement

A
  • May be total or partial

- Prosthetic device may be cemented or uncemented

86
Q

Cemented

A

Glue or cement is used to attach the new device to the healthy bone
-Older adults that are less active

87
Q

Uncemented

A

A hole is drilled into the healthy bone to attach the new device

  • younger adults
  • high levels of activity, better movement, easier to revise
88
Q

Total Hip Replacement (Arthroplasty)

A

involves removal of the ball and socket as well as the neck of the femur

89
Q

Partial Hip Replacement (Hemi-Arthroplasty)

A

involves the removal of the ball as well as the neck of the femur, but NOT the socket

90
Q

Joint Replacement Post Op Education

A
  • Hemovac drain
  • May need blood transfusions (autologous)
  • Usually closed w/ staples
  • Island dressing
  • Continuous passive motion machine
  • Partial weight bearing w/ slow progression to full
91
Q

Total Joint Knee Precautions

A
  • Do not pivot or twist

- Do not kneel or squat

92
Q

Total Joint Hip Precautions

A
  • Avoid flexion beyond 90 degrees
  • Do not pivot or twist
  • Do not cross legs
  • Do not elevate HOB more than 60 degrees
93
Q

Complications of Joint Replacement

A
  • Bleeding/hypovolemia
  • Orthostatic hypotension
  • Wound infection
  • Dislocation
  • DVT
  • Pulmonary embolism
94
Q

S/S Hip dislocation

A
  • pain and swelling
  • acute groin pain
  • shortening of affected leg
  • abnormal rotation
  • Popping sound
95
Q

Amputation

A

Removal of body part

  • performed at the lowest point w/ highest chance of successful healing
  • Conserve as much as possible
96
Q

Complications of Amputation

A
  • Hemorrhage
  • Infection
  • Skin breakdown
97
Q

Phantom Limb Pain

A

Sensation that an amputated body part is still attached, numbness, tingling, and burning sensations manifest from the removed limb

98
Q

Treatment for Phantom Limb Pain

A
  • Antidepressants
  • Anticonvulsants
  • Mirror technique
  • Validate pain and encourage to touch amputation
  • Exercise limb

Nursing (21 decks)

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