Chapter 32 Part 4

Question 1

Provide support for fractures that has been reduced

It can be easily removed for assessment and care of the skin then reapplied

Answer 1

Brace and splint

Question 2

What type of braces use for the elbows and knee

Answer 2

Hinge brace

Question 3

A fresh plaster cast should never be

Answer 3

Should never be covered air circulation speeds up drying

Question 4

Is the application of mechanical pull to a part of the body for the purpose of extending and holding the part in a certain position during immobilization

Answer 4

Traction

Question 5

What are the two types of traction

Answer 5

Skeletal and skin traction

Question 6

The surgeon inserts pins, wires, or tongs directly through the bone at a point distal to the fracture so that the force of the pull from the weight is it exerted directly on the bone

Answer 6

Skeletal traction

Question 7

A bandage or foam traction boot is applied to the limb below the site of fracture and pull is exerted on the limb

Answer 7

Skin traction

Question 8

What is the difference between skin and skeletal traction

Answer 8

Skeletal use 10lb or more

Skin 7 to 10 lbs

Question 9

Open comminuted fracture should be surgically addressed w/in

What is given one hour before the surgery and after the surgery

Answer 9

Six hours to decrease the chance of infection

Cefazolin one hour before and 2 doses after

Question 10

What should the nurse monitor if the pt had a fracture. Levels

Answer 10

WBC

Temp

Appearance

Redness and swelling

Heat and purulent

Question 11

Is a bacterial infection of the bone

Answer 11

Osteomyelitis

Question 12

The most causative organism to cause osteomyelitis is

Answer 12

Staphylococcus aureus

Question 13

Enters the bloodstream from a distant focus of infection

Such as boil or furuncle or open wound

Answer 13

Staphylococcus aureus

Question 14

Where is osteomyelitis usually found

Answer 14

Tibia or fibula

Vertebrae

Or at the site of joint prosthesis

Question 15

S/s of osteomyelitis

Answer 15

Severe pain

Tenderness at site

High fever with chill

Swelling of adjacent soft parts

Headache

Malaise

Question 16

Pt with diabetes or with chronic renal failure or on long term steroids are all at risk of

Answer 16

Infection and osteomyelitis

Question 17

How is osteomyelitis diagnosed

Answer 17

Laboratory findings indicating acute infection which = high wbc

Radiograph which shows bones destruction 7 to 10 days after onset of the disease

History of injury to the part, open fracture, boil, FURUNCLES, and other infections

Biopsy in which the bones sample exhibit signs of necrosis

Question 18

What type of treatment is needed or earlier osteomyelitis

Answer 18

Intervenous antibiotics which are prescribed 4 to 6 weeks

Debridement

The abscess is incised and drained

Question 19

A simple skin traction that is used to treat muscle spasms from fractures of the hip or femur, preoperatively, and for dislocation of the hip

Answer 19

Bucks extension

Question 20

the use of tongs inserted into the skull, the use of a halo device, or a head halter

Answer 20

Cervical traction

Question 21

Failure to heal

Answer 21

Nonunion

Question 22

A fraction that fail to heal how can it be treated

Why do use this

Answer 22

By electrical bone growth stimulating device =growth of bone cells (osteogenesis )

It can prevent further surgery and bone grafting

Question 23

Is rare but serious complication of fractures of the bone that has an
Abundance of Morrow fat

Example include

Answer 23

Fat embolism

Long bone, pelvis, and rib

Question 24

Sign and symptoms of fat embolism

Answer 24

Change in mental status

Respiratory distress

tachypnea

Crackles and wheezes
On auscultating the lungs

Rapid pulse

Fever

Petechiae

Question 25

A fine rash over the chest, neck, upper arms, or abdomen

Answer 25

Petechiae

Question 26

What should the nurse to when the patient has a fat embolism

Answer 26

Stay with the patient Put them in high Fowler position Use a nonrebreather mask and give high flow of oxygen Establish a peripheral IV line Intubation or mechanical ventilation may be needed

Question 27

When should you get the provider when a patient has a fat embolism

Answer 27

Immediately because there is a proximately 80% mortality rate from this complication since it’s very rare Anticipate hydration what IV fluids and correction of acidosis

Question 28

Who are at high risk for a fat embolism

Answer 28

Older adults with fractured hip

Question 29

What are vulnerable to thrombus formation

Answer 29

The veins of the pelvis and lower extremities

Question 30

What are used when you have a Venous | Thrombosis on the unaffected lower extremities

Answer 30

Compression stockings Sequential compression device and range of motion

Question 31

What are you look for when a patient has a VENOUS thrombosis

Answer 31

If the patient is on any prophylactic anti-coagulant Aspirin warfarin heparin

Question 32

It is a restriction of blood flow that occurs in one or more muscle compartment of the extremities

Answer 32

Compartment syndrome

Question 33

Is caused by the external or internal pressure

Answer 33

Compartment syndrome

Question 34

Occur from the dressing or casts that are too tight

Answer 34

External pressure

Question 35

Occurs from IV fluid infiltration, inflammation and Edema

Answer 35

Internal pressure

Question 36

What is key to preventing swelling and compartment syndrome Toes and fingers should be higher than

Answer 36

Elevation The truck

Question 37

Sign and symptoms of compartment syndrome is

Answer 37

Severe unrelenting pain And unrelieved by narcotics Decrease sensation Numbness and tingling Paleness of the skin Weakness of extremities are other signs

Question 38

What are the six things that you assess for when dealing with compartments syndrome What are you doing when you see those type of symptoms

Answer 38

Pain Pallor Paresthesia Pulselessness Paralysis Poikilothermia Notify the provider immediately

Question 39

Cold to touch

Answer 39

Poikilothermia

Question 40

Split through all the layers of material

Answer 40

Bivalved

Question 41

Linear incision in the fascia down the extremities

Answer 41

Fasciotomy

Question 42

What is done for post treatment of a factor

Answer 42

Rice Elevating the limb Pain medication If pain is not relieved within 30 minutes notify their healthcare provider

Question 43

Every immobilized patient should be routinely assess for the various problems of

Answer 43

Skin breakdown UTI Constipation Atelectasis DVT Adequate nutrition and fluids are needed to promote healing