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Muscle/bone disorder
Fx, disorders, complications, interventions
| Question | Answer |
|---|---|
| Closed nondisplaced | Simple fracture; does not cause a break in skin; remains contained (transverse) |
| Open Fracture | Compound; a fx in which damage also involves the skin or mucus membranes; Skin integrity has been impaired |
| Oblique | a fracture occuring at an angle across the bone; less stable then a transverse fracture |
| Comminuted | A fracture in which bone has splintered into several fragments |
| Impacted | a fracture in which a bone fragment is driven into another bone fragment |
| Displaced | two fractured pieces move away from each other and can cause damage to surrounding tissue and muscle |
| When do fractures occur?(In general, not causes) | Fractures occur when the bone is subjected to stress greater than it can absorb |
| What are some causes of fractures? | Direct blows, crushing forces, sudden twisting motions and even extreme muscle contractions. |
| What are the early complications of fracture healing? | Shock, fat embolism syndrome, compartment syndrome, and thromboembolic complications like DVT and PE. |
| Define fat embolism syndrome | An embolism caused by globules of fat obstructing blood vessels. Occurs after fx of long bones and pelvic bones, can also occur after lipid infusion. May cause DIC. |
| What are the S&S of Fat embolism syndrome | Neuro disfunction- confusion, change in LOC; Pulmonary insufficiency- pulmonary edema,atelectasis,tachypnea,tachycardia,hypotension; Petechiae of upper body; thrombocytopenia |
| Interventions for Fat embolism | Assess for embolism, client may need intubation if in repiratory distress; steriods; treat symptoms |
| Define compartment syndrome | Eleveation of tissue pressure w/i a closed fascial compartment, causing a decreased arteriovenous pressure and decreased muscular perfusion |
| S&S of compartment syndrome | Early: pain, normal or dec. pulse; Late: cyanosis; paraesthesias; severe pain (lactic acid build up b/c of anaeorbic resp) |
| Who's at risk for compartment syndrome? | Pt's with burns, casts, circumferential dresings, crushing injuries |
| Intervention for compartment syndrome | Ice, elevation; Absent or diminished pulses need surgical consult (if s&s not cleared in 30 mins) Medical Tx: Fasciotomy (lengthwise incision made on limb to relieve edema and pressure) |
| What does it mean to reduce a fracture? | To restore bones to previous anatomical locations; maintains correct alignment and restores function |
| What is the difference between closed reduction and open reduction? | Closed reduction is done nonsugically and open reduction is done surgically- rods and screws are used to realign bones |
| What does ORIF stand for? | Open reduction with internal fixations |
| Name one pro and one con for ORIF? | Healing is faster; Risk for infection r/t internal fixation devices |
| Define Myotonic dystrophy | A hereditary dx in which the muscles are weak and are slow to relax after contraction. Charcaterized by muscular wasting, mytonia(tonic spasms of a muscle), and cataract. |
| Define Marfan syndrome | a hereditary syndrome of abnormal length of limbs, especially fingers and toes, with cpmplete or partial dislocation of the lens, cardiovascular abnormalities, and other defects. |
| Define Amyotrophic Lateral Sclerosis (ALS); also known as Lou Gehrig disease | Disease of the motor neurons,from the brain to the spinal cord and the spinal cord to the peripheral nerves that control muscle movement. These neurons die, leading to a progressive loss of the ability to move virtually any of the muscles in the body. |
| How do the use of steroids affect bones? | Steroids excrete calcium from bones |
| What effect does Torazine (antipsychotic med)have on gait? | Torazine can cause a change in the patient's gait. It causes the pt to shuffle while walking. |
| What can an increase of ALK Phosphate indicate? | Metastasis to the bones |
| What is a bone scan? | The injection of a radioactive substance to enable visualization of a bone via the image produced by emission of radioactive particles. |
| What is an EMG (Electromyography)? | A test that records the electrical activity of muscles. Electrodes are placed on or in the skin; the patterns of electrical activity are projected on a screen or over a loudspeaker. Used to test for muscular dystrophy. |
| What should you avoid before having an EMG? | No caffeine or cigs for 3 hours prior to test. Avoid meds that have an impact on musculoskeletal system (flexeril- muscle relaxants) |
| Name 6 characteristics of most fractures | Pain (Pt guarded and protective); Loss of function- lack of wt bearing; Deformity (sometimes); Abnormal motion; Swelling; Aletered sensation |
| S&S of fractures | Edema- bleeding into tissues can occ. circ. & damage nerves; Pain- helps prevent movement; Deformity- if not fixed may inhibit restoration of function; Crepitaion-crunching or grating- inc. chance for non-union |
| What are the six stages of bone healing? | Hematoma Formation; Hematoma to granulation tissue; Callus formation; Osteoblastic proliferation; Bone remodeling; bone healing completed |
| In what stage of bone healing can the pt start bearing wt? | Bone remodeling stage- wear bearing can be reintroduced |
| In what stage of bone healing results in a change of bone structure? | Last stage when Bone healing is complete. |
| What factors influence healing of fx's? | Age, Site of the fracture, Blood supply, Immobilization, Infection, Hormones |
| What is traction? | The exertion of a pulling force applied in two directions to reduce, immobilze a fx, prevents spasms and prevent soft tissue damage. |
| What are some interventions some important interventions for traction? | Proper alignment; Ensure wt's hang freely and do not touch the floor; Don't remove or lift the wt's w/o MD order; Ensure pulleys are not obstructed and ropes able to move freely; Place knots in rope to prevent slipping; check ropes for fraying |
| What is skin traction? | Uses tape, boots and splints; Applied dierctly to skin; assists in reducing fx; dec. muscle spasms; short term use 48-72 hrs; wt's 5-10 lbs; Most common- Buck's traction |
| What is skeletal traction? | Uses pins or wires inserted into bones; long term use; used to align injured bones and joint contractures and congential hip dysplagia; wt's 5-45 lbs |
| Define internal fixation | Follows open reduction; involves the application of screws, plates, & pins to hold fragments in alignment; risk of infection |
| Defin external fixation | An external frame used with multiple pins applied through bone; provides more freedom of movement than with traction |
| Define countertraction | pulling force exerted in the opposite direction to prevent the client from sliding to the end of the bed; ex: pt's wt, elevating the foot of the bed (trendelenberg), and elevating the head of the bed with cervical traction |
| What instuctions would you give a pt w/ a hip fx? | Don't flex hip more than 90 degrees; Use a raised toliet seat; HOB no more than 60 degrees to prevent flexion of hip; maitain hip abduction,use a wedge pillow & brace between legs; Avoid external and internal rotation |
| What is gout? | Inflammatory response to hyperuricemia; Primary cause-genetic error in purine metabolism; impaired uric acid secretion; Secondary cause- Overproduction of uric acid b/c of htn, renal dx, or leukemia |
| What is the 1st symptom of gout? | Night time pain in great toe |
| Name some precipitating factors for gout? | Potassium sparing durrtics, salicylates, ETOH use, changes in diet; surgeries |
| What meds are used to treat gout? | Indocin, NSAIDs, Allopurinol(disrupts uric acid production- contraindicated in pt's w/ renal, GI, cardiac,& hepatic disfunctions) |
| What food should a person with gout avoid? | Foods high in purines- organ meats |
| What kind of nutrition should you encourage a pt with a fracture to eat? | Vit- B,C,D; 2-3 L of fluids/day; high fiber; fruits and veggies |
| What are the 6 P's your assessing for with fractures? | Pain, pallor, pulselessness, paresthesia, paralysis, poikilothermia |
| Define Systemic Lupus Erythematosus (SLE) | Chronic inflammatory autoimmune disorder that affects the connective tissues. Characterized by recurring remissions and exacerbations; Affects multiple organs; diffuse production of autoantibodies that attack and cause damage to body organs and tissue |
| What is the most common cause of death with SLE? | Kidney failure is the most common cause of death |
Created by:
mibbs
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