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11 Cards in this Set
- Front
- Back
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Revise the procedure for taking neurovascular observations:
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Monitor:
colour warmth movement sensation |
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Why do we take these observations?
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- to identify vascular insufficiency early
- detect nerve pressure/damage - prevent compartmnet syndrome - decrease consequence of complications (e.g limb loss) |
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When do we take these observations?
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Initially 1 hourly, then 4 hourly
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What pulses are assessed for lower limb neurovascular obs?
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dorsalis pedis - top of foot
posterior tibial - side of foot |
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How do you make a pain assessment of a patient who has had an othopaedic procedure?
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- Pain score 0-10
- Location of pain - Quality of pain - What makes the pain better or worse |
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What nursing measures can you apply to reduce both pain and swelling?
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- elevation
- administer paracetamol - request increased pain relief in a medication order - loosen bandages |
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List the complications that can occur after orthopaedic surgery?
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- pressure ulcers (depends which bone)
- infection - DVT/PE - Pain - Decreased movement --> affected psychological wellbeing |
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Your patient has severe unrelieved pain in his calf after ORIF # tibia, the calf is swollen and the foot looks dusky in colour. What could be happening to his leg?
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Compartment syndrome
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What is compartment syndrome?
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Build up of fluid in fascia leading to increased pressure in the compartment.
This pressure can decrease blood flow resulting in serious consequences. |
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What immediate nursing action should you take if you suspect this occurring?
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- Call for MO
- elevate limb to height of the heart - loosen bandages |
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What surgical procedure is performed to relieve compartment syndrome?
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Fasciotomy
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