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54 Cards in this Set
- Front
- Back
hip arthroplasty or total hip replacement is done when
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when the arthritis involves the head of the femur and the acetabulum
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when a pt has a total hip replacement should keep the legs
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abducted with a wedge or abduction pillow
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pt should sit in chair first the first week, and then second week
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10 - 15 minutes 2 to 3 times a day for the first week and then the second week for 20 - 30 minutes four times a day
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when pt goes home they should limit hip flexion to
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90 degrees for 2 to 3 months
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what is the most common type of fx treated in the hospital
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hip fx
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fx of the hip include
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intracapsular (femur is broken inside the joint, they may disrupt the blood supply to the joint) or the extracapsular (most common, occurs outside of the hip joint capsule)
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intracapulsular fx are treated with
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insertion of femoral prosthesis
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extracapulsular fx tx how
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with screws and nails
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signs and symptoms of a hip fx are
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severe pain at the fx site inability to move the leg voluntarily and shortening or external rotation of the leg
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what is most important when a person has a hip fx
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keep the injure part at rest because movement of a fx bone can cause additonal damage and may cause a closed fx to become open
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dx tests for a fx hip include
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xray, hemoglobin test shows decrease shows bleeding at the site
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what is the preferred methodof managing intracapsular and extracapsular hip fx
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surgical tx
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you should teach a pt with a hip fx not to
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cross there legs, stand with toes turned in, bend way over, lie without pillows between the legs, do not elevate the operative leg when sittng in a chair
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complications of hip fx are the most common cause of death after the age of
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75
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first fx are described as either
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open (compound) or close (simple)
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incomplete fx in which the fx line extends only partially through the bone. the bone is broken but still at one side this fx occurs in more children
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greenstick fx
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fracture line extends entirely through the bone, with the periosteum disrupted on both sides of the bone
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complete fx
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bone is splintered into three or more fragments at the site of the bone. there is more than one fx line
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comminuted fx
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sometimes called a telescope fx because one bone fragment is forcibly wedged into another bone fragment . in long bone this can create a shortening of the extremity
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impacted fx
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break runs directly across the bone , it is at the right ngle of the bones axis
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transverse fx
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break runs along a slant to the the length of the bone, approx 45 degree angle to hte shaft of the bone
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oblique fx
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break coils around the bone. it is sometimes called a torsion fx and will result from a twisting force
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spiral fx
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fx of the distal portion of th radius within 1 inch of hte joint of the wrist. commonly occurs when a person trys to break the fall by putting the hands down
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colles fx
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occurs at the distal end of the fibula and is characterized by chipping off pieced of hte meidial malleoulus with a displacement of hte foot outwrard
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potts fx
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extracapsular fx involves a fx near the joint but one that has not entered the
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joint capsule
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is a fx withing the joint capsule
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intracapsular fx
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what ate the seven ps of assessment for a fx
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pain, pallor, paresthesia, paralysis, polar temp, puffiness, pulselessness
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pathological condition caused by the pregressivedevelopment of arterial vessel compression and reduced blood supply to a extremity
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compartment syndrome
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irreversible muscle ischemia can occur within how long
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6 hours
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paralysis and sensory loss with contracture and permanent disablility can occur in
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24 - 48 hours
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what is the subjective data of compartment syndrome
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pt complains of severe pain, deep unrelenting poorly localized pain. numbness and tingling in he affected extremity is common
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objective data of compartment syndrome is
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inability to flex fingers or toes, coolness of theextremity and the absence of pulsation in the affectted etremity. assess the skin for pallor or cyanosis , capillary refill will be slow
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what is the tx for compartment syndrome
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a fasciotym (incision into the fascia) to relieve pressure and allow return of normal blood flow to the area. the incision is often left open to heal by granulation
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what is the nursing intervention for compartment syndrome
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pain relief, elevating the limp no higher than heart level
application of cold packs and removing constricting material. |
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what is the most common complication hen decompression is delayed in compartment syndrome
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tissue necrosis
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what is a permanent contracture that can occur in as a result of compartment syndrome
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volkmanns cntracture
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volkmans contracture is
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permanent contracture, with clawhand, flexion of wrist and figers ad atrophy of the forearm
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involves the embolization of tissue fat with platelets and circulating free fatty acids within the pulmonary capillaries
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pulmonary fat embolism
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fat embolism can cause
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brain hypoxia and tissue death
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fat embolisms should be suspected if hte pt has multiple fx of hte
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long bones
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the onset of a fat embolism may occur in
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48 hours
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pulmonary fat embolism is the most serious complication of
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long bonefx
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the pt with shows signs of
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irritability, restlessness, stupor, disorientation, coma
pt will also experience chest pain |
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the nurse assess the pt for
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petechia, tachypnea, dyspnea, hypoxemia, auditory crackles and wheezes
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dx test is
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they occur in 24 - 48 hours
fat will present in the blood and urine |
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the dr will order for fat embolism
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iv fluids. steroid therapy, digoxin, oxygen, IS
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the nurse will monitor closely
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ABG,
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what is the most common cause of death in fat embolism
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respiratory failure
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what can help prevent fat embolism
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stabalization and immobilization of long bone fx
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this form of traction is used temporarily until a more permanent tx is intiated. it is used to maintain the reduction of a hip fx before surgery and tx muscle spasms, minor fx of the lower spine
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bucks traction - it is a horizontal plane with affected extremity
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a knee sling is set up to provide support to affected extremity. it allows for more movement in the bed and permits flexion of the knee joint. commonly used for ip and knee fx
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russels traction
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used in pediatrics for small children with fx femurs
both legs are suspended at a 90 degree angle to the trunk of the body and the weight of hte lower body pulls the bone fragents of hte fx leg into alignment |
byrants traction
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where do you assess the pulses in a traction
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distal pulses bilaterally for circulatory integrity
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you should cleanse the pin site every
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8 hours with hydrogen peroxide or normal saline
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