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54 Cards in this Set

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hip arthroplasty or total hip replacement is done when
when the arthritis involves the head of the femur and the acetabulum
when a pt has a total hip replacement should keep the legs
abducted with a wedge or abduction pillow
pt should sit in chair first the first week, and then second week
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
when pt goes home they should limit hip flexion to
90 degrees for 2 to 3 months
what is the most common type of fx treated in the hospital
hip fx
fx of the hip include
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)
intracapulsular fx are treated with
insertion of femoral prosthesis
extracapulsular fx tx how
with screws and nails
signs and symptoms of a hip fx are
severe pain at the fx site inability to move the leg voluntarily and shortening or external rotation of the leg
what is most important when a person has a hip fx
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
dx tests for a fx hip include
xray, hemoglobin test shows decrease shows bleeding at the site
what is the preferred methodof managing intracapsular and extracapsular hip fx
surgical tx
you should teach a pt with a hip fx not to
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
complications of hip fx are the most common cause of death after the age of
75
first fx are described as either
open (compound) or close (simple)
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
greenstick fx
fracture line extends entirely through the bone, with the periosteum disrupted on both sides of the bone
complete fx
bone is splintered into three or more fragments at the site of the bone. there is more than one fx line
comminuted fx
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
impacted fx
break runs directly across the bone , it is at the right ngle of the bones axis
transverse fx
break runs along a slant to the the length of the bone, approx 45 degree angle to hte shaft of the bone
oblique fx
break coils around the bone. it is sometimes called a torsion fx and will result from a twisting force
spiral fx
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
colles fx
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
potts fx
extracapsular fx involves a fx near the joint but one that has not entered the
joint capsule
is a fx withing the joint capsule
intracapsular fx
what ate the seven ps of assessment for a fx
pain, pallor, paresthesia, paralysis, polar temp, puffiness, pulselessness
pathological condition caused by the pregressivedevelopment of arterial vessel compression and reduced blood supply to a extremity
compartment syndrome
irreversible muscle ischemia can occur within how long
6 hours
paralysis and sensory loss with contracture and permanent disablility can occur in
24 - 48 hours
what is the subjective data of compartment syndrome
pt complains of severe pain, deep unrelenting poorly localized pain. numbness and tingling in he affected extremity is common
objective data of compartment syndrome is
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
what is the tx for compartment syndrome
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
what is the nursing intervention for compartment syndrome
pain relief, elevating the limp no higher than heart level
application of cold packs and removing constricting material.
what is the most common complication hen decompression is delayed in compartment syndrome
tissue necrosis
what is a permanent contracture that can occur in as a result of compartment syndrome
volkmanns cntracture
volkmans contracture is
permanent contracture, with clawhand, flexion of wrist and figers ad atrophy of the forearm
involves the embolization of tissue fat with platelets and circulating free fatty acids within the pulmonary capillaries
pulmonary fat embolism
fat embolism can cause
brain hypoxia and tissue death
fat embolisms should be suspected if hte pt has multiple fx of hte
long bones
the onset of a fat embolism may occur in
48 hours
pulmonary fat embolism is the most serious complication of
long bonefx
the pt with shows signs of
irritability, restlessness, stupor, disorientation, coma
pt will also experience chest pain
the nurse assess the pt for
petechia, tachypnea, dyspnea, hypoxemia, auditory crackles and wheezes
dx test is
they occur in 24 - 48 hours
fat will present in the blood and urine
the dr will order for fat embolism
iv fluids. steroid therapy, digoxin, oxygen, IS
the nurse will monitor closely
ABG,
what is the most common cause of death in fat embolism
respiratory failure
what can help prevent fat embolism
stabalization and immobilization of long bone fx
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
bucks traction - it is a horizontal plane with affected extremity
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
russels traction
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
where do you assess the pulses in a traction
distal pulses bilaterally for circulatory integrity
you should cleanse the pin site every
8 hours with hydrogen peroxide or normal saline