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TERM 4 N2261 KNLG 3 > ORTHOPEDICS > Flashcards

ORTHOPEDICS Flashcards

(54 cards)

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1
Q

What is the difference between dislocation and subluxation?

A

Dislocation: Complete displacement of joint (severe injury)

Subluxation: Incomplete displacement of joint (mild to moderate injury)

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2
Q

What is the term for a procedure to remove fluid from the space around a joint using a needle and syringe?

A

Joint aspiration

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3
Q

What are 4 complications associated with dislocation and subluxation?

A
  1. Fractures
  2. Compartment syndrome
  3. Avascular necrosis
  4. Repeated dislocations
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4
Q

What are the 4 stages of fracture healing?

A
  1. Hematoma
  2. Granulation tissue (procallus)
  3. Bony callus formation, ossification, consolidation
  4. Remodeling
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5
Q

Describe how skin traction is applied

A

Boot/splint applied to skin with traction weight

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6
Q

Describe how skeletal traction is applied

A

Pin or wire inserted into bone

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7
Q

Casts are usually used after what kind of fracture repair?

A

Closed reduction

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8
Q

What are the two kinds of cast materials used?

A

Plaster of Paris
Fiberglass

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9
Q

What are 4 examples of reasons fiberglass preferred over plaster of paris?

A
  1. Light & strong
  2. Water resistant
  3. Porous: less skin irritation
  4. Requires only 3 hrs to dry
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10
Q

What are some features that can be used in casts?

A
  1. Stockinette and padding over bony prominences
  2. Observation windows
  3. Bi-valved: split on sides
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11
Q

What is the term for a cast with a rubber pad on the sole to assist weight bearing?

A

Walking cast

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12
Q

What is the term for a cast involving a portion of the trunk/extremities?

A

Spica cast

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13
Q

What is the term for a cast that circles the trunk and is used for spinal fractures?

A

Body cast/jacket

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14
Q

What are 3 nursing actions to take immediately after cast application?

A
  1. Neurovascular assessment
  2. Elevate limb
  3. Examine for drainage (outline and monitor)
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15
Q

How should a damp cast be handled?

A

With palms, and wear gloves

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16
Q

How should the patient be positioned after cast application?

A

Ensure warm & dry air circulates around/under the cast

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17
Q

What are 4 points to include in client education regarding cast care?

A
  1. Keep cast clean by wiping with damp cloth
  2. Protect from knocks/bangs
  3. Keep dry, use plastic cover in shower
  4. Only to be removed by physician
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18
Q

What are 3 points to include in client education regarding protecting the extremities?

A
  1. Protect digits from cold by covering with socks/mittens
  2. Use circulation exercises (e.g. wiggling digits)
  3. Elevate limb when possible, otherwise keep in a sling or restrict activity as instructed
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19
Q

What are 5 points to include in client education regarding when to see a physician?

A
  1. Loss of circulation to digits
  2. Burning/tingling under cast
  3. Too tight or too loose
  4. Breaks
  5. Smells bad or has discharge
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20
Q

What is the term for an orthopedic surgery to remove degenerative debris from a joint?

A

Debridement

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21
Q

What is the term for an orthopedic surgery to reconstruct or replace a joint?

A

Arthroplasty

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22
Q

What is the definition of a hip fracture?

Study These Flashcards
A

Fracture of the proximal third of the femur

23
Q

Which kind of hip replacement uses glue, and is recommended for older, less active adults?

Study These Flashcards
A

Cemented THA (total hip arthroplasty)

24
Q

Which kind of hip replacement uses porous coating, providing longer implant stability due to growth of new bone tissue into the porous surface, and is used in younger patients?

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A

Uncemented THA (total hip arthroplasty)

25
What are 3 principles of nursing management of patients with hip replacement?
1. Maintain alignment 2. Hips cannot be lower than knees 3. Lay on unaffected side
26
What is the term for a knee replacement that uses a small (3-5 inch) incision, does not cut tendon, and works between the fibers of the quadriceps muscle?
MIS (minimally invasive surgery) arthroplasty
27
What supplies are usually applied to a patient after knee replacement?
Compression dressing to stabilize knee for first 24 hours Zimmer immobilizer splint
28
What is the difference between delayed union, nonunion, and malunion?
Delayed union: Healing progresses more slowly than expected but does eventually heal Nonunion: Fracture fails to heal despite treatment, no callus formation Malunion: Fracture heals in unsatisfactory position
29
What is the term for deposition of calcium in muscle tissue at the site of muscle trauma?
Myositis ossificans
30
What is the term for inflammation in the affected joint after trauma or after surgery?
Post-trauma arthritis
31
What is the term for a severe infection of bone, bone marrow, and surrounding soft tissue via direct or indirect entry?
Osteomyelitis
32
What is the difference between acute and chronic osteomyelitis?
Acute: 1 month Chronic: >1 month
33
What kind of dressings are usually used for osteomyelitis?
Vac dressing
34
What are 4 steps in the pathogenesis of compartment syndrome?
1. Increased pressure within muscle compartment causes blood vessel compression 2. Histamine release 3. Vasodilation 4. Exacerbation of pressure
35
What are the 3 P's of early compartment syndrome?
Pain, Pressure, Paresthesia
36
What are the 3 P's of late compartment syndrome?
Pallor, Paralysis, Pulselessness
37
Besides the 6 P's, what are 2 assessments nurses should perform to prevent compartment syndrome?
Neurovascular assessment Myoglobin in urine
38
What is the definitive treatment for compartment syndrome, and what should NOT be done?
Fasciotomy Do not elevate or ice
39
What are 4 nursing interventions to prevent VTE?
1. Prophylactic medications 2. SCDs (sequential compression devices) or compression stockings 3. Encourage mobilization 4. CVS assessment and vitals
40
What are 4 signs of DVT?
Rubor, warmth, pain/tenderness, and/or unilateral swelling along the vein
41
What are 6 signs of PE?
1. Sx of hypoxia, O2 desat 2. Sudden unexplained dyspnea 3. Tachycardia 4. Crackles 5. Pleural chest pain 6. Blood-tinged sputum
42
Which lab test is used in diagnosis of both DVT and PE, and what does it indicate?
D-dimer: protein made when blood clot dissolves in body
43
What test is used to definitively diagnose DVT?
Duplex ultrasonography
44
What 2 tests are used to definitively diagnose PE?
CT-PE, VQ scan (nuc med)
45
What treatment is used in both DVT and PE?
Anticoagulants such as heparin or LMWH
46
What surgical intervention is used in DVT?
Venous thrombectomy
47
Which pharmacological treatment is used in PE and not DVT?
Fibrinolytics
48
What are 5 levels of weight bearing as ordered by the physician or physiotherapy?
1. Non weight bearing 2. Touch down/toe touch weight bearing 3. Partial weight/feather weight bearing 4. Weight bearing as tolerated 5. Full weight bearing
49
Which arrangements should be made before a patient is discharged home?
1. Home environment assessed for safety 2. Home support services in place
50
Why would x-ray be chosen over CT?
X-ray shows dense areas e.g. bone CT shows soft tissues in more detail
51
What are 3 reasons external fixation may be used?
1. Casting is contraindicated 2. Many fragments at fracture site 3. There is a wound adjacent to fracture site that cannot be covered
52
When assessing for swelling of a limb, how can the nurse ensure consistent measurements?
Mark the limb at the level measured from
53
What are 2 methods used by physicians to close a fasciotomy site?
ABRA Purse-string sutures
54
Immediately post-op, why are SCDs used for VTE prophylaxis instead of anticoagulant medications?
We should not be anticoagulating a patient who may still be bleeding

TERM 4 N2261 KNLG 3 (9 decks)

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