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Adult Health 1 > Fractures BABBBAY > Flashcards

Fractures BABBBAY Flashcards

1
Q

Risk Factors

A
  • Riding in cars
  • Falling
  • Malnutrition
  • Sports
  • Osteoporosis
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2
Q

Incidence

A

Adults: Ribs
Young/ middle age: Femoral
Oler: Femur

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3
Q

Health Promotion

A

Seat belts, airbags, reducing driving while impaired, osteoporosis screening/ treatment, fall prevention

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4
Q

Assessment

A

History- type of injury, alcohol and drug use, disease states
Physical assessment- ABC, PAIN, HTT, change in bone alignment, shortening, change in shape, bruising & swelling

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5
Q

CMS

A

Circulation-
Color, pulse, cap refill, Temp (warm, cool)

Motion -
Movement

Sensation-
Tingling? Pain? Numbness?

Check extremity distal to injury compare it to other extremity

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6
Q

Diagnostics

A
  • H&H
  • WBC
  • ESR
  • XR
  • CT- scan (hip & spine)
  • MRI
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7
Q

Problems/ND

A
  • Pain, potential for infection, potential for impaired circulation/ NV compromise , immobility
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8
Q

Interventions

A

-Proritize based on clinical situation and presentation
-ABC
- Pain management
-Immobilize via splint
-Sterile guaze
- reduction
Elevation
ICe

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9
Q

In a closed Reduction

A

Assist and support provider and patinet

- monitor patinet and admin meds

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10
Q

Immobilizers

A
  • Splints: Commerical immobilizer, preferred over cast if appropriate, more commonly used on body parts that do not bear weight
  • Orthopedic shoes and boots: used to immbolize ankle and foot when bearing weight is allowed. Also preferred overcast if possible
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11
Q

Casts Fiberglass

A
  • Reserved for complex fractures and LE fractures
  • Fiberglass is most commonly used
  • dries and hardens quickly, reduce skin breakdown, can get wet (but padding underneath cannot)
  • Also requires a stockinette and a padidng
  • Cannot be fully immersed in water
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12
Q

Plaster Casts

A
  • Traditional material/ not used often
  • requires a stockinette under plaster/ then padding/ then plaster
    takes 24 hours and feels warm when drying
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13
Q

Cast interventions

A
  • May have a window if skin is open
  • May be too tight
  • bivalve
  • Elevation
  • ICe
  • Used in conjuction with sling or critches when appropriaet
    Assess For:
    increase pain, drainage, foul smell, CMS
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14
Q

TRaction

A
  • reduction in aligment in bone

- Used to reduce muscle spasms

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15
Q

Running verus balance traction

A

Balanced: Fracture extremity is suspended with two opposing forces
Running: Force exerted in one plane only (fractured limps is opposing force)

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16
Q

Skin versus Skeletal

A

Skin: Force is applied to the fractured limp with use of bandage or splint
skeletal: Force is applied to fractured limp with use of pins inserted into bone

17
Q

Tractions

A

do not let wieghts drop on floor

18
Q

Buck’s traction

A
  • Running, skin traction

- used for pain reduction

19
Q

Cervical traction

A
  • bolted in skull
  • halo
  • pain reduction
20
Q

Open reduction with internal fixation (ORIF)

A
  • One of the most common ways to reduce and fix a fracture
  • open surgery
  • metal pins, rods, prostheses, or plates are used for fixation
  • Affected area is kept immobile during healing process
  • Allows for mobility
21
Q

Post operative care

A

Pain management, NV compromise, ambulation, prevent complications, PT

22
Q

External Fixation

A

Less blood loss

  • Early ambulation
  • promotes healing
23
Q

Complications ( fractures) - Acute compartment syndrome

A
  • Assess for CMS
  • Avoid tight dressing and casts
  • 6 P’s
  • Prevention of outward expansion
24
Q

Volkmans contracture

A

common in forearm from acute comaprment syndrome

25
Q

Fat embolism syndrome

A

Fat globules released with all long bone fractures

  • also hip and knee arthroplasty
  • small percentage of people will develop FES
  • 24-72 hours after trauma
  • Traid of sumptoms:
  • Lungs (low O2, dyspnea, tachypnea)
  • Brain (Confusion, headache, seizure, altered LOC)
  • Skin (petechia on neck, chest and arms)
26
Q

Prevention of FES

A
  • early fixation

- surgical technique

27
Q

Supportive of FES

A
  • oxygen, fluids, albumin
28
Q

infection

A
  • increased risk of infection with open fractures
  • can lead to osteomyelitis
  • surgical site infection: if site becoes infected within 30 days of surgery) or if hardware becomes infected in the 1st year
  • Assess and educate
29
Q

Expcted outcomes

A
  • pain is manged
  • free of infection
  • able to ambulate with or without assistive devices
  • No NV compromise
30
Q

Upper extremity fractures

A
  • Remove jewely
  • perfrom NV assessment
  • immobilize
  • Elevate
  • Apply ice
  • mange pain
31
Q

Hip Fractures

A

Most common injury in Older adults

  • High moraltity rate
  • Osteoporosis is the biggest risk of factor
  • IV morphine/ PCA
  • Avoid demerol
  • Delirium
  • mobility
32
Q

Chest/ pelvis fractures

A 
Potential for heart and lung damage
- ABC 
- Internal organ damage 
- Lookfor blood in urine orstool 
Abdominal rigidity 
- Abd swelling 
- pelvis fractures can lead to death
33
Q

Spinal fractures

A

Associated with osteoporis, cancer, MM

  • cause pain, deformity and neuro compromise
  • non-surgica
  • surgical (kyphoplasty and vertebroplasty)

Adult Health 1 (18 decks)

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