Brainscape's Knowledge GenomeTM

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


See full index

From Flashcardlet > (3) Exam 1- Chapter 63 ✔️ > Flashcards

(3) Exam 1- Chapter 63 ✔️ Flashcards

0
Q

With a strain full function returns within how many weeks

A

3–6 weeks

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

Most strains occur in large muscle groups such as

A

Lower back, calf, hamstrings

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

What areas are most commonly dislocated

A

Thumb, elbow, shoulder, hip, patella

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

😰Clinical manifestations of dislocation

A

Obvious deformity

Pain

Tenderness

Loss of function

Swelling

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

Complications of dislocations

A

Open joint injuries

Intra-articular fracture’s

Avascular necrosis (bone death)

Damage to adjacent tissue

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

What is often considered an orthopedic emergency

A

Dislocation

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

Dislocation can be accomplished by a closed reduction, but often requires

A

Surgery

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

😷Nursing management of dislocation

A

“PROM”

Pain relief
Support, protect injured joint
Gentle ROM exercises
Exercise program to slowly restore the joint

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

Patient who has a dislocated joint is a greater risk for repeated dislocation related to

A

Loose ligaments

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

😷 Nursing Management / Treatment for soft tissue injuries

A

“RICE”

Rest – immobilize patient
Ice – first 24 hours. 24–48 hours use warm compress
Compress
Elevate

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

The majority of fractures are from Trumatic injuries such as

A

Direct blow
Crushing force
Sudden twisting motion

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

Some fractures are secondary to process of diseases such as

A

Cancer or osteoporosis

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

What is a closed/simple fracture

A

Fractured bone doesn’t break through the skin

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

What is an Open/compound fracture

A

Fractured bone breaks through the skin

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

Grade 2 open/compound fracture

A

Total breakthrough skin with soft tissue and muscle damage

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

Grade 3 Open/compound fracture

A

Same as 2 but more excessive with nerve tissue and blood vessel damage

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

What is an oblique fracture

A

Line fracture is angled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a transverse fracture

A

Fracture runs across the bone

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

What is a Longitudinal fracture

A

Fracture runs length of bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a spiral fracture

A

Fracture is a result of twisting or rotation of bone

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

What is a comminuted fracture

A

Broken in more than two places

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

What is an impacted fracture

A

Fragments driven into each other

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

What is an avulsed fraction

A

Torn away by a ligament or tendon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is a displaced fracture

A

Absent of any alignment

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

😰 Clinical manifestations of a fracture

A 
Pain
Muscle spasm
Loss of function
Deformity
Shortening because of muscle spasm
Swelling and discoloration
Crepitus
Localized edema and Ecchymosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Fractures are managed by

A

External and internal fixation

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

What is external fixation

A

Metal pins and rods are inserted into the bone and attached to external rods to stabilize the fracture while it heals

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

What is internal fixation

A

Metal pins and rods are surgically inserted to realign and maintain bony fragments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

🍓Nutrition management for fracture

A

Protein (1 g/kg body weight)

Vitamin B (dairy, salmon, vegetables, nuts, avocado, watermelon), C (peppers, green leafy vegetables, Keewee, oranges, strawberries), D (tuna, salmon, dairy, beef liver, cheese, egg yolks)

Calcium (dairy, sardines, dark leafy vegetables, fortified cereals and juices)

Phosphorus (milk, meat, soy)

Magnesium (dark green leafy vegetables)

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

Complications of a fracture

A

Venus thromboembolism (VTE)
Fat embolism
Compartment syndrome

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

After fracture, veins of lower extremities and pelvis are highly susceptible to

A

Thrombus formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Interventions to prevent Venus thromboembolism

A

Compression stockings

Sequential compression devices

Instruct patient to move fingers or toes of affected extremity against resistance

Perform ROM exercises on the unaffected lower extremity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

After a fracture when is the patient at greatest risk for fat embolism

A

In the first 36 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the initial symptom of a fat embolism

A

Confusion due to hypoxemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What to assess for with fat embolism

A

Respiratory distress

Restlessness

Irritability

Fever

Petechiae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What to do if fat embolism is suspected

A

Notify provider stat

Draw blood gases

Administer O2

Assist with endotracheal intubation/treatment of respiratory failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What fractures most often cause fat embolism

A

Those of the long bones, ribs, tibia, and pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

With a fat embolism clients often report a feeling of

A

Impending doom or disaster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are the two basic types of compartment syndrome

A

Decreased compartment size (From restrictive dressings, splints, casts, excessive traction, premature closure of fascia)

Increased compartment content (due to bleeding, inflammation, edema, or IV infiltration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

After the onset of compartment syndrome, ischemia can occur within how many hours

A

4 to 8 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Contractures, disability, and loss of function can occur with what complication

A

Compartment syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

😰 Clinical manifestations of compartment syndrome

A

“6 P’s”

Pain- distal to injury that is not relieved by opioid analgesics
Pressure
Paresthesia- numbness or tingling
Pallor- coolness and loss of normal color
Paralysis- loss the function
Pulselessness- diminished or absent peripheral pulses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

In compartment syndrome what do you want to assess due to the possibility of muscle damage

A

Urine output and kidney function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

When assessing urine output and kidney function with suspected compartment syndrome, what is a common sign of acute kidney injury

A

Dark reddish brown urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

In compartment syndrome how should the extremity be elevated

A

Did extremity should not be elevated above the heart level. Elevation my lower venous pressure and slow arterial perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

In compartment syndrome what should not be used because it may result in vasoconstriction and exacerbate

A

Ice or cold compresses should not be applied

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

😷 Nursing Management / Collaborative care for compartment syndrome

A 
No elevation above the heart
No ice or cold compress
Loosen bandage or splint cast
Remove all external sources of pressure
Reduce traction weight

Surgical decompression (fasciotomy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

To ensure adequate soft tissue decompression, how long is the fasciotomy site left open

A

Several days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is a potential problem following a fasciotomy

A

Infection resulting from delayed wound closure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

In joint replacement, what are the most commonly replaced joints

A

Hip
Knee
Shoulder
Finger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is the #1 concern post operatively after joint replacement

A

Infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What do you want to monitor after joint replacement surgery

A

Incision site

Functioning of extremity

I&O- encourage fluid intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

When monitoring the incision site after joint replacement surgery what do you want to assess for

A

Bleeding/drainage
Suture line for erythema/edema
Suction drainage apparatus for proper functioning

53
Q

After joint replacement surgery, how do you monitor functioning of the extremity

A

Check circulation, sensation, movement of extremity distal to replacement

Provide proper alignment of affected extremity

Provide abductor appliance (hip replacement) or continuous passive motion (CPM) device if indicated

54
Q

Fractures of bone, especially if long bones are involved, predisposes clients to

A

Anemia

55
Q

💉After joint replacement surgery how often do you want to check the hematocrit to monitor RBC production

A

Every 3-4 days

56
Q

After joint replacement surgery why do you want to instruct the client not to lift the leg upward from a lying position or to elevate the knee when sitting

A

It could pop the prosthesis out of the socket

57
Q

What is the cause of amputation in approximately 80% of cases

A

Peripheral vascular disease

58
Q

What are the goals of amputation

A

Adequate relief from the underlying health problem
Satisfactory pain control
Reach maximum rehabilitation potential for with use of a prosthetic
Cope with body image changes
Make satisfying lifestyle adjustments

59
Q

Preoperative teaching for amputation

A

Reason for amputation
Prosthesis
Mobility training
Phantom pain

60
Q

😷 Nursing management of amputations postoperatively

A

Pain control
Prosthetics
Rehabilitation
Bandage

61
Q

Positions to relieve edema and spasms at residual limb (stump) site after amputation

A

Elevate stump for first 24 hours on one pillow

Do not elevate stump after 48 hours postoperatively

Keep stump in extended position and turn client to prone position 3x/day

62
Q

For the first 24 hours after amputation, why do you want to elevate stump on only one pillow

A

It can cause contracture if too high

63
Q

After amputation why do you want to turn the client to the prone position 3x/day

A

To prevent hip flexion contraction

64
Q

How do you treat phantom pain

A

Phantom pain is real! Treated as such

65
Q

After amputation, instruct the client to clean prosthesis socket daily with

A

Milk soap and rinse thoroughly

66
Q

What is the purpose of traction

A

Reduce, align and immobilize fractures
Minimize muscle spasms
Reduce deformity
Increase space between opposing services

67
Q

With traction, weight is not removed unless it is what type of traction

A

Intermittent traction

68
Q

For healing without delays, interruptions or problems, when must traction weight hang freely

A

At all times!!

69
Q

With traction, what must not touch the pulley or foot of the bed

A

Knots in the ropes or foot plates

70
Q

What type of traction?
The application of traction to the joints of the spine or extremities to know appropriate positions and intensities for the force.
Applied through hands of clinician (Hands on)

A

Manual traction

71
Q

What type of traction?

Traction on an extremity by means of adhesive tape or other types of strapping applied to the limb

A

Skin traction

72
Q

What type of traction?
A system of splints, ropes, slings, pulleys, and weights for suspending the lower extremities of the body, used as an aid to realignment and healing for fractures or from surgical intervention

A

Balance suspension traction

73
Q

What type of traction?
Traction pull on a bone structure mediated through a pen or wire inserted into the bone to reduce a fracture of long bones

A

Skeletal traction

74
Q

How long is skin traction used

A

48-72 hours

75
Q

What is the traction weight for skin traction

A

5 to 10 pounds

76
Q

What type of assessment is imperative when using skin traction

A

Skin assessment and prevention of breakdown

77
Q

What is the simplest form of traction

A

Bucks extension traction

78
Q

When is Bucks extension traction indicated

A

Femur / hip involvement

79
Q

With what traction is the hip flexed to 20° from the mattress

A

Russel’s traction

80
Q

When is russel’s traction indicated

A

Femur / hip joint fracture

81
Q

What traction incorporates the use of a knee sling

A

Russel’s traction

82
Q

When is Bryant’s traction indicated

A

Children with congenital hip dislocation

83
Q

Bryant’s traction is for children below 2–3 years and weighs less than

A

30 to 40 pounds

84
Q

Weight for skeletal traction ranges from

A

5 to 45 pounds

85
Q

Too much weight used for skeletal traction can result in

A

Delayed union or nonunion

86
Q

What are the major disadvantages of skeletal traction

A

Infection in the area of the bone where the skeletal pin is inserted and the consequences of prolonged immobility

87
Q

What type of traction is Buck’s, Russel’s and Bryant’s Tractions

A

Skin traction

88
Q

In what traction are weights attached directly to the bone

A

Skeletal traction

89
Q

What traction is at risk for osteomyelitis

A

Skeletal traction

90
Q

Care of pin site for skeletal traction

A

Clean with antiseptic
Apply antibiotic
No Betadine (rust pins)
No peroxide (aerobic infection)

91
Q

With the skeletal traction the patient should be in the center of the bed and in what position

A

Supine

92
Q

Principles of effective skeletal traction

A

Continuous (never interrupted)
Weights are not removed
Good body alignment
Ropes must be unobstructed

93
Q

What is one of the more common types of skeletal traction

A

Balanced suspension traction

94
Q

With balanced suspension traction at what degree are the hips fixed

A

30°

95
Q

When traction is used to treat fractures, the forces are usually exerted on the

A

Distal fragment

96
Q

What complication can occur with traction due to the inability of the patient to perform deep breathing exercises

A

Atelectasis and pneumonia

97
Q

How often are the lungs auscultated when using traction

A

Q4-8 hours

98
Q

Complications of traction

A

Atelectasis and pneumonia

Constipation and anorexia

Urinary stasis an infection

Venus thromboembolism

99
Q

What signs and symptoms are monitored of urinary stasis an infection when using traction

A

Hesitancy
Urgency
Frequency
Dysuria

100
Q

🍓Diet for constipation due to complications of traction

A

High fiber and increased fluids (>2500 mL/day)

101
Q

When using a walker the elbows should bend at what angle

A

30°

102
Q

When using crutches, The crutch pads should be how many inches below the armpits with the shoulders relaxed

A

1.5–2 inches

103
Q

When using crutches the patients elbows are flexed at what degree

A

15–30°

104
Q

What gait is used when the client can move and bear weight on each leg

A

Four point gait

105
Q

What gait is used when client can bear little or no weight on one leg or one client has only one leg

A

Three point gait

106
Q

What gait do you move both crutches and the affected leg forward first

A

Three point gait

107
Q

What is the most rapid gait of all “point” gaits

A

Two point gait

108
Q

What gait do you advance the right crutch and the left foot simultaneously

A

Two point gait

109
Q

What gait looks like a marching soldier

A

Two point gait

110
Q

What gait is used for clients who have paralysis of hips or legs or who wears bilateral braces on legs

A

“Swing To” gait

111
Q

What do you never want to do when going in or coming out of sitting position

A

Never pivot

112
Q

Steps to take when going from standing to sitting position using crutches

A

Walk up to chair ➡️ when one step away from chair, turn until you’re back faces the chair using the unaffected leg and crutches ➡️ move backwards until chair touches back of unaffected leg ➡️ remove scratches from under arms, hold both in one hand (side of affected leg) and reach for the chair with the other hand ➡️ stretch the affected leg out in front ➡️ sit down slowly

113
Q

Steps to take when going from sitting to standing position using crutches

A

Hold handgrips of both crutches in one hand (side of affected leg) ➡️ place other hand on the side of the chair ➡️ stretch the affected leg out straight ➡️ push on the crutches, chair and unaffected leg and stand up

114
Q

When walking up stairs with crutches what leg goes first

A

The unaffected leg goes first and the crutches move with the affected leg

115
Q

When walking down stairs with crutches what leg goes first

A

The affected leg goes down first and the crutches move with the affected leg

116
Q

What do you do if you’re falling while ambulating with crutches

A

Throw crutches out and to the side and use arms to break the fall

117
Q

Transport safe wheelchairs have undergone several crash tests and are able to withstand a collision at what speed

A

30 mph

118
Q

How long does it take for a plaster cast to dry

A

24–36 hours

119
Q

Keep plaster cast uncovered until

A

Fully dry

120
Q

When using a walker, how far do you instruct the client to move the Walker forward

A

6–8 inches

121
Q

When using crutches, how far do you instruct the client to move the crutch/crutches forward

A

12 inches

122
Q

What is the most common compression neuropathy in the upper extremity

A

Carpal tunnel syndrome

123
Q

What condition is associated with continuous wrist movement

A

Carpal tunnel syndrome

124
Q

What is the cardinal sign of a fracture

A

Obvious deformity

125
Q

During assessment of an open fracture what specifically should the nurse question the patient about

A

Status of tetanus immunization

126
Q

The nurse suspects a fat embolism rather than a pulmonary embolism from a vascular thrombosis when the patient with a fracture develops

A

Petechiae around the neck and upper chest

127
Q

A patient with a fractured right hip has an anterior Open reduction and internal fixation of the fracture. What should the nurse plan to do postoperatively

A

Get the patient up to the chair on the first postoperative day

128
Q

What traction incorporates the use of a knee sling

A

Russel’s Traction

129
Q

What type of traction is generally used for short-term treatment until skeletal traction or surgery is possible

A

Skin Traction

130
Q

With what traction do you make use of Thomas Splint with Pearson Attachment

A

Balanced Suspension Traction

131
Q

With what traction is part of the body off the bed

A

Balanced Suspension Traction

From Flashcardlet (47 decks)

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