Mobility: Fractures

Question 1

What is a closed fracture?

Answer 1

Bone breaks but skin remains intact. Also called a simple fracture

Question 2

What is an open fracture?

Answer 2

Bone breaks and protrudes through the skin; increased risk of osteomyelitis. Also called a compound fracture

Question 3

What is a complete fracture?

Answer 3

Fracture involves the entire width of the bone

Question 4

What is a greenstick fracture?

Answer 4

Bone fragments are still partially joined. Also called an incomplete fracture. Occurs commonly in children

Question 5

What is a comminuted fracture?

Answer 5

Bone fragments into many pieces. Common in individuals with brittle bones, such as patients with osteogenesis imperfecta

Question 6

What is an impacted fracture?

Answer 6

The two ends of the bone are forced together. Also called a buckle fracture. Often seen with children’s arm and hip fractures

Question 7

What is an oblique fracture?

Answer 7

Fracture occurs diagonal to the bone’s axis

Question 8

What is a transverse fracture?

Answer 8

Fracture occurs at a right angle to the bones axis

Question 9

What is a linear fracture?

Answer 9

Fracture occurs parallel to the bone’s axis

Question 10

What is a displaced fracture?

Answer 10

Broken ends of bones move out of correct anatomical alignment. Also called an unstable fracture. Requires immediate attention to prevent further damage

Question 11

What is a nondisplaced fracture?

Answer 11

Broken ends of bones remain aligned. Also called a stable fracture

Question 12

What is an avulsion fracture?

Answer 12

A fragment of bone is separated from the rest of the bone. May also involve displacement of surrounding tissues

Question 13

What is a stress fracture?

Answer 13

Caused by small repetitive forces on the bone. Often caused by participation in sports or exercise

Question 14

What is a spiral fracture?

Answer 14

Fracture spirals around the bone. Occurs as the result of a twisting force, often during sports. Occurs commonly in children.

Question 15

What is a depression fracture?

Answer 15

Bone is forced inward. Occurs commonly in skull fractures

Question 16

What is a pathologic fracture?

Answer 16

Caused by a disease that weakens the bone such as osteoporosis, bone cancer, and osteogenesis imperfecta

Question 17

What is a compression fracture?

Answer 17

Bone is crushed; occurs most commonly in vertebrae. Common in patients with osteoporosis

Question 18

What is a nonunion?

Answer 18

A fracture that shows no clinically significant progress toward complete healing for at least 3 months based on x-rays.

Question 19

What is a delayed union?

Answer 19

Occurs when the healing process takes significantly longer than expected.

Question 20

How long do phalanges and femurs typically take to heal from a fracture?

Answer 20

Phalanges: 3 weeks
Femurs: 12 weeks

Question 21

What is a malunion?

Answer 21

Occurs when the bone fragments join in a position that is not anatomically correct

Question 22

What are some complications that can occur when someone has a fracture?

Answer 22

1. compartment syndrome
2. DVT
3. Fat embolism syndrome
4. Infection
5. Smoking

Question 23

What is compartment syndrome?

Answer 23

1. Swelling and edema and increased pressure in the muscle compartment.
2. decreased blood flow and potential muscle and nerve damage
3. If left untreated, it can cause the patient to lose the limb.

Question 24

How does a nurse detect early the start of compartment syndrome?

Answer 24

5 P’s:

1. Pain
2. Pulse
3. Pallor
4. Parathesis
5. Paralysis

Question 25

What can cause a DVT if someone has a fracture, what should the nurse look for, and what should the nurse not do?

Answer 25

Immobility causes it. Look for edema distal to the DVT (edema in the feet, if the DVT is in the leg), Pain or tenderness, and nurse and patient should not massage the area

Question 26

When does fat embolism syndrome occur, and what happens with it?

Answer 26

Occurs mostly during long bond and pelvic fractures. It is an emergency situation because the fat can get lodged somewhere. It can be like a PE (feeling of impending doom)

Question 27

What patients with fractures are at most risk for infection?

Answer 27

Patients with open fractures, rods placed, or in surgery

Question 28

What should the nurse do to promote proper healing?

Answer 28

1. maintain proper alignment 2. Promote mobility 3. Monitor neurovascular status 4. Prevent infection (Education the patient on what infection looks like, redness, warmth, drainage, look for other complications)

Question 29

What discharge instructions should the nurse give to someone who has had a fracture?

Answer 29

1. older people should not have throw rugs. They should have shower bars, a walker or a cane to help them ambulate 2. younger people need education on risky behaviors 3. maintain ideal body weight 4. Maintain good nutrition 5. Maintain adequate rest 6. Nonpharmacologic pain management 7. provide resources for therapy and assistive devices 8. Don't wear slippers and nonskid socks

Question 30

What interventions should the nurse take for compartment syndrome?

Answer 30

1. removal of tight cast 2. Fasciotomy 3. Ice 4. Elevation

Question 31

What interventions are taken for a DVT?

Answer 31

1. bedrest 2. Anticoagulants 3. Thrombolytics 4. Surgical 5. Surgical insertion of filter 6. Early immobilization of the fracture 7. Regular exercise 8. Early ambulation 9. Compression stockings or boots

Question 32

What interventions are taken for fat embolism syndrome?

Answer 32

1. administration of oxygen 2. mechanical ventilation 3. Corticosteroids 4. Early immobilization of injury