Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

kol- Med Surg 320 Spring > Fractures/Ortho Surgery > Flashcards

Fractures/Ortho Surgery Flashcards

1
Q

4 classifications for fractures?

A
  1. Extent of break
  2. Extent of soft tissue damage
  3. Cause
  4. Type
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

classifying fracture by extent

A

Complete versus Incomplete

Open vs Closed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

complete vs incomplete fracture

A 
Complete = broken in two 
Incomplete = not broken into two pieces, still connected
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

open versus closed fracture

A 
closed = no bone sticking out of skin
open = sticking out of bone - risk of infection and osteomyelitis!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

classifications of fracture by cause

A

Pathologic or Spontaneous = osteoporosis
Fatigue/Stress = running /jumping
Compression = fall and land on feet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is an example of a cause of pathologic fracture?

A

osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

example of cause of fatigue or stress fracture?

A

running/jumping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

example of compression fracture cause?

A

fall and land on feet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

fracture where bone broke and not aligned well

A

displaced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

fracture that runs all the way around the bone

A

spiral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

fracture in kids that is like incomplete

A

greenstick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

fracture where there is still some connection b/w bone but also fragments

A

fragmented

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

fracture where there is shattering of bone in many pieces

A

comminuted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

fracture runs up the bone length

A

oblique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

fracture where two bones pushed together and leads to comminuted fracture

A

impacted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

risk factors for fractures?

A 
*Riding in cars -> car accident risk
Falling
Malnutrition -> over age on 30 need to take in enough Ca and Vit D
Sports
Osteoporosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

where do adults, young/middle aged, and older adults have most of their fractures?

A

Adults: Ribs
Young and middle-aged: Femoral
Older adults: Femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

health promotion education/interventions for fracture prevention

A 
Seat belts
Airbags
Reducing driving while impaired
Osteoporosis screening/ treatment
Fall Prevention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

3 things to get in history when assessing fracture

A

Type of Injury
Alcohol and drug use
Disease states

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what do we prioritize with physical assessment of fracture

A

ABC!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is indicator that we need to get imaging for fracture

A

pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

head to toe signs of fracture?

A
  • Change in bone alignment
  • Shortening
  • Change in Shape
  • Bruising & Swelling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

C in CMS assessment

A 
Circulation
Color
Pulse
Capillary refill
Temperature (warm, cool?)

-compare to other extremity, focus on distal end

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

M in CMS assessment for fracture

A

Motion : Movement distal to fracture?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

S in CMS assessment for fracture

A

Sensation
Tingling? Pain? Numbness?
Check extremity distal to injury… Compare it to other extremity… Changes?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Change in CMS=

A

indication of compartment syndrome = priority assessment!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Diagnostics for fracture

A 
H&H-bleeding
WBC- infection
ESR
X-Ray
CT-scan
	Hip
	Spine
MRI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

When do we immobilize fracture?

A

immediately to prevent damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

types of immobilization

A

Bandage
Splint
Cast
Traction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

interventions for fracture

A
  • ABC
  • Pain
  • Immobilize
  • Sterile Gauze
  • Reduction
  • Elevation
  • Ice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

can nurses reduce bones?

A

no

32
Q

what is most common way to manage a simple fracture

A

closed reduction

33
Q

what happens in closed reduction?

A

Utilization of traction on bone and moving ends to position of realignment

34
Q

what do we use to confirm proper placement of bone after closed reduction?

A

xray

35
Q

when do we want to do complete a closed reduction?

A

ASAP to prevent nerve damage/promote proper bone healing

36
Q

nurse role in closed reduction?

A

Administer medications

Monitor patient

37
Q

when do we use splints? which is more goodly- splint or cast?

A

More commonly used on body parts that do not bear weight

–> preferred over cast b/c can adjust if swelling !

38
Q

what do we use to immobilize ankle and foot id weight bearing is allowed?

A

orthopedic boot or shoe

*also preferred over cast

39
Q

when do we use a cast?

A
  • Typically reserved for complex fractures and LE fractures

- Also utilized for correction of deformities and when NWB

40
Q

what material do we prefer to make casts out of

A

fiberglass!

41
Q

can fiberglass cast get wet?

A

Can get wet (but padding underneath cannot)

42
Q

can use _____ to waterproof but it cannot be fully submerged in water

A

gore-tex

43
Q

fiberglass vs plaster cast

A 
fiberglass = most common, dries quick, reduces skin breakdown, need stockinette and padding underneath
plaster = need stockinette and padding underneath, 24 hours to dry
44
Q

when do we use bivalve in cast?

A

for swelling, whole top and bottom come off

45
Q

why put a window on a cast?

A

if open wounds and need to do wound care

46
Q

cast intervention assessment

A

Increased pain
Increased drainage
Fowl smell
Circulation

47
Q

______ is risk for compartment syndrome

A

cast

48
Q

running vs balanced traction

A

Balanced: Fractured extremity is suspended with two opposing forces
–> can move limb w/o changing the traction

Running: Force exerted in one plane only (fractured limp is the opposing force)
–> if move limb they change traction

49
Q

if move limb they change traction: balanced or running

A

running

50
Q

skin vs skeletal traction

A

Skin: Force is applied to the fractured limp with use of bandage or splint

Skeletal: Force is applied to fractured limp with use of pins inserted into bone

51
Q

it is important to make sure the weights for traction are not ____ ____ _____

A

on the floor

52
Q

who do we contact if changes in weight w/ traction?

A

provider

53
Q

what is buck’s traction? what kind of pain is it particularly helpful for?

A

Buck’s Traction

  • Running, skin traction
  • Used for pain reduction specifically - esp. for hip fracture until repaired surgically
54
Q

what is halo traction used for?

A
  • cervical fracture

- used for pain reduction

55
Q

Open Reduction with Internal Fixation (ORIF) uses what to reduce fracture?

A
  • Metal pins, rods, prostheses or plates are used for fixation in open surgery
  • Affected area is kept immobile during healing process
56
Q

how quickly can you become mobile again after ORIF?

A

immediately! and no traction

57
Q

do you need traction with ORIF!

A

no!

58
Q

post op ORIF care

A
  • Pain Management : need to be able to move, breathe, what pain goal can get you there?
  • Ambulation right away
  • Prevent Complications
  • PT
  • NV Compromise
59
Q

benefits of external fixation?

A

Less Blood Loss
Early Ambulation
Promotes Healing

60
Q

complications from fixation surgery

A 
Acute Hypovolemic shock
Hypovolemic Shock
Fat Embolus Syndrome
VTE (PE)
Infection (Including osteomyelitis)
Avascular Necrosis
Delayed Union
61
Q

what is acute compartment syndrome?

A
  • muscles are in fascia compartments but with swelling the fascia prevents expansion and get compression in blood vessel and nerves
  • –> ischemia of muscle
  • —> damage to vessel, nerves, septic, amputation
62
Q

acute compartment syndrome prevention

A

> Avoid tight dressings and casts
Perform frequent CMS assessments for EARLY detection
—6 P’s changes

63
Q

volkmann’s contracture

A
  • forearm fracture as a result of acute compartment syndrome

- -> muscles necrosed and becomes misshapen

64
Q

fat embolism syndrome –> what is it and when do you see it?

A

-Fat globules released with all long bone fractures
(also hip and knee arthroplasty)
-Small percentage of people will develop FES
–>24-72 hours after trauma

65
Q

FES triad of sxs

A
  • Lungs (low O2, Dyspnea, tachypnea)
  • Brain (Confusion, headache, seizure, altered LOC)
  • Skin (Petechia on neck, chest and arms)
66
Q

FES treatment

A
  • Prevention
  • > Early fixation
  • > Surgical technique
  • Supportive
  • Oxygen
  • Fluids
  • Albumin: bind to fatty acid
67
Q

define surgical site infection

A

=If site becomes infected within 30 days of surgery

=If hardware becomes infected in the 1st year

68
Q

surgical site infection can lead to ….

A

osteomyelitis

69
Q

systemic vs local signs of infection

*consideration for elderly

A 
systemic = fever, elderly have depressed immune response and may not have a fever with infected fracture
local= red, hot
70
Q

upper extremity fracture interventions

A
  • Remove jewelry ASAP!
  • Perform NV assessment
  • Immobilize
  • Elevate
  • Apply Ice
  • Manage Pain
71
Q

hip fracture interventions/risks (things to consider for elderly)

A
  • High mortality rate
  • *Osteoporosis is the biggest risk factor
  • IV Morphine/ PCA
  • Avoid Demerol can contribute to delirium
  • Delirium
  • Mobility important
72
Q

biggest risk factor for hip fracture

A

osteoporosis + elderly

73
Q

avoid ______ in elderly with fracture b/c it can contribute to delerium

A

demerol

74
Q

chest and pelvis fracture interventions/assessment

A
  • -Potential for heart and lung damage (and other organs)
  • ABC First

-Pelvis Fractures can quickly lead to death (loss of blood)
Look for blood in the urine, stool
*****Abdominal rigidity????
Abdominal swelling

75
Q

spine fractures

A

-Associated with osteoporosis, cancer, MM
Causes pain, deformity and Neuro compromise
Non-surgical
Surgical
Kyphoplasty
Vertebroblasty

kol- Med Surg 320 Spring (43 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions