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20 Cards in this Set
- Front
- Back
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What are the different ways a fracture is classified? |
Open/closed Complete/incomplete Displaced/nondisplaced |
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How do fractures heal? |
1. Fracture hematoma 2. Granulation tissue 3. Callus formation 4. Ossification 5. Consolidation 6. Remodeling |
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What are the clinical manifestations/certain assessments you can make about a pt with a potential fracture? |
Deformity or unnatural position of affected limb Edema (localization of serous fluid and bleeding) Ecchymoses (extravasation of blood into subcutaneous tissue) Muscle spasm (muscle contraction near fracture) Tenderness and pain (muscle spasm, direct tissue trauma, nerve pressure, movement of fractured bone) Loss of function Numbness, tingling (nerve damage, nerve entrapment) Crepitus (grating of bone) Open wound over injured site, exposure of bone |
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What are some acute interventions a nurse can make after identifying a fracture? |
Do not: attempt to straighten fractured or dislocated joint manipulate protruding bone ends Do: Control external bleeding with pressure and elevation of extremity Splint joints above and below fracture sites Apply ice packs to affected area Check neurovascular status distal to injury Mark location of pulses to facilitate repeat assessment Physician orders: x-rays |
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nonsurgical, manual realighment of bone fragments to their previous anatomical position |
Closed reduction |
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correction of bone alignment through a surgical incision |
Open reduction |
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application of a pulling force to an injured part of the body while countertraction pulls in the opposite direction |
Traction freduction (2 types) -skin traction (non-invasive) -skeletal traction (invasive) |
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This form of immobilization allows the pt to perform many ADLs while providing sufficient immobilization to ensure stability. It also incorporates the joints above and below a fracture |
Casts |
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This form of immobilization uses metallic devices composed of metal pins inserted into bone and attached to external rods. Used to stabilize the fracture while it heals. |
External fixation |
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What is a open reduction internal fixation (ORIF)? |
Internal fixation devices (pins, plates, rods, screws) are surgically inserted at the time of realignment. |
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ORIF hip precautions |
If anterior approach- Hip precautions are few; WBAT If posterior approach- Avoid greater than 90 degrees flexion Avoid adduction Avoid internal rotation |
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areas in the body in which muscles, blood vessels, and nerves are contained within fascia |
compartments |
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an inelastic tissue that surrounds groups of muscles, blood vessels, and nerves in the body |
Fascia |
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What is compartment syndrome |
A serious condition: Increased pressure within one or more compartments reduces circulation to the area Causes perfusion to be reduced below a level necessary for tissue viability What happens…Muscle and nerve cells are destroyed Loss of function can occurdisability |
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2 causes for compartment syndrome |
decreased compartment size d/t restrictive dressings, splints, casts, excessive traction increased compartment content d/t bleeding, edema |
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What are the clinical manifestations of compartment syndrome |
The “six Ps” : Paresthesia (numbness and tingling) Pain distal to the injury not relieved by opioid analgesics Pressure increases in the compartment Pallor (loss of normal colour, coolness) Paralysis or loss of function Pulselessness (diminished/absent peripheral pulses) [late sign] |
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What is a fasciotomy? |
Surgical decompression (fasciotomy) of the involved compartment may be necessaryfasciotomy site is left open for several days to ensure adequate soft tissue decompression |
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FES |
Fat embolism syndrome. Fat is released from the marrow of injured bone and enters the systemic circulation where the fat embolizes to other organs |
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Clinical manifestations of FES (pulmonary embolism) |
If transported to the lungs: symptoms caused by poor oxygen exchange Changes in mental status (drowsy, sleepy) Chest pain Tachypnea CyanosisD ecreased 02 sat Dyspnea Tachycardia Feeling of impending disaster Rapid and acute course Cl may become comatose in a short time Treatment directed at prevention |
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