Brainscape's Knowledge GenomeTM

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


See full index

Health Challenges > Fractures > Flashcards

Fractures Flashcards

1
Q

Soft tissue injuries

A

Soft tissue injuries is damage to the muscle, tendons and ligaments
-Contusions
-Sprains and strains
-Dislocations and subluxations

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

Contusions, sprains, and strains; treatment

A

-Rest
-Ice
-Compressikn
-Evelate

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

Joint dislocations; Collaborative management

A

-Confirm by x ray
-Reduction
-Pain management

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

Joint dislocations; nursing management

A

-Assess Nerovascular status
•CMS
-Protect joint
•immobilize

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

Neurovascular assessment

A

Circulation
-Assess the colour of the skin
-Assess temperature
-Assess capillary refill
-Assess peripheral pulse if accessible

Motor
-Assess movement of involved fingers and toes
•Radial, medial, ulnar
•Peroneal, tibial
-Assess for presence of pain with movement

Sensation
-Assess presence and abnormal sensation
-Pressure, pinprick and temperature discrimination

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

Fractures

A

-Disruption or break in continuity of the structure of bone
-Majority of fractures from traumatic injuries
-Some fractures secondary to disease process
•Cancer or osteoporosis-known as pathological

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

Avulsion fracture

A

A fracture in which a fragment of bone has been pulled away by a tendon and it’s attachment

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

Commiuted fracture

A

A fracture in which bone has splintered into several fragments

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

Compression fracture

A

A fracture in which bone has been compressed (seen in vertebral fractures)

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

Depressed fracture

A

A fracture in which fragments are driven inwards (see frequently in fractures of skull and facial bones)

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

Epiphyseal fracture

A

A fracture through the epiphysis

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

Greenstick fracture

A

A fracture in which one side of a bone is broken and the other side is bent

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

Impacted fracture

A

A fracture in which a bone fragment is driven into another bone fragment

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

Oblique fracture

A

A fracture occluding at an angle across the bone (less stable than transverse fracture)

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

Open fracture

A

A fracture in which also involves the skin or mucus membranes, also called a compound fracture

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

Pathological fracture

A

A fracture that occurs through an area of diseased bone (eg osteoporosis, bone cyst, pagers disease) can o occur without trauma or fall

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

Simple fracture

A

A fracture that remains contained, with no disruption of the skin integrity

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

Spiral fracture

A

A fracture that shifts around the shaft of the bone

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

Stress fracture

A

A fracture that results from repeated loading of bone and muscle

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

Transverse fracture

A

A fracture that is straight across the bone shaft

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

With fractures adjacent structures are damaged

A

-Soft tissue edema
-Bleed into muscles and joints
-Joint dislocations
-Ruptured tendons, severed nerves
-Damage to blood vessels
-Body organs may be damaged by force that causes the fracture

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

Fractures; clinical manifestations

A

-Pain
-Loss of function
-Guarding
-+- deformity
+- shortening of the extremity
-Crepitus
-Local swelling and discolouration
-Patient usually reports injury to the area

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

Fractures; initial management

A

-Stabilize limb and support above & below site
•assess neurovascular status before and after splinting
-Open fracture: cover with sterile dressing to prevent contamination
-Remove clothing from unaffected side first

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

Fractures; collaborative care

A

-Anatomical realignment of bone fragments
-Immobilization to maintain realignment
-Restoration of normal or near-normal function of injured parts
-Prevention of infection (open fractures)

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

Complete break

A

Completely through bone

26
Q

Incomplete break

A

Bone is still in one piece but break occurs across the bone shaft

27
Q

You are an RN in the ED. The triage note for Ms. k reads “75 y/o female, fell in her outstretched hand while out walking. Obvious deformity Rt wrist.
Assessment specific to this injury includes

A

-Edema and swelling
-Pain and tenderness
-Deformity
-Ecchymosis or contusion
-Loss of function
-Crepitation
-Muscle spasm

28
Q

Immediate nursing interventions would include

A

-A,B,C
-Control bleeding with direct pressure
-Check neuromuscular status distal to the injury
-Elevate injured limb if possible
-Apply ice
-Splint fracture site, do not attempt to straighten fractured or dislocated joints, do not manipulate protruding bone ends

29
Q

A colles’ fracture is a

A

Fracture of the distal radius

30
Q

Most colles’ fractures occour in patients

A

> 50 years old with osteoporosis

31
Q

The ED physician decides to reduce the fracture. A closed deduction is

A

A nonsurgical, Manual realignment of the bone to their previous position

32
Q

One key intervention following the application of a cast is to check for…

A

circulation, sensation, and movement

33
Q

What is traction

A

Traction is the application of a pulling force to an injured or diseased part of body or extremity, while countertraction pulls in opposite direction
-Prevent or reduce muscle spasm
-Immobilize joint or part of body
-Reduce a fracture of dislocation
-Treat a pathological joint condition

34
Q

Traction is also indicated to

A

-Provide immobilization to prevent soft tissue damage
-Reduce muscle spasm associated with low back pain or cervical whiplash
-Expand a joint space before major joint reconstruction

35
Q

Traction; pourpouse

A

-Prevent or decrease muscle spasm
-Immobilize joint or part of body
-Decrease a fracture or dislocation
-Treat a pathological joint condition

36
Q

Two most common types of traction

A

Skin traction
Skeletal traction

37
Q

Fractures; skin traction

A

-Used for short term treatment until skeletal traction or surgery is possible
-Tape, boots, or splints applied directly to skin to maintain alignment, assist in reduction, and help diminish muscle spasms in injured extremity
-Traction weighs 2.3-4.5Kg

38
Q

Skeletal traction

A

-In place for longer periods
-Used to align injures bones and joints or to treat joint contractures and congenital hip dysplasia
-Provides a long-term pull that keeps injured bones and joints aligned
-Physician inserts pin or wire into bone, either partially or completely, to align and immobilize injured body part
-Skeletal traction weigh range 2-20kg
-Too much weight results in delayed nonunion

39
Q

Traction; cont

A

-Countertraction commonly supplied by patients body weight or augmented by elevating end of bed
-Imperative that nurse maintains traction constantly and does not interrupt weight applied to traction

40
Q

Overall goals of fracture treatment

A

-Anatomical realignment of bone fragments
-Immobilization to maintain realignment
-Restoration or normal or near-normal function of injured parts

41
Q

Fracture healing

A

Not occour in the expected time
-Delayed union

Not occour at all
-Nonunion

-Healing time for fractures increases with age.

42
Q

Casts

A

Restrict tendinoligamentous movement
-Assisting with joint stabilization while fracture heals
-Applicaiton incorporates joints above and below fracture
-Plaster sets in 15 minutes (not strong enough for weight bearing until 24-72 hours)
-Fresh plaster should never be covered with a blanket
-Once completely dry may need to be petalled to avoid skin irritation

43
Q

What are 3 main complications of bone fracture

A
  1. Infection
  2. Compartment syndrome
  3. Fat Embolism
44
Q

Infection (osteomyelitis)

A

-High incidence in open fractures and soft tissue injuries
-Massive or blunt soft tissue injury often has more serious consequences than fracture
-Deviated and contaminated tissue is an ideal medium for pathogens
-May manifest years later
-Must be treated aggressively with antibiotics

45
Q

Compartment syndrome

A

Decreased compartment size
-Resulting from restrictive dressing, splints, casts, excessive traction, or premature closure of fascia

Increased compartment size
-Related to fracture, bleeding, edema, chemical response to snakebite, or IV filtration

46
Q

The 6 Ps of compartment syndrome

A

Pain
Pressure
Pallor
Pulselessness
Paresthesia
Paralysis

47
Q

Compartment syndrome; clinical manifestations

A

-Pain: distal to injury that is not relieved by opioid analgesics and pain on passive stretch of muscle travelling through compartment
-Paresthesia: numbness and tingling
-Urine output must be assessed because there is a possibility of muscle damage
-Myoglobin released from damaged muscle cells precipitates as a gel-like substance
-Causes obstruction in renal tubes
-EARLY RECOGNITION AND TREATMENT IS ESSENTIAL
-Ischemia can occour 4-8 hours after onset
-Regualr neurovascular assessments
-May occur initially or may be delayed for several days

48
Q

Compartment syndrome; CM cont

A

-Large amount of myoglobin may result in acute tubular necrosis
-Acute tubular necrosis causes a tire renal failure
-Common signs of myoglobinuria
•Dark reddish brown urine
•CM associated with acute renal failure

49
Q

Compartment syndrome; Collaborative care

A

-Prompt, accurate diagnosis
-Extremity should not be elevated above heart level
•elevation may raise blood pressure and slow arterial perfusion
-Application of cold compress may result in vasoconstriction and may exacerbate compartment syndrome

50
Q

Compartment syndrome; collaborative care

A

-If at all suspicious - cut bandage, release Velcro straps on simmer splint or bivalve cast
-Reduction in traction weight may decrease external circumferential pressures
-Surgical decompression may be nessacary

51
Q

Fat embolism syndrome

A

-Presence of systemic fat globules from fracture that are distributed into tissues and organs after a traumatic skeletal injury
-Contributory factor in many deaths associated with fracture

52
Q

Fat embolism syndrome; Clinical manifestations

A

-Early recognition crucial in preventing potentially lethal course
-Most patients manifest symptoms 24-48 hours after injury
-Fat globules transported to lungs cause a hemorrhagic interstitial pneumonitis
-Clinical course of fat embolus may be rapid and acute
-Patient frequently expresses a feeling of impending disaster
-In short time skin colour changes from pallor to cyanosis
-Patient may become comatose

53
Q

Fat embolisim syndrome; collaborative care

A

Treatment
-Fluid resuscitation
-Correction of acidosis
-Replacement of blood loss
-Encourage coughing and deep breathing
-Oxygen to treat hypoxia
-ICU-mechanical ventilation

54
Q

Nutritional therapy

A

Patients dietary requirements must include:
-Ample protein (1G/1KG BW)
-Vitimans (B, C, D)
-Calcium
-Phosphorus
-Magnesium

55
Q

Indications for joint replacement

A

-Relieve chronic pain
-Improve joint mobility
-Correct malalignment
-Remove intra-articular causes of erosion

56
Q

Preoperative care hip replacement

A

-Typically elective surgery, unless in the case of traumatic injury (I.e. hip fracture)
-Pre-operative goal: having the patient in optimal health prior to the surgery

57
Q

Pt pre op teaching

A

-No flexion of affected limb past 90°
-No crossing of legs
-No bending over to reach for objects
-No driving x 6/52
-No heavy lifting
-No NSAIDs or ETOH 48 hours Preoperative (risk of bleeding)

58
Q

Postop nursing management

A

-Asses pain and administer analgesics
-Elevate affected leg (foot above heart)
-Monitor dressing
-Pillow between legs when Turing in bed
-Early ambulaiton

59
Q

Discharge teaching

A

-Emphasize hip percautions
-Typically d/c on anticoagulation therapy (Fragmin)
-Ensure pt understands when and how to take medications
-Typically full weight bearing with crutches or walker
-Physio and ambulation - as per surgeon
-Signs of infection
-When and how to contact health care provider
-Dressing care
-Resources for patients

60
Q

Post op care knee athroplasty

A

-Compression drsg to immobilize knee in extension x 24 hours
-Zimmer splint to maintain extension x 24/52

61
Q

Complications joint surgery

A

-Infection
-Thromboembolism
-Fat embolism

Health Challenges (13 decks)

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