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NURS 3000 > Week One > Flashcards

Week One Flashcards

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1
Q

What is a fracture?

A

Disruption or break within the continuity of the bone

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2
Q

What are the most common causes of fractures?

A

Most frequently caused by trauma; other causes include pathological conditions such as cancer or osteoporosis

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3
Q

Define open fracture

A

A fracture where the bone breaks through the skin

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4
Q

Define closed fracture

A

A fracture where the bone does not break through the skin

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5
Q

What is the difference between complete and incomplete fractures?

A

Complete fractures involve a break across the entire bone, while incomplete fractures do not

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6
Q

What distinguishes displaced from non-displaced fractures?

A

Displaced fractures have fragments that are not aligned, while non-displaced fractures have aligned fragments

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7
Q

What occurs during the fracture hematoma stage?

A

Hematoma forms, changing from liquid to semisolid clot within 72 hours

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8
Q

What is granulation tissue in the context of fracture healing?

A

Tissue that forms 3-14 days post-fracture, consisting of new blood vessels, fibroblasts, and osteoblasts

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9
Q

What minerals are deposited during callus formation?

A

Calcium, phosphorus, and magnesium

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10
Q

After how many months does ossification begin post-fracture?

A

3-6 months after fracture

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11
Q

What is the goal of fracture treatment?

A

Anatomical realignment of bone fragments, immobilization, and restoration of normal function

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12
Q

What is traction in fracture care?

A

A pulling force used to reduce fractures, relying on correct position and body weight as counter-traction

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13
Q

What is external fixation in fracture immobilization?

A

A method that stabilizes bone fragments using pins or screws attached to an external frame

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14
Q

What is the purpose of casting in fracture care?

A

To immobilize the fracture site and assist in stabilization for healing

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15
Q

Fill in the blank: Casts restrict _______ movement.

A

tendon and ligament

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16
Q

What are the do’s of cast care?

A

Apply ice over cast, dry cast if exposed to water, elevate extremity, move joints above and below cast regularly

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17
Q

What are the don’ts of cast care?

A

Get plaster cast wet, remove padding, insert items into cast, cover cast for long periods

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18
Q

What are the symptoms assessed during an acute injury evaluation?

A

Pain, muscle spasms, guarding, ecchymosis, crepitation, edema & swelling, deformity, loss of function

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19
Q

What does the peripheral vascular assessment include?

A

Color, capillary refill, edema, and peripheral pulses

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20
Q

What are the 6 P’s of compartment syndrome assessment?

A

Pain, Pallor, Poikilothermia, Paresthesia, Pulselessness, Paralysis

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21
Q

What is compartment syndrome?

A

Swelling and pressure in a limited space that compromises blood vessels, nerves, and tendons

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22
Q

What is the primary treatment for compartment syndrome?

A

Fasciotomy

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23
Q

What is the highest incidence of amputation related to?

A

Peripheral vascular disease (PVD), atherosclerosis, and vascular changes related to diabetes mellitus (DM)

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24
Q

What is phantom limb sensation?

A

Sensation that feels like the limb is still present; occurs in 60-100% of patients post-amputation

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25
What kind of pain is associated with phantom limb pain?
Shooting, burning, sharp, or crushing pain
26
What are fractures most frequently caused by?
Trauma
27
What is a fracture?
Disruption or break within the continuity of the bone
28
What are the most common causes of fractures?
1. Trauma 2. Pathological such as cancer or osteoporosis
29
What is the difference between an open fracture and a closed fracture?
Open fractures breakthrough the skin, while closed fractures do not
30
What is an incomplete fracture?
When only one side of the bone is broken and the other either remains intact or bends slightly but does not complete break into two pieces
31
What is a complete fracture?
Bone has broken into separate pieces
32
What is a displaced fracture?
A displaced fracture is a type of bone fracture in which the broken bone ends are no longer aligned properly. This misalignment can occur when the force causing the break moves the bone fragments out of their normal anatomical position.
33
What is a non-displaced fracture?
A non-displaced fracture is a type of bone fracture in which the bone cracks or breaks but maintains its normal alignment.
34
What is a transverse fracture?
Bone fracture that occurs in a straight, horizontal line.
35
What is a spiral fracture?
Fracture where the break spirals around the bone, similar to a corkscrew
36
What is a greenstick fracture?
incomplete fracture that occurs when a bone bends and partially breaks, without breaking completely through. Most common in children, due to their bones being more soft/flexible
37
What is a comminuted fracture?
When a bone breaks into pieces Most common in trauma or high-impact injuries.
38
What is an oblique fracture?
When a break occurs at an angle (diagonal), relative to the bones axis.
39
What is a pathological fracture?
a type of bone fracture that occurs in a bone weakened by an underlying disease or condition, rather than from a significant trauma or force. These fractures can happen with minimal stress or normal activities that would not typically cause a bone to break. * cancer, osteoporosis, genetic conditions, etc.
40
What is a stress fracture?
A stress fracture is a small crack or severe bruising within a bone that occurs due to repetitive stress or overuse, rather than from a single traumatic event. These fractures are common in weight-bearing bones and often develop gradually over time. * runners
41
How many stages for fracture healing is there?
Six
42
What is fracture hematoma and when does it occur?
1. Occurs within the first 72 HR 2. Occurs following the fracture, consistency of blood changes from liquid to semisolid clot (hematoma)
43
What is granulation tissue and when does it occur?
1. Occurs during day 3-14 2. Phagocytosis occurs locally, hematoma changes to granulation tissue and produces the basis for new bone substance called osteoid (consists of new blood vessels, fibroblasts, and osteoblasts)
44
What is callus formation and when does it occur?
1. Occurs day 14 2. Minerals such as calcium, phosphorus, and magnesium and new bone matrix are deposited into the osteoid
45
What is ossification and when does it occur?
1. Occurs from 3-6 months 2. Callus becomes ossified starting three months post fracture, continuing until fracture is healed. (Fracture can still be seen on X-ray) 3. Movement is prevented 4. Small amount of weight bearing 5. Cast may be removed
46
What is consolidation and when does it occur?
1. Continues up to 1 year after injury 2. Callus continues to develop, distance between bone fragments lessens and closes
47
What is remodelling and when does it occur?
1. Final stage 2. Excess bone is reabsorbed, with strength, structure and shape returns to pre-fracturestate
48
What is bone healing influenced by?
Influenced by many factors; - site of fracture and the degree, or how badly the bone is displaced and the amount of blood supply the bone receives.
49
What are the goals in fracture treatment?
Anatomical realignment (reduction) Immobilization to maintain realignment Restoration of normal or near-normal functioning.
50
What is involved in the reduction process for a closed fracture?
- non surgical, manual realignment of bone fragments to their normal position. - anesthesia is used - cast, splint, or brace usually applied afterwards
51
What is involved in the reduction process in an open fracture?
- correction of bone alignment with surgery - often uses wires, pins, screws, rods, nails, or plates to secure bones - increases risk of infection
52
What is traction?
A pulling force on an injured part of the body, used in fracture care to reduce fractures. It relies on correct position and body weight as a counter-traction.
53
What is an external fixation?
Pins and wires are attached to bones to apply traction or compress bone fragments while immobilizing the bones. - used on closed fractures, when there is soft tissue damaged, or when there is malunion. - can be used to prevent amputation
54
What is an internal fixation?
Uses pins, rods, screws, nails and plates that are inserted surgically to align the bones (open fracture) - alignment is evaluated via X-ray to monitor
55
What is casting?
Immobilization device used after closed reduction, involves the bones above and below the fracture to assist in stabilization for healing, restricting tendon and ligament movement - padding/stocking placed over skin before casting.
56
Plaster of Paris
- sets within 15 min - no weight bearing 24-72h - don’t cover fresh splatter cast (burns) - avoid pressure (reduces pressure points and denting)
57
Fiberglass cast
- more commonly used - lighter than plaster - water resistant - quick drying - less likely to cause burn
58
What are the cast care DONT’s?
- get plaster wet - remove padding - insert items in cast - cover cast for long periods - leave case in dangle position (edema)
59
What are the cast care DO’s?
- apply ice over cast - dry cast if exposed to water - elevate above heart for first 24h - move joints above/below regularly - ensure to monitor and follow up appts
60
Nursing assessment: Acute Injury
- how it happened & position found in - health and medication history - pain (at tissues & with movement) - muscle spasms - guarding - Ecchymosis (bruising) - Crepitation (crunching of bone) - edema and swelling - deformity (abnormal bone position) - loss of function (use limb/bear wt)
61
Nursing assessment: Neurovascular
- cast/constructing dressing and/or poor positioning can cause nerve/vascular injury. - colour - temp (cool: arterial insufficiency; warm/cyanotic: poor venous return) - capillary refill <2 sec - edema - peripheral pulses (compare ranges)
62
Direct complications of fracture
1. Bone infection (more associated with soft tissue injury) 2. Malunion 3. Vascular Necrosis
63
Indirect complication of fracture
1. Compartment syndrome 2. Rhabdomyolysis 3. Embolism (VTE, fat embolism) 4. Hypovolemic shock
64
What are the life threatening complications of a fracture?
Open fracture, massive hemorrhage, organ damage
65
How many compartments are in the human body?
38
66
What are the two main causes of compartment syndrome?
Decreased compartment size Increased compartment contents
67
What is compartment syndrome?
Swelling and pressure in a limited space, the pressure compromises the function of blood vessels, nerves and tendons of that compartment.
68
What are the 6 P’s of the compartment syndrome assessment?
1. Pain - pain to injury site 2. Pallor - pale appearance 3. Poikilothermia - cool temperature 4. Parathesia - numbness and tingling 5. Pulselessness - (or decreased pulse; a late sign) 6. Paralysis - loss of function (late sign)
69
What is used to treat compartment syndrome?
Fasciotomy or amputation
70
What is a fasciotomy?
1. Incision into the fascia surrounding the compartment, as it will release the compartment and allow it to expand to promote vascular flow. Fasciotomy is left open for several days (Monitor for infection)
71
What is involved in amputation?
1. Removal of body extremity 2. The goal of amputation surgery is to preserve extremity length and function while removing all infected pathological, ischemic tissue and gangrene.
72
What is involved in post op nursing care for amputation?
1. Monitor vital signs and assess dressing 2. Sterile technique for all dressing changes and wound care. 3. Have a surgical tourniquet available 4. If excessive bleeding occurs - tell MD
73
Nursing considerations for amputee patients?
1. psychosocial assessment and support 2. Phantom limb sensation 3. Phantom limb pain
74
What is phantom limb sensation?
1. Feels like limb is still present 2. Occurs in 60-100% of all patients 3. Can be any sensation such as touch, pressure, wetness, cold. (except pain)
75
What is phantom limb pain?
1. Usually occurs right after surgery 2. Can be shooting, burning, sharp, crushing. 3. Often intermittent, but occurs multiple times per day.

NURS 3000 (3 decks)

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