OA Fractures Flashcards Preview

OA Exam 2 > OA Fractures > Flashcards

Flashcards in OA Fractures Deck (71)
Loading flashcards...
1

Fracture Risk Factors

Primary: age, bone disease, poor nutrition

Secondary: lifestyle habits

2

Types of Fractures

-transverse
-linear
-oblique, nondisplaced
-oblique, displaced
-spiral
-greenstick
-comminuted

3

clinical manifestations of fractures

-pain

-deformity or misalignment

-swelling

-hypovolemia/shock or ecchymosis

4

Complications of fractures

-compartment syndrome
-DVT
-Fat embolism syndrome

5

compartment syndrome

fascia surrounding muscles do not expand. When swelling occurs, muscle dies

6

S/S of compartment syndrome

-severe pain
-swelling
-pallor
-numbness

7

DVT

Deep Vein Thrombosis

-clot forms in one of the deep veins

8

S/S of DVT

-redness
-warmth of skin
-leg pain cramping
-swelling

9

Prevention of DVT

-early surgery
-anticoagulation
-compression strategies

10

Treatment for DVT

-bedrest
-anticoagulants
-vena caval filter

11

Complications of DVT

-CVA
-Pulmonary embolism

12

Fat Embolism Syndrome

Fat emboli are released from closed long bone or pelvic fractures.

-These emboli enter the blood stream

13

The fat emboli entering the blood stream causes...

-dyspnea that may progress to respiratory failure

-petechial rash

-neurological symptoms such as confusion, restlessness, seizures or come

14

There is an increased risk of infection with...

-open fractures
-external fixation devices
-immunocompromised patients

15

Collaborative Treatment Strategies

-Diagnostic Xrays
-Surgery
-Casting
-Traction to align bones to heal

16

3 phases of fracture healing

Inflammatory

Reparative

Remodeling

17

Inflammatory phase

damage to bone, vessels, and tissue -----> hematoma ----->macrophages/neutrophils enter wound to degrade -----> lasts until osteoblasts and endothelial cells begin to proliferate at fracture site

18

Reparative phase

fibroblasts, osteoblasts, and chrondoblasts begin to secrete collagen to form fibrocartilage ----> soft callus joins fractured bone ---->Endothelial cells begin to form vessels in damaged area ----> woven bone replaces soft callus (endochondral ossification) -----> hard callus ---->lasts 6-8 wks for relatively simple fractures

19

Remodeling phase

woven bone is replaced by highly organized lamellar bone

20

lamellar bone

stronger and more compact with better blood circulation compared to woven bone.

21

Nonunion

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

22

Delayed union

occurs when healing process takes significantly longer than expected, usually more than 3-6 months

23

Malunion

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

24

Which unions may require surgical correction?

nonunions and malunions

25

Nursing Implementation

-provide effective pain management

-provide proper alignment

-promote mobility

-monitor neurovascular status

-prevent infection

-provide discharge instructions

26

Providing effective pain management

-pain meds prn
-elevation
-ice
-relaxation techniques
-support above and below extremity

27

Providing proper alignment

-teach cast and splint care
-if in traction, keep aligned in bed and ensure that weights are free hanging

28

Promoting mobility

-reposition q 1-2 hours if not OOB yet
-ambulate
-teach to use crutches and walker

29

Monitoring neurovascular status

5Ps
-Pain
-Pulses
-Pallor
-Parasthesia
-Paralysis/Paresis

30

For Paresthesia assessment....

ask client about changes in sensation such as burning, tingling, or numbness

-presence of paresthesia indicates neural damage or involvement