Ortho

Question 1

What do you do with open fractures?

Answer 1

Put most (sterile) saline gauze over it

Question 2

What 2 things do splits help prevent with fractures?

Answer 2

1. Fat emboli

2. Muscle spasm

Question 3

What are 3 complications with fractures?

Answer 3

1. Hypovolemic shock
2. Fat embolism
3. Compartment syndrome

Question 4

Increased swelling occurs within a limited space due to fluid accumulation in the tissue. Impaired tissue perfusion occurs. The muscle becomes hard and swollen. Pain is not relieved with pain medication.

Answer 4

Compartment syndrome

Question 5

What are the 2 common areas for compartment syndrome?

Answer 5

1. Forearms

2. Quads

Question 6

What are 4 ways to treat and prevent compartment syndrome?

Answer 6

1. Elevate extremity
2. Soft cast then rigid cast
3. Loosen cast to restore blood flow
4. Fasciotomy (6 hours without a pulse)

Question 7

What 3 types of fractures can lead to fat embolism?

Answer 7

1. Long bones (femur)
2. Pelvic fractures
3. Crush injuries

Question 8

What are 5 ways to care for a plastic and fiberglass cast?

Answer 8

1. Ice packs on sides for 24 hours (cast is still wet)
2. Use palms to handle cast for first 24 hours
3. Don’t rest cast on hard surface
4. Cover cast close to groin with plastic (don’t want urine on it)
5. Neuro checks

Question 9

What is the most important assessment with fractures?

Answer 9

Neuro checks

Question 10

Should you ever relieve traction?

Answer 10

No - unless physician orders it

Question 11

Type of traction used short term to relieve muscle spasms and immobilize until surgery. This is when tape, a boot, or splint is stuck to the skin and the weights pull against it.

Answer 11

Skin (Buck’s) traction

Question 12

What type of assessment must be done when a patient is in traction?

Answer 12

Skin assessment

Question 13

This type of traction is applied directly to the bone with pins and wires and is used when prolonged traction is needed. Must monitor the pin sites and do pin care every shift. Sterile technique is used and crusts must be removed.

Answer 13

Skeletal traction

Question 14

What type of mattress is needed for any type of orthopedic or joint problem patient?

Answer 14

Firm

Question 15

Is it ok if a total hip replacement patient sleeps on the operated side?

Answer 15

No

Question 16

What 3 ways do you position a total hip replacement patient?

Answer 16

1. Neutral rotation –> toes to the ceiling
2. Limit flexion; want extension of the hip
3. Abduction

Question 17

What are 3 types of exercises that are good for the postoperative total hip replacement patient?

Answer 17

1. Walking
2. Swimming
3. Rocking chair

Question 18

What type of exercise is done with total knee replacement patients?

Answer 18

Continuous Passive Motion - keeps knee in motion and prevents blood clots; gradually increases flexion and extension of knee

Question 19

How are amputations performed?

Answer 19

Most distal point that will heal; try and save elbow and knee

Question 20

What should you keep at a postop amputee’s bedside?

Answer 20

Turnicate

Question 21

How should you position an amputated limb?

Answer 21

Extension

Question 22

How do you teach a client to toughen the stump?

Answer 22

Press into soft pillow, hard pillow, mattress, then wooden chair
Ok to massage the stump; want it shaped like a cone for prosthetics

Question 23

What is the first intervention to decrease phantom pain?

Answer 23

Diversional activity