Fractures- EXAM 3

Question 1

What is a fracture

Answer 1

A break in continuity of bone
Most common in patients who have experienced trauma or older adults

Question 2

Two main factors that contribute to a fracture

Answer 2

Strength of the force acting against the bone & strength of the bone
Force includes: direct blow, twisting, trauma, repetitive force

Question 3

Fracture healing phases

Answer 3

Inflammatory, Reparative, and Remodeling phase

Question 4

Inflammatory phase

Answer 4

The reactive phase
Damage to bone, blood vessels and surrounding tissue causes bleeding, hematoma and inflammation

Question 5

Reparative phase

Answer 5

Fibroblasts, osteoblasts secrete collagen–fibrocartilage–soft callus–woven bone–hard callus

Question 6

Remodeling phase

Answer 6

Woven bone replaced by lamellar bone
Stronger, more compact, better blood circulation

Question 7

What is normal healing

Answer 7

Union, bone heals properly

Question 8

Delayed union

Answer 8

Healing process takes significantly longer than expected

Question 9

Nonunion

Answer 9

Fracture shows no sign of healing for at least 3 months

Question 10

Malunion

Answer 10

Bone fragments join in position that is not automatically correct

Question 11

Risk factors

Answer 11

Age; younger from sport injuries
Older from falls and disease
Presence of bone disease
Poor nutrition
Bone cancer
Low intake of Vitamin D, calcium
Anorexia or bulimia

Question 12

Manifestations of a fracture

Answer 12

Pain
Visible fracture on xray
Visible deformaty
Swelling
Numbness
Loss of blood
Crepitus

Question 13

What is compartment syndrome

Answer 13

When cast is placed too tight
Swelling is caused and decreased blood flow
If it continuous for too long, muscles and nerves can die and limb may need to be amputated

Question 14

Symptoms of Compartment syndrome

Answer 14

Severe pain and tenderness
Swelling
Absent pulse
Most common in lower legs and forearm

Question 15

DVT and symptoms

Answer 15

Blood clot forms in a deep vein, usually in legs
Redness and warmth, Leg pain, Cramping, Swelling

Cured with anticoagulants or compression stockings

Question 16

Complications of DVT

Answer 16

Blood clot can dislodge and travel elsewhere in the body
In brain, can cause stroke
In lungs, can cause pulmonary embolism
In coronary arteries, can cause myocardial infraction

Question 17

When is surgery needed

Answer 17

Open fractures and commented fractures

Question 18

Pharmacological therapy

Answer 18

Tylenol is given BUT IF SEVERE, opioids are given
Want to start slow and low and then move up from it if not working
NSAID’s for pain and inflammation
Antibiotics to prevent or treat infection
anticoagulants to prevent or treat DVT

Question 19

NonPharmacological therapy

Answer 19

CAST- palpate for hot spots:infection
Report any drainage
Assess for compartment syndrome
SPLINT
TRACTIONS- provides proper alignment
skin or skeletal tractions

Question 20

RICE therapy

Answer 20

REST
ICE
COMPRESSION- enough to provide support fro injured area
ELEVATION

Question 21

Infants with fractures

Answer 21

Difficult to detect because they can’t communicate location
Inconsolable crying, limited movement to extremity, Swelling of extremity, Deformity of area

Long bone fractures higher in C-sections or breech birth

Question 22

Adults with fractures

Answer 22

Lengthened recovery time, especially women after menopause

Question 23

Older adults with osteoporosis

Answer 23

Increased risk for hip fractures
More likely to develop DVT, infection
Alterations in mental status increase risk