Nursing Management of Fractures

Question 1

Risk for peripheral neurovascular dysfunction r/t nerve compression, edema OUTCOME

Answer 1

Maintain circulation, sensation, and movement of an extremity within client’s own normal limits

Question 2

Goal of fracture management

Answer 2

To restore function to the bone

Accomplished by realignment of bone fragments (reduction)

Immobilization of fragements to facilitate healing

Question 3

Pain, Acute r/t edema, movement of bone fragments, and muscle spasms OUTCOME

Answer 3

Report no pain or tolerable pain level <3

Question 4

Risk for Infection r/t disruption of skin integrity OUTCOME

Answer 4

No evidence of infection; WBC wnl, afebrile

Question 5

TNI risk for peripheral neurovasuclar function

Answer 5

1. Assess 6 Ps
2. Capillary refill time greater than 3 seconds (not good)
3. Check for edema
4. Elevate extemity above the level of the heart if no compartment syndrome
5. Apply ice compresses if no compartment syndrome
6. Monitor appropriate application and function of corrective device every 1-4 hours as needed
7. Notify MD if pt. c/o increasing pain that is unrelieved by medications

Question 6

TNI Pain, Acute

Answer 6

1. Be gentle
2. Use pain scale 0-10
3. Administer analgesics and/or muscle relaxants as indicated
4. Elevate, apply ice as prescribed
5. Be alert for pain that is not diminished after analgesic is administered. May be sign of compartment syndrome

Question 7

TNI Risk for infection

Answer 7

1. Assess fracture or pin insertion points for rednes, drainage, swelling
2. Administer antibiotics as ordered
3. Provide pin care per MD order

Question 8

Closed Reduction

Answer 8

Non-surgical manipulation of the bone fragments to restore them in the correct anatomical alignment, position, and length. After reduction occurs the injured part will be immoblixied by casting the limb, using a brace, or by the use of traction.

Question 9

Open Reduction

Answer 9

Surgical manipulation and realignment of bone fragments through a surgical incision. Heard during report is that “the client had an ORIF of their R. femur.” ORIF= open reduction and internal fixation. The bone fragments are usually reduced and immbolized through the use of wire, screws, pins, nails, or rods. Biologically inert metals such as stainless steel and titanium are used for internal fixation devices. Can support early mobilization.