Ortho Flashcards

0
Q

True or false: with compartment syndrome, the tissue cannot expand anymore and it implodes and moves inwards.

A

True

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1
Q

What syndrome is associated with fractures or extensive soft tissue damage or crush injury of an extremity?

A

Compartment syndrome

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2
Q

What are the internal factors of compartment syndrome?

A

Edema and extreme muscular activity

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3
Q

What are the causes of external compartment syndrome?

A

Burns, tight dressing, cast

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4
Q

What is the classic sign of compartment syndrome?

A

Pain unrelieved by analgesic

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5
Q

What is the appropriate nursing care for compartment syndrome?

A

Raise extremity to heart level- no higher!
No ice- vasoconstriction exacerbates syndrome
Loosen bandages

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6
Q

What is the treatment option for compartment syndrome?

A

Fasciotomy (slits cut into skin)

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7
Q

What is it called when fat from the bone enter circulation and form emboli in the pulmonary capillaries and arterioles?

A

Fat embolism

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8
Q

True or false: fat embolisms are very rare

A

True

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9
Q

Name the disease: fluid leaks into the alveoli, increases workload on right side of heart, decrease lung compliance, triggers hypoxemia.

A

Fat embolism

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10
Q

What is the distinguishing factor of a fat embolism?

A

Petechia

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11
Q

What are the major signs and symptoms of a fat embolism?

A

Hypoxemia, tachypnea, tachycardia, pulmonary edema, crackles, confusion, fever

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12
Q

True or false: there is no definitive lab work to diagnose a fat embolism

A

True (however there can be fat in urine or sputum)

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13
Q

What is the best prevention for a fat embolism?

A

Try to limit touching the fracture

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14
Q

Name the disease: muscles break down, releases myoglobulin, causes acute renal failure.

A

Rhabdomyolysis

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15
Q

What are the major causes of rhabdomyolosis?

A

Trauma, poison bites, infections, HIV, statins, alcohol

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16
Q

What are the clinical manifestations of rhabdomyolosis?

A

Agitation, delirium, reddish/brown urine, high K high PHOS

17
Q

What labs diagnose rhabdomyolosis?

A

Increase CK, increase BUN/Creatinine, hypocalcemia, elevated wbc

18
Q

How do you treat rhabdomyolosis?

A

Osmotic/loop diuretics, admin NSS Iv 12-15liters over 24hr, dialysis if needed

19
Q

What nursing care is provided for rhabdomyolosis?

A

Monitor all levels, analgesics

20
Q

What are the major causes of low back pain?

A

No exercise, prior injury, obesity, age ( time wears away the cushion between the vertebrae), spinal stenosis, Clauda equina

21
Q

What do you assess for with low back pain?

A

Palpation, symmetry, uneffected side first, reflexes, bowel/bladder issues, nv checks, gait

22
Q

What is the difference between mild and severe back pain?

A

Mild is relieved by rest. Severe has significant neurological deficets

23
Q

True or false: diagnostic studies are not used for mild back pain.

A

True

24
Q

What is the collaborative care for lower back pain?

A

Rest, steroids/anti-inflammatory/muscle relaxers, exercise/pt, hot/cold, quit smoking, lose wt

25
Q

What is the best position to sleep with lower back pain? (Spider-Man)

A

Williams position

26
Q

What is severe pain unrelated to original pain caused by long term use of opioids?

A

Opioid induced hyperalgesia

27
Q

What surgeries can be performed for back pain?

A

Kyphoplasty (balloon inserted to put cement between discs), spinal fusion, bone grafting, discectomy, laminectomy

28
Q

What is an allograft?

A

Cadaver bone

29
Q

How do you position a pt after back surgery?

A

Log-roll pt, pillow propping, NO trapeze, assess q2h

30
Q

What is an infection in the bone?

A

Osteomyelitis

31
Q

What is the direct way to get osteomyelitis?

A

Open fracture or surgery

32
Q

What is the indirect way of getting osteomyelitis?

A

Blood borne infection: teeth, tonsils, boils, diabetic ulcers

33
Q

What is the contiguous method of getting osteomyelitis?

A

Cellulitis

34
Q

What is the difference between acute and chronic osteomyelitis?

A

Acute lasts less than a month. Chronic lasts longer than 4 weeks.

35
Q

True of false: bone turns to pus due to bacterial growth in osteomyelitis

A

True

36
Q

True or false: clinical manifestations of osteomyelitis are similar to the flu

A

True

37
Q

What is the collaborative care for osteomyelitis?

A

Vigorous antibiotic, surgical debridement, suction/irrigation, hyperbaric 02 therapy

38
Q

What is the buergers test with amputations?

A

Pt lays supine, legs elevated, look for colors in feet

39
Q

What is disarticulation?

A

Amputation at joint

40
Q

How do you prevent flexion contractions?

A

Lie flat on back for 30 mins at a time 3-4 times a day