Ortho Flashcards
True or false: with compartment syndrome, the tissue cannot expand anymore and it implodes and moves inwards.
True
What syndrome is associated with fractures or extensive soft tissue damage or crush injury of an extremity?
Compartment syndrome
What are the internal factors of compartment syndrome?
Edema and extreme muscular activity
What are the causes of external compartment syndrome?
Burns, tight dressing, cast
What is the classic sign of compartment syndrome?
Pain unrelieved by analgesic
What is the appropriate nursing care for compartment syndrome?
Raise extremity to heart level- no higher!
No ice- vasoconstriction exacerbates syndrome
Loosen bandages
What is the treatment option for compartment syndrome?
Fasciotomy (slits cut into skin)
What is it called when fat from the bone enter circulation and form emboli in the pulmonary capillaries and arterioles?
Fat embolism
True or false: fat embolisms are very rare
True
Name the disease: fluid leaks into the alveoli, increases workload on right side of heart, decrease lung compliance, triggers hypoxemia.
Fat embolism
What is the distinguishing factor of a fat embolism?
Petechia
What are the major signs and symptoms of a fat embolism?
Hypoxemia, tachypnea, tachycardia, pulmonary edema, crackles, confusion, fever
True or false: there is no definitive lab work to diagnose a fat embolism
True (however there can be fat in urine or sputum)
What is the best prevention for a fat embolism?
Try to limit touching the fracture
Name the disease: muscles break down, releases myoglobulin, causes acute renal failure.
Rhabdomyolysis
What are the major causes of rhabdomyolosis?
Trauma, poison bites, infections, HIV, statins, alcohol
What are the clinical manifestations of rhabdomyolosis?
Agitation, delirium, reddish/brown urine, high K high PHOS
What labs diagnose rhabdomyolosis?
Increase CK, increase BUN/Creatinine, hypocalcemia, elevated wbc
How do you treat rhabdomyolosis?
Osmotic/loop diuretics, admin NSS Iv 12-15liters over 24hr, dialysis if needed
What nursing care is provided for rhabdomyolosis?
Monitor all levels, analgesics
What are the major causes of low back pain?
No exercise, prior injury, obesity, age ( time wears away the cushion between the vertebrae), spinal stenosis, Clauda equina
What do you assess for with low back pain?
Palpation, symmetry, uneffected side first, reflexes, bowel/bladder issues, nv checks, gait
What is the difference between mild and severe back pain?
Mild is relieved by rest. Severe has significant neurological deficets
True or false: diagnostic studies are not used for mild back pain.
True
What is the collaborative care for lower back pain?
Rest, steroids/anti-inflammatory/muscle relaxers, exercise/pt, hot/cold, quit smoking, lose wt
What is the best position to sleep with lower back pain? (Spider-Man)
Williams position
What is severe pain unrelated to original pain caused by long term use of opioids?
Opioid induced hyperalgesia
What surgeries can be performed for back pain?
Kyphoplasty (balloon inserted to put cement between discs), spinal fusion, bone grafting, discectomy, laminectomy
What is an allograft?
Cadaver bone
How do you position a pt after back surgery?
Log-roll pt, pillow propping, NO trapeze, assess q2h
What is an infection in the bone?
Osteomyelitis
What is the direct way to get osteomyelitis?
Open fracture or surgery
What is the indirect way of getting osteomyelitis?
Blood borne infection: teeth, tonsils, boils, diabetic ulcers
What is the contiguous method of getting osteomyelitis?
Cellulitis
What is the difference between acute and chronic osteomyelitis?
Acute lasts less than a month. Chronic lasts longer than 4 weeks.
True of false: bone turns to pus due to bacterial growth in osteomyelitis
True
True or false: clinical manifestations of osteomyelitis are similar to the flu
True
What is the collaborative care for osteomyelitis?
Vigorous antibiotic, surgical debridement, suction/irrigation, hyperbaric 02 therapy
What is the buergers test with amputations?
Pt lays supine, legs elevated, look for colors in feet
What is disarticulation?
Amputation at joint
How do you prevent flexion contractions?
Lie flat on back for 30 mins at a time 3-4 times a day
