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70 Cards in this Set
- Front
- Back
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What is a sprain?
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injury to a ligament resulting from a twisting motion
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What is a strain?
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stretching of a muscle and its fascial sheath (pulled muscle)
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What is an avulsion fracture?
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ligament pulls loose a piece of bone
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What is hemathrosis?
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bleeding into a joint
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What is the intervention for an acute sprain or strain?
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RICE
rest ice compression elevation (fifth one would be analgesia) |
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How do you want to do the I in rice?
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ice - every 20 minutes on and 20 minutes off
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How do you want to do the C in rice?
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compression - wrap it and take wrap off every 30 minutes for 15 minutes
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How do you want to do the E in Rice?
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elevate - above the heart
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After the acute phase (which is _________ hours), what can you do to a sprain or strain?
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24-48 hours
you can apply heat (2 days later) 20 on/20 off |
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What do you want to make sure to instruct patient in regards to activity with a sprain or strain?
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Remember this is a muscle, so eliminate weight bearing
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What medication do you want to take for a sprain or strain?
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NSAIDs b/c they decrease inflammation through prostaglandins
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What is the assessment of an acute sprain or strain include?
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pain
edema decrease in function bruising Always do n/v assessment |
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Why does compression help with swelling?
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decreases arterial flow and allows venous return so decreases swelling
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What is a dislocation?
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separation of contact between 2 bones of a joint
displacement of a bone from its correct articularing position within a joint |
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What does the assessment for dislocation include?
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pain
change in shape of joint change in length of extremity loss of function always do n/v assessment |
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Three main treatments of a sprain/strain
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support
rest NSAIDS |
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What is avascular necrosis?
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bone cell death as a result of inadequate blood supply
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What are the complications of dislocation?
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avascular necrosis and impengment of nerve
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What are pathologic dislocations commonly caused by?
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arthritis - destruction of tissue
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What is the first goal of dislocation?
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realign the joint (closed reduction) with or without local anesthesia
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Once you realign a dislocated joint, what do you do?
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immobilize it so it can rest
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What does the nursing management of a dislocation include?
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relief of pain
support protection of the injured joint neurovascular assessment |
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What is a subluxation?
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a partial dislocation
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What does the patient with a subluxation experience?
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popping or giving out at the site
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What nerve is affected with carpal tunnel syndrome?
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median nerve
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What are the manifestations of carpal tunnel syndrome?
DX with ________ |
weakness of limb
pain, numbness and tingling Phalen's test |
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What does the ND: ineffective therapeutic regimen managment mean?
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they really aren't doing the things they should be to help their illness
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Exactly list the things in a neurovascular assessment.
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color
temperature capillary refill peripheral pulses edema sensation motor function pain |
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What are the parts of the n/v assessment that are neurological?
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sensation
motor function pain |
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What are the parts of the n/v assessment that are vascular?
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edema
peripheral pulses capillary refill temperature color |
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A crushing fracture with more than 2 fragments.
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comminuted
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A overriding fracture that the bone is completely broken and overriding the other bone.
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displaced
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Incomplete fracture. One side is splintered and the other side is bent.
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Greenstick
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Comminuted fracture in which more than two fragments are driven into eachother.
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Impacted
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A fracture that extends to the joint surface of the bone.
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Interarticular
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A fracture all along the edge of the bone. It is incomplete.
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longitudinal
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What is not injured in a longitudinal fracture?
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periosteum is not torn away from bone
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A diagonal fracture.
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oblique
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A spontaneous fracture at site of a bone disease.
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pathological
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Jogging or running can cause this type of fracture
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stress
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Straight across break at a right hangle.
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Transverse
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What is the difference between a stable or unstable fx?
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whether the periosteum is still in place keeping the fragments stationary
(stable - periosteum is holding everything "stable") (unstable - periosteum is pulled away from bone and bits broken are "unstable") |
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What is a compound fracture?
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The outside environment is involved (the bone is sticking out)
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What is another word for compound fracture?
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open
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What is avulsed in regard to a fracture?
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muscles are peeled back (she said)
Book says it is the bone being broken by the tendons or ligaments) |
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What is the pain in a fracture caused from?
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the muscles
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What is the initial condition of nerves at a bone break?
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Local numbness and muscle flaccidity occur due to temporary loss of nerve function which may last only a few minutes
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What happens after the initial numbness and flaccidity?
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muscle spasms in the area cause pian, swelling and tenderness at the site
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What are the initial interventions for a fracture?
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-control bleeding
-split (above and below the break) -elevate -ice -x-ray -tetanus/diptheria shot **** -mark location of pulses to facilitate repeat assessments (****prior student says that if test question refers to a construction man entering ER with open fracture, choose TETANUS shot as 1st intervention!!) |
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After you split the break above and below the actual fracture, what do you do?
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n/v status distal to injury site
(you also did this prior to splinting) N/V Before and After splinting |
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What is the first stage of fracture healing?
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Fracture hematoma - a hematoma surrounds the ends of the fragments. It eventually forms a semi clot. Initial 72 hours after injury
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What happens in the second stage of fracture healing?
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Granulation tissue - phagocytosis absorbs the products of necrosis. Hematoma becomes granulation tissue...produces osteoid (which is substance of new bone)
3 to 14 days post injury |
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What are the first three stages of fracture healing?
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fracture hematoma
granulation tissue callus formation |
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What happens in the third stage of fracture healing?
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callus formation - Deposits of minerals and matrix are made in the osteoid. It is called callus. You can see it on x-ray
2 weeks |
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After callus formation, the next two steps are:
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ossification
consolidation |
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What happens in the ossification phase?
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The callus ossifies for the next 6 months. Bones can handle a bit of stress and stay aligned. THis is at week three. This is the stage of CLINICAL UNION and the cast may be removed
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What happens after ossification?
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consolidation - the distance between the bone fragments finally closes.
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What is the last stage of fracture healing?
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remodeling - excess bone tissue is reabsorbed in the final stage and the union is complete. Stress is important part of remodeling. Can take up to a year to finish
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What are the six P's to IMPENDING compartment syndrome?
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Paresthesia
Pain Pressure Pallor Paralysis Pulselessness |
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What is paresthesia?
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altered sensation - abnormal such as numbness or tingling
-decreased or increased sensation |
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According to Ms. King's notes, what are the main categories of n/v assessment?
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color
temperature pulse sensation movement |
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The hand is cyanotic and cool. What most likely is the problem?
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arterial insufficiency
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The hand is warm and dusky. What is most likely the problem?
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Venous return restriction
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What are the descriptive words for the pulses?
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ALWAYS COMPARE BOTH SIDES
1+ to 4+ strong diminished audible only by doppler absent |
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What are the things to assess under movement?
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reduced motion
reduced strength |
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In order to have loss of function, what must have been damaged?
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nerves, muscles, ligaments or tendons
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What are the two causes of compartment syndrome?
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decreased compartment size
increased volume inside |
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What is another cause of compartment syndrome other than decreased compartment size or increased volume inside?
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exterior (cast/ACE)
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What is affected in compartment syndrome?
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fascia and muscle
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When does compartment syndrome usually happen?
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first 48 hours
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