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Nurs220FInal > Fractures > Flashcards

Fractures Flashcards

1
Q

Def: Fracture

Differentiate Complete vs Incomplete

A

Break in continuity of the bone. Complete: a break through the full thickness of the bone
incomplete: A break that is NOT through the full thickness of the bone

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2
Q

Def: Pathological fracture

A

May occur during normal activity or following minimal injury when a bone is weakened by a disease process

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3
Q

Def: Fatigue or stress Fracture

A

Normal bone subjected to repeated stress w/o bone and muscle recovery

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4
Q

Fracture Classifications

A

Closed (simple) Fracture

Open (compound) fracture

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5
Q

Def: Closed Fracture

A

AKA: Simple fracture - Skin in tact over fracture site

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6
Q

Def: Open Fracture

A

AKA: Compound fracture - Skin over injury site is broken, either by fracture fragments piercing skin or a penetrating outside force.

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7
Q

S&S of Fractures

A 
Edema
Pain and tenderness
muscle spasms 
deformity 
ecchymosis
loss of function 
crepitation
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8
Q

Important Lab tests for Fractures

A

x-ray
Computed Tomography (CT)
Magnetic Resonance Imaging (MRI) (for tissue damage)
White Blood Cell Count (WBC)
Hemoglobin (HBG) and Hematocrit (HCT) - assess for blood loss
Partial Thromboplastin Time (PTT) and International Normalized Ratio (INR) - assess clotting abilities

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9
Q

name the 6 stages of Fracture Healing, the time frame they would be occuring in, and what the stage is characterized by.

A
  1. Fracture Hematoma- semisolid clot- 72hrs
  2. Granulation Tissue - osteoid (precursor to bone tissue formation) 3-14 days
  3. Callus formation - minerals deposited - 14days
  4. Ossification -Strength, clinical union - 3wks - 6months
  5. Consolidation - distance diminishes, radiological union - 6months-1year
  6. remodelling - preinjury shape and strength - up to 1 year
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10
Q

Fracture management goals

A

Realignment (reduction)
Immobilization
Restoration

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11
Q

Def: Closed reduction

A

Non surgical, manual realignment of bone fragments to previous anatomical position - includes traction

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12
Q

Def: Open reduction

A

Correction of bone alignment through surgical incision - includes internal fixation with use of wires, screws, pins, plates, intramedullary rods or nails

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13
Q

Def: Traction

A

Application of a pulling force to an injured or diseased part of body or extremity while counter traction pulls in opposite direction

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14
Q

Def: Skeletal Traction

A

Traction applied for days or weeks, more weighted and is screwed into bone itself

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15
Q

Def: Skin Traction

A

On for a max of 72hrs before surgery - traction applied to the surface by pulling on skin.

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16
Q

4 was to immobilize a fracture

A

Fixation (internal or external)
Splits
Casts
Traction

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17
Q

when are external fixators used?

A

Complex fractures and when there is tissue damage or a wound that requires cleaning.

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18
Q

Neurovascular Assessment

A

CSM
C- Circulation (colour, temp, cap refill, edema, pulses)
S- Sensation (includes pain)
M- movement

19
Q

Pre Op Fracture management

A
  • Maintain CSM and alignment
  • pain management
    Assess for and prevent early complications
  • maintain skin integrity, hydration, NPO
  • Ins and Outs, IV therapy
  • Prepare for surgery (Physical, psychosocial, Labs)
20
Q

Post Op Fracture Management

A 
Monitor VS 
Dressing changes 
promote ambulation 
monitor wound drainage, drains 
prevent complications
Meds (analgesic, antibiotics, anticoagulants, bowel care, muscle spasms, antiemetic)
Pain assessment 
Neurovascular assessment* 
Oxygenation And rest status 
Hydration 
Urinary retention 
education 
referrals (OT/Pt)
Nutrition and diet (those with healing fractures need increased protein)
21
Q

Cast care

A
  • elevate limb
  • apply ICE
  • Avoid handling (before cast is completely dry)
  • Neurovascular checks
  • Don’t get it wet
22
Q

Complications with Fractures

A 
Edema 
Compartment syndrome 
infection 
Deep Vein Thrombosis 
Pressure injuries
23
Q

treatment for Edema

A
  • Elevation and Ice
24
Q

S&S of Compartment Syndrome - which are early and which are late signs

A
  • Pain on passive motion and unrelieved w/ narcotic medication (one of the earliest signs)
  • Poikilothermia: decrease in temperature (early sign)
  • Pallor
  • Parethesia: numbness or tingling (Early sign)
  • Paralysis: very late sign
    Pulselessness: very late sign
25
Q

what to do if compartment syndrome is suspected and why?

A

Lower the limb and do NOT apply ice. ice cause vasoconstriction and makes it more difficult for blood to reach the tissues. lowering the limb allows gravity to assist blood profusion.

26
Q

Treatment for Compartment syndrome?

A

Fasciotomy

27
Q

Prevention of Compartment Syndrome

A

Elevation of limb and reduce restriction caused by casts or wraps. - may be doctors order to cut cast if pt pain is increasing and uncrontollable

28
Q

S&S of Infection

A 
Tenderness 
pain 
redness 
swelling 
local warmth 
elevated temperature 
purulent drainage 
delayed union or non-union of surgical site
29
Q

Prevention of Infection

A

Infection control and aseptic techniques when cleansing wounds
possible prophylactic Antibiotics (depends on infection risk, open vs. closed fracture)

30
Q

Treatment of infection

A

Antibiotics

31
Q

S&S of Deep Vein Thrombosis

A

Swelling
warmth
tenderness to area

32
Q

Prevention of Deep vein Thrombosis

A

Anti Embolic Stockings, Pneumatic Compression Stockings, mobility, bed exercises, prophylactic anticoagulants

33
Q

How is Deep Vein thrombosis Diagnosed?

A

Doppler Ultrasound

34
Q

Ways of Preventing Pressure injuries

A 
Pressure relieving mattress 
Early mobilization 
Frequent turning and positioning 
Keep body surfaces clean and dry 
Braden scale for risk assessment
35
Q

S&S of Hip Fractures

A

Leg is shortened and externally rotated
Pain
Unable to weight bear

36
Q

Hip Fracture Types

A

Intracapsular

Extracapsular

37
Q

Intracapsular Hip Fracture

A

Femoral neck fractures, inside joint capsule; usually r/t bone disease

38
Q

Extracapsular Hip fracture

A

Outside joint capsule; usually r/t a fall or trauma

39
Q

Treatment of Intracapsular Hip Fracture

A

Surgical insertion of a femoral head prosthesis

40
Q

Treatment of Extracapsular fractures

A

Internal fixation with screws

41
Q

indications for Total Hip Arthroplasty

A

Hip Replacement
- sever trauma
- Osteoarthritis
Failed past surgeries

42
Q

Post-op Total Hip Arthroplasty / hip surgery care

A 
dressing changes as ordered
Hemovac drain x 24-48 hrs
positioning - on back or side with a pillow between legs 
DO NOT cross ankles or legs 
Typical hospital stay 3-7 days
43
Q

Why should someone who has had recent Hip surgery (total hip arthroplasty or hemiarthroplasty) not cross legs or ankles?

A

Crossing ankles or legs forces hip inwards or outwards - more 90 degree flexion.

Nurs220FInal (2 decks)

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