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BSN LAST TEST-Pt 1 > Amputations and Fractures > Flashcards

Amputations and Fractures Flashcards

1
Q

What is the most common pain with surgical amputations due to a chronic condition that has given you pain for a period of time?

A

Phantom limb pain

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2
Q

Ask what when asking about phantom limb pain?

A

What the pain is like

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3
Q

What is treatment for overall phantom limb pain?

A

Calcitonin

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4
Q

How is calcitonin given?

A

IV infusion during first post-op week to help reduce phantom limb pain

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5
Q

What is given for dull, boring pain?

A

BB (propanolol)

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6
Q

What is given for knifelike, sharp burning pain

A

Antiepileptic (gabapentin)

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7
Q

What phantom pain is this given for?

Propranolol

A

Dull, burning pain

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8
Q

What phantom pain is this given for?

Calcitonin

A

Overall pain

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9
Q

What phantom pain is this given for?

Antiepileptic

A

Knifelike, sharp, burning pain

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10
Q

What to give for incision pain post ampuation ?

A

Analgesics

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11
Q

What to give for muscle pain post amputation?

A

Antispasmodics (baclofen)

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12
Q

How to wrap limb after amputation?

A

Figure 8 wrap –tight but not too tight

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13
Q

T/F: Position is very important post amputation

A

T

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14
Q

What is position for first 24 hours post amputation and why?

A

Elevated on pillow to help decrease edema and help with drainage

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15
Q

T/F: Contractors will occur if elevated on pillow 36 hr post op

A

T

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16
Q

Post amputation

___ position for __ minute periods several times a day

A

Prone; 20 min

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17
Q

Post amputation

What kind of mattress?
How often to turn?

A

Firm

q2h

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18
Q

Post amputation

Practice what with the limb?

A

Pushing down limb on soft pillow

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19
Q

What is skeletal traction?

A

Screws are surgically inserted into BONE (halo traction)

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20
Q

Skeletal traction

Short or long traction time?
What weight limits?

A

Use longer traction times

15-30 lbs

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21
Q

Skeletal traction

Aids in ____

A

Bone realignment

22
Q

Skeletal traction

Weight should not be doing what?

A

Touching floor or touching end of bed–touching nothing!!!

23
Q

Skeletal traction

What happens if patient falls down in bed and weight touches floor?

A

The patient needs assistance using the trapeze bar to pull himself back up

24
Q

Skeletal traction

How should cords be?

A

Free, not touching anything else

25
Q

Skeletal traction

What needs to be in right suspension?

A

Counterweight

26
Q

Skeletal traction

T/F: There should be some pressure on skin

A

F–check this (esp. pelvic area!)

27
Q

Skeletal traction

Pin in bone so do what?

A

Pin site care

28
Q

Skeletal traction

Pin site care–what drainage in the beginning?

A

Clear is normal in beginning; report anything else to MD

Clean per hospital policy

29
Q

Skeletal traction

Patient should not be in severe pain. If they are, then what do we do?

A

Re-align the patient but DO NOT TOUCH THE WEIGHTS!!!

*notify MD position is not working

30
Q

Skeletal traction

How often to monitor circulation?

A

q1hr for first 24 then q4h

31
Q

Complications of fractures

Splinting or casting–what is better?

A

Splinting

  • splinting better to reduce complications
  • may need cast if worried pt. won’t wear splint (peds)
32
Q

Complications of fractures

Check 6 Ps. What are those?

A 
Pain
Paresthesia
Pallor
Paralysis
Pulselessness
Pressure
33
Q

Complications of fractures

Check skin. Also check cast…what should cast be like?

A

One finger should fit underneath; should not be too tight

34
Q

Complications of fractures

When is it ok to cast?

A

When swelling has gone down

*ice area to reduce swelling

35
Q

Acute compartment syndrome

What is this?

A

Increased pressure causes reduced circulation to area

*due to infection, persistent motor weakness, contractures, myoglobiuric renal failure, hyperkalemia

36
Q

Acute compartment syndrome

Assess what?

A

6Ps

37
Q

Acute compartment syndrome

What happens if there is an immediate increase in pain?

A

Assess quickly

*use doppler pulse –dont just give pain med

38
Q

Acute compartment syndrome

Where is this more common?

A

Hand and lower leg

39
Q

Acute compartment syndrome

Hallmark symptom?

A

Severe pain that does not respond to elevation or pain meds

*in severe cases, there may be numbness, tingling, weakness, and paleness of skin

40
Q

Acute compartment syndrome

Tx?

A

Remove cast

Fasciotomy (open area to relieve pressure)

41
Q

Crush Syndrome

What is this?

A

External crush injury that compresses one or more compartments in leg, arm, or pelvic

42
Q

Crush Syndrome

Symptoms? (8)

A
  • ACS
  • ATN
  • Dark brown urine
  • HYPOvolemia
  • HYPERkalemia (cell breaks and release to BS)
  • Muscle weakness
  • Pain
  • Rhabdomyolysis
43
Q

Crush Syndrome

What is a lower extremity crush injury at high risk for?

A

AKI

44
Q

Fat embolism syndrome

Obstruction of what?

A

Pulmonary vascular bed by fat globules

45
Q

Fat embolism syndrome

More specific to ___ bone fracture in the first ___

A

Long bone fracture in first 48 hr

*comes from yellow marrow with break–gets in BS and lodges into things like lungs

46
Q

Fat embolism syndrome

Symptoms similar to?

A

VTE, DVT, PE

47
Q

Fat embolism syndrome

Difference in symptoms between fat embolism syndrome and VTE/DVT/PE?

A

Petechia with fat embolism!!!

48
Q

Fat embolism syndrome

Other symptoms besides petechia?

A
  • Altered mental status
  • Tachypnea, tachycardia, fever
  • Chest pain, dyspnea, crackles, decreased SaO2
  • Mild thrombocytopenia
49
Q

Fat embolism syndrome

tx?

A

Supportive care

Oxygen (or vent)

50
Q

VTE

What is the purpose of elastic stockings?

A

To prevent thrombophlebitis (common complication following orthopedic surgery)

51
Q

VTE

Thrmoboemboli can occur up to 6 months after surgery..Why is this important to tell pt?

A

That the client will need to still wear them after d/c

BSN LAST TEST-Pt 1 (27 decks)

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