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Flashcards in Ortho Deck (23)
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1
Q

What do you do with open fractures?

A

Put most (sterile) saline gauze over it

2
Q

What 2 things do splits help prevent with fractures?

A
  1. Fat emboli

2. Muscle spasm

3
Q

What are 3 complications with fractures?

A
  1. Hypovolemic shock
  2. Fat embolism
  3. Compartment syndrome
4
Q

Increased swelling occurs within a limited space due to fluid accumulation in the tissue. Impaired tissue perfusion occurs. The muscle becomes hard and swollen. Pain is not relieved with pain medication.

A

Compartment syndrome

5
Q

What are the 2 common areas for compartment syndrome?

A
  1. Forearms

2. Quads

6
Q

What are 4 ways to treat and prevent compartment syndrome?

A
  1. Elevate extremity
  2. Soft cast then rigid cast
  3. Loosen cast to restore blood flow
  4. Fasciotomy (6 hours without a pulse)
7
Q

What 3 types of fractures can lead to fat embolism?

A
  1. Long bones (femur)
  2. Pelvic fractures
  3. Crush injuries
8
Q

What are 5 ways to care for a plastic and fiberglass cast?

A
  1. Ice packs on sides for 24 hours (cast is still wet)
  2. Use palms to handle cast for first 24 hours
  3. Don’t rest cast on hard surface
  4. Cover cast close to groin with plastic (don’t want urine on it)
  5. Neuro checks
9
Q

What is the most important assessment with fractures?

A

Neuro checks

10
Q

Should you ever relieve traction?

A

No - unless physician orders it

11
Q

Type of traction used short term to relieve muscle spasms and immobilize until surgery. This is when tape, a boot, or splint is stuck to the skin and the weights pull against it.

A

Skin (Buck’s) traction

12
Q

What type of assessment must be done when a patient is in traction?

A

Skin assessment

13
Q

This type of traction is applied directly to the bone with pins and wires and is used when prolonged traction is needed. Must monitor the pin sites and do pin care every shift. Sterile technique is used and crusts must be removed.

A

Skeletal traction

14
Q

What type of mattress is needed for any type of orthopedic or joint problem patient?

A

Firm

15
Q

Is it ok if a total hip replacement patient sleeps on the operated side?

A

No

16
Q

What 3 ways do you position a total hip replacement patient?

A
  1. Neutral rotation –> toes to the ceiling
  2. Limit flexion; want extension of the hip
  3. Abduction
17
Q

What are 3 types of exercises that are good for the postoperative total hip replacement patient?

A
  1. Walking
  2. Swimming
  3. Rocking chair
18
Q

What type of exercise is done with total knee replacement patients?

A

Continuous Passive Motion - keeps knee in motion and prevents blood clots; gradually increases flexion and extension of knee

19
Q

How are amputations performed?

A

Most distal point that will heal; try and save elbow and knee

20
Q

What should you keep at a postop amputee’s bedside?

A

Turnicate

21
Q

How should you position an amputated limb?

A

Extension

22
Q

How do you teach a client to toughen the stump?

A

Press into soft pillow, hard pillow, mattress, then wooden chair
Ok to massage the stump; want it shaped like a cone for prosthetics

23
Q

What is the first intervention to decrease phantom pain?

A

Diversional activity