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TERM 4 N2261 KNLG 3 > ORTHOPEDICS > Flashcards

ORTHOPEDICS Flashcards

1
Q

What is the difference between dislocation and subluxation?

A

Dislocation: Complete displacement of joint (severe injury)

Subluxation: Incomplete displacement of joint (mild to moderate injury)

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2
Q

What is the term for a procedure to remove fluid from the space around a joint using a needle and syringe?

A

Joint aspiration

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3
Q

What are 4 complications associated with dislocation and subluxation?

A
  1. Fractures
  2. Compartment syndrome
  3. Avascular necrosis
  4. Repeated dislocations
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4
Q

What are the 4 stages of fracture healing?

A
  1. Hematoma
  2. Granulation tissue (procallus)
  3. Bony callus formation, ossification, consolidation
  4. Remodeling
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5
Q

Describe how skin traction is applied

A

Boot/splint applied to skin with traction weight

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6
Q

Describe how skeletal traction is applied

A

Pin or wire inserted into bone

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7
Q

Casts are usually used after what kind of fracture repair?

A

Closed reduction

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8
Q

What are the two kinds of cast materials used?

A

Plaster of Paris
Fiberglass

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9
Q

What are 4 examples of reasons fiberglass preferred over plaster of paris?

A
  1. Light & strong
  2. Water resistant
  3. Porous: less skin irritation
  4. Requires only 3 hrs to dry
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10
Q

What are some features that can be used in casts?

A
  1. Stockinette and padding over bony prominences
  2. Observation windows
  3. Bi-valved: split on sides
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11
Q

What is the term for a cast with a rubber pad on the sole to assist weight bearing?

A

Walking cast

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12
Q

What is the term for a cast involving a portion of the trunk/extremities?

A

Spica cast

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13
Q

What is the term for a cast that circles the trunk and is used for spinal fractures?

A

Body cast/jacket

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14
Q

What are 3 nursing actions to take immediately after cast application?

A
  1. Neurovascular assessment
  2. Elevate limb
  3. Examine for drainage (outline and monitor)
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15
Q

How should a damp cast be handled?

A

With palms, and wear gloves

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16
Q

How should the patient be positioned after cast application?

A

Ensure warm & dry air circulates around/under the cast

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17
Q

What are 4 points to include in client education regarding cast care?

A
  1. Keep cast clean by wiping with damp cloth
  2. Protect from knocks/bangs
  3. Keep dry, use plastic cover in shower
  4. Only to be removed by physician
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18
Q

What are 3 points to include in client education regarding protecting the extremities?

A
  1. Protect digits from cold by covering with socks/mittens
  2. Use circulation exercises (e.g. wiggling digits)
  3. Elevate limb when possible, otherwise keep in a sling or restrict activity as instructed
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19
Q

What are 5 points to include in client education regarding when to see a physician?

A
  1. Loss of circulation to digits
  2. Burning/tingling under cast
  3. Too tight or too loose
  4. Breaks
  5. Smells bad or has discharge
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20
Q

What is the term for an orthopedic surgery to remove degenerative debris from a joint?

A

Debridement

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21
Q

What is the term for an orthopedic surgery to reconstruct or replace a joint?

A

Arthroplasty

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22
Q

What is the definition of a hip fracture?

A

Fracture of the proximal third of the femur

23
Q

Which kind of hip replacement uses glue, and is recommended for older, less active adults?

A

Cemented THA (total hip arthroplasty)

24
Q

Which kind of hip replacement uses porous coating, providing longer implant stability due to growth of new bone tissue into the porous surface, and is used in younger patients?

A

Uncemented THA (total hip arthroplasty)

25
Q

What are 3 principles of nursing management of patients with hip replacement?

A
  1. Maintain alignment
  2. Hips cannot be lower than knees
  3. Lay on unaffected side
26
Q

What is the term for a knee replacement that uses a small (3-5 inch) incision, does not cut tendon, and works between the fibers of the quadriceps muscle?

A

MIS (minimally invasive surgery) arthroplasty

27
Q

What supplies are usually applied to a patient after knee replacement?

A

Compression dressing to stabilize knee for first 24 hours
Zimmer immobilizer splint

28
Q

What is the difference between delayed union, nonunion, and malunion?

A

Delayed union: Healing progresses more slowly than expected but does eventually heal

Nonunion: Fracture fails to heal despite treatment, no callus formation

Malunion: Fracture heals in unsatisfactory position

29
Q

What is the term for deposition of calcium in muscle tissue at the site of muscle trauma?

A

Myositis ossificans

30
Q

What is the term for inflammation in the affected joint after trauma or after surgery?

A

Post-trauma arthritis

31
Q

What is the term for a severe infection of bone, bone marrow, and surrounding soft tissue via direct or indirect entry?

A

Osteomyelitis

32
Q

What is the difference between acute and chronic osteomyelitis?

A

Acute: 1 month
Chronic: >1 month

33
Q

What kind of dressings are usually used for osteomyelitis?

A

Vac dressing

34
Q

What are 4 steps in the pathogenesis of compartment syndrome?

A
  1. Increased pressure within muscle compartment causes blood vessel compression
  2. Histamine release
  3. Vasodilation
  4. Exacerbation of pressure
35
Q

What are the 3 P’s of early compartment syndrome?

A

Pain, Pressure, Paresthesia

36
Q

What are the 3 P’s of late compartment syndrome?

A

Pallor, Paralysis, Pulselessness

37
Q

Besides the 6 P’s, what are 2 assessments nurses should perform to prevent compartment syndrome?

A

Neurovascular assessment
Myoglobin in urine

38
Q

What is the definitive treatment for compartment syndrome, and what should NOT be done?

A

Fasciotomy
Do not elevate or ice

39
Q

What are 4 nursing interventions to prevent VTE?

A
  1. Prophylactic medications
  2. SCDs (sequential compression devices) or compression stockings
  3. Encourage mobilization
  4. CVS assessment and vitals
40
Q

What are 4 signs of DVT?

A

Rubor, warmth, pain/tenderness, and/or unilateral swelling along the vein

41
Q

What are 6 signs of PE?

A
  1. Sx of hypoxia, O2 desat
  2. Sudden unexplained dyspnea
  3. Tachycardia
  4. Crackles
  5. Pleural chest pain
  6. Blood-tinged sputum
42
Q

Which lab test is used in diagnosis of both DVT and PE, and what does it indicate?

A

D-dimer: protein made when blood clot dissolves in body

43
Q

What test is used to definitively diagnose DVT?

A

Duplex ultrasonography

44
Q

What 2 tests are used to definitively diagnose PE?

A

CT-PE, VQ scan (nuc med)

45
Q

What treatment is used in both DVT and PE?

A

Anticoagulants such as heparin or LMWH

46
Q

What surgical intervention is used in DVT?

A

Venous thrombectomy

47
Q

Which pharmacological treatment is used in PE and not DVT?

A

Fibrinolytics

48
Q

What are 5 levels of weight bearing as ordered by the physician or physiotherapy?

A
  1. Non weight bearing
  2. Touch down/toe touch weight bearing
  3. Partial weight/feather weight bearing
  4. Weight bearing as tolerated
  5. Full weight bearing
49
Q

Which arrangements should be made before a patient is discharged home?

A
  1. Home environment assessed for safety
  2. Home support services in place
50
Q

Why would x-ray be chosen over CT?

A

X-ray shows dense areas e.g. bone
CT shows soft tissues in more detail

51
Q

What are 3 reasons external fixation may be used?

A
  1. Casting is contraindicated
  2. Many fragments at fracture site
  3. There is a wound adjacent to fracture site that cannot be covered
52
Q

When assessing for swelling of a limb, how can the nurse ensure consistent measurements?

A

Mark the limb at the level measured from

53
Q

What are 2 methods used by physicians to close a fasciotomy site?

A

ABRA
Purse-string sutures

54
Q

Immediately post-op, why are SCDs used for VTE prophylaxis instead of anticoagulant medications?

A

We should not be anticoagulating a patient who may still be bleeding

TERM 4 N2261 KNLG 3 (9 decks)

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