Orthopedics Flashcards
Fractures will cause ____ and tenderness, unnatural ____, possible _____, shortening of ______, crepitus, swelling, discoloration
Worry about ________ syndrome
Treat by ________ the bone, support fracture ______ and ____ site, splints help prevent _____ emboli and _____ spasms
Open fracture? ______ it with something, preferably ___
Most important check? __________, which includes pulses, color, movement, sensation, cap refill and temp
pain
movement, deformities, extremity
compartment
immobilizing, above
below, fat
muscle
cover, sterile
NEUROVASCULAR
Complications of fractures include shock d/t ______ loss, _____ embolism usually seen with ______ fractures, _____ bone fractures and ______ injuries–these same fractures lead to ______
S/S of fat embolus depend on ___________, young _____ are more at risk and the greatest risk is the first ______ hours (fat embolism _____ time)–unique S/S include ______ on chest, conjunctival ______, snow storm on _____
Compartment syndrome = ______ pressure in a ______ space; ______ accumulates in tissue, impairs ________ so the muscle _______ and client is in _____ that is _______ and unrelieved by pain ______; if compartment syndrome is not detected, ______ damage and ______ is possible–most common areas are ______ & _____
Extremity ____ and _____ cast first are measures to ______ compartment syndrome; treat CS with loosening the cast to restore ______–REMOVING is a ______ resort, be very careful in choosing that answer! Cast cutters remove the cast, tell client it will ______; fasciotomy also treats CS
blood
fat, pelvic
long, crushing
shock
where the embolus goes males 36, danger petechiae, hemorrhage CXR
increased, limited fluid, circulation swells, pain unpredictable, meds nerve, amputation forearm, quadriceps
elevation, soft
prevent
circulation, LAST
vibrate
Cast Care
put ice packs on the ______ and use ____ to avoid _______; allow cast to _____ dry, rest on _____, ___ plastic, ______ breakthrough bleeding—circle, ____ and time it; cover the cast close to _______ once cast is _____; _______ checks with the 5 p’s
If client complains of pain, what to do FIRST? _______, SECOND: _______, THIRD: _______, FOURTH, _______: want to do least ______ first. If all those don’t relieve ______, think ________!
_______ put anything into a cast–relief of itching inside can be helped with a ______ hairdryer
Fiberglass casts are _____ and provide earlier _____ than plaster casts
sides, palms indentations, air, pillow, NO mark, date groin dry; neurovascular
NEUROVASCULAR CHECK
ELEVATE, COLD PACKS
PAIN MEDS, invasive
pain, complication
NEVER
cool
stronger, weight-bearing
Traction can be skin or skeletal, both ______ muscle spasms, ______ the bone (reduces), and immobilizes
traction is ______, weights should hang _______, keep client _____ with good alignment, exercise non-immobilized _____; ropes should move _____ and knots should be _______
Skin Traction used for _____ term relief of muscle _____ and immobilization until _____; skin is _____ penetrated, most common type is _____ traction, used with ____ and _____ fractures; must do good ______ assessments!
Skeletal Traction is applied directly to _____ with _____ and wires when _____ traction is needed; must _____ pin sites and do _____ care with ______ technique, remove _____, ____ drainage is OK
If pin comes out–_______ the joint—YOU become the equipment!
________ RELEASE TRACTION UNLESS YOU HAVE AN ORDER
decrease
re-align
continuous, freely
centered
joints, freely
secure
short, spasms
surgery, NOT
Buck’s, hip
femoral, SKIN
bone, pins
prolonged, assess
pin, sterile
crusts, serous
IMMOBILIZE
NEVER
Total Hip Replacement
_____ traction is common pre-op
_______ checks post-op, _____ drains, joints need support with ______ mattress, ______ for upper-body strength building
Position with ______ rotation (toes to _______), limit _____ because we want extension of the _____, _______ will keep the join in the socket
Client can do ______ exercises while in bed, use a trochanter roll to prevent _______ rotation (don’t forget to _______ in chart); _____ weight-bearing until you have an order; don’t ______ legs or _____ over since these put ______ on joint; ____ sleep on the operative side; hydration is _____ since client is immobile; minimal stress to new hip joint for ______ months; _____ give IM meds in the operative hip
Complications: dislocation can cause _____ & _____ damage–S/S include ______ of leg, abnormal _____, unable to _____ the extremity and PAIN; infection prevention includes ______ indwelling catheters and drains ________ and prophylactic ______; avascular _____ can occur d/t poor ______; immobility problems with _______ and _____ can occur
Best exercise is _____, _____ is good too; avoid flexion
Buck’s
Neurovascular, monitor
firm, trapeze
neutral, ceiling
flexion, hip
abduction
isometric external document, NO cross, bend pressure, NEVER important 3-6, NEVER
circulation, nerve shortening, rotation move removing ASAP, antibiotics necrosis, circulation walking, PT
walking, swimming
Total Knee Replacement = _______
Continuous Passive Motion keeps knee moving and prevents ________ formation which will _____ mobility later on; _____ sets this machine to ______ increase flexion and extension; NEVER ________ or hyperflex the knee; want to do ______ checks and _____ relief
arthroplasty
scar tissue, limit
PT, gradually
hyperextend
neurovascular, pain
Amputations are performed at the most ______ point that will _____–attempts to preserve _____ and _____
Keep ______ at the bedside, _____ position is best, prevent contractures by _______ hip and knee; if elevation is ordered, only do it for a _____ time to ______ swelling; ensure residual limb lies completely ______ on the bed; ______ pain is real–first intervention is ________ activity; Phantom pain seen mostly with ______, usually subsides in ____ months
limb shaping is important to ensure _______ fit, stump should be shaped like a ____, limb sock worn _____ prosthesis–with compression to _____ hemorrhage; important to strengthen ______ body because they’ll use a ______ to ambulate. ______ the stump to promote _____ and decrease _______
How to TOUGHEN the stump: 1. ______ pillow 2. _____ pillow 3. _____ 4. _____
distal
heal, elbow, knee
tourniquet, prone extending short decrease flat, phantom diversional AKA, 3
prothesis cone, under decrease upper walker, massage circulation, tenderness
soft, firm
bed, chair
Walkers
walk _____ the walker, don’t ____ it
Crutches
should be 1-2 inches below ______
on stairs–_____ with bad leg, ____ with good leg
Canes
use the _____ side of the body
into, push
axilla
down, up
strong
