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Musculo Finals
| Question | Answer |
|---|---|
| CONTUSIONS - | bruise; results from external injuries from soft tissue |
| CONTUSIONS - ECCHYMOSIS | black and blue |
| CONTUSIONS - HEMATOMA | swelling |
| CONTUSIONS - TREATMENT | (a) Elevate the extremity (Edema)(b) Heat to remove muscle soreness(c) Alternate with ice every 20 minutes |
| SPRAIN - | involves ligament, tendon & muscle usually results from twisting or wrenching of joints. Ie: twisted ankle, ligaments maybe torn. Maybe pulled from bone. Blood vessels might be ruptured. You can have edema. |
| SPRAIN - HEMARTHROSIS | bleeding into joint |
| SPRAIN - TREATMENT | (a) Elevate the extremity b) Ice for 24 hours every 20 minutes. Alternate with heat. c) No weight bearing d) Xray e) Splint f) Ace wrap g) Tape h) Cast i) No minimal exercise right away |
| DISLOCATIONS - | (SUBLUXATIONS) displacements |
| DISLOCATIONS - CAUSES | (a) Diseased joint b) Trauma |
| DISLOCATIONS - ACCOMPANIED BY | (a) Stretching and tearing ligaments and tendons b) Severe pain or deformity c) Muscle function |
| DISLOCATIONS - COMMON SITES | Shoulder, hip, knee |
| DISLOCATIONS - ASSESSMENT | a) May or not be visible b) May change length of extremity c) Might be partially immobilized |
| DISLOCATIONS - TREATMENT | a) Closed reduction by manipulation b) Immobilize c) Iced with 24 hours on/off every 20 mins (no heat!) d) Ace wrap, splints, slings, cast e) Pain control |
| DISLOCATIONS - S/S | Pain, deformity, loss of joint function |
| STRAINS - | tearing of muscle due to overstretching |
| STRAINS - TREATMENT | Ice for 24 hours |
| FRACTURES | break |
| FRACTURES - CLASSIFICATIONS - OPEN OR COMPOUND | gunshot wound |
| FRACTURES - CLASSIFICATIONS - CLOSED | simple. Appearance are usually greenstick, complete, communited, impacted |
| FRACTURES - CLASSIFICATIONS - CLOSED- COLLES FX | fracture of wrist (most common fracture!)Distal end of radius is broken. It drops down like fork |
| FRACTURES - CLASSIFICATIONS - CLOSED - POTTS FX | distal end of fibula (leg back end) Chips off a piece of malleolus of the foot & foot is displaced outward. |
| FRACTURES - CLASSIFICATIONS | Place of bone: proximal, midshaft or distal according to displace. ; (d) Movement of fragments. Might be sideways, rotate, override, ambulate |
| FRACTURES - Healing Stages of Bone | a) Clot formation at the end of the fractured bone b) Fibroblast invades area and fibrin meshwork is formed c) WBC’s wall off area. Osteoblast enter the fibrous area and help hold union firm |
| FRACTURES - Healing Stages of Bone | d) Within 6-10 days, a callous formation occurs. Osteoclasts comes in and destroy the dead bone. e) Collagen strengthens and incorporates calcium deposits. (i) Arm bone = 3 months (ii) Leg bone = 6 months |
| FRACTURES - Electrical bone stimulator | either open or closed. Electrodes implanted and stimulates bone |
| FRACTURES - Hip Fractures: S/S | a) Pain at fracture site b) Usually the effected extremity will be a little shorter c) The foot is usually out. |
| FRACTURES - Nursing implications: | 1. Assess the need to teach 2. Review instructions with family and patient 3. Encourage activities within the restriction of fracture |
| FRACTURES - ORIF: Open Reduction & Internal Fixation | Allows visualization of reduction in the surrounding tissue. It also allows internal fixation. Allows stabilization of fracture with use of nails or screws. NAIL = stainless steel or Austin Moore/Bateman prosthesis. ALWAYS DO PIN CARE! |
| FRACTURES - First Aid | a) Do not try to put the displaced bone back! b) Treat the bleeding! (pressure) c) Cover open wound with clean dressing d) Move patient as little as possible e) Put splint/sling on it f) Do not move patient g) No food or liquid |
| FRACTURES - COMPLICATIONS - Pulmonary embolism | blood clot in lungs (Sudden severe sharp pain and dyspnea). Look for s/s of shock. Use stockings, luminox, anticoagulants. |
| FRACTURES - COMPLICATIONS - Fat Embolism | most common in young adults and older with fractured hip. |
| FRACTURES - COMPLICATIONS - Fat Embolism - S/S | chest pain, dyspnea, confusion. |
| FRACTURES - COMPLICATIONS - Fat Embolism - prevention | minimum manipulation of bone fragments with immediate immobilization. |
| FRACTURES - COMPLICATIONS - Gangrene, Tetanus | rapid destruction of tissue with acute infection with fever, wound pain, bubble and edema. If untreated, will lead to systemic toxemia and death. |
| FRACTURES - COMPLICATIONS - Compound fracture | anaerobic bacteria (without oxygen) |
| FRACTURES - COMPLICATIONS - Compound fracture - Treatment | a. Wound debridement b. Hyperbolic oxygen c. Antibiotic and anticonvulsions d. Amputations may be necessary |
| FRACTURES - COMPLICATIONS - Compartment syndrome | progressive development of arterial vessel compression with circulatory compromise. Rapid results. Permanent deformity of hand and foot |
| FRACTURES - VOLKMAN CONTRACTURE | Muscle in compartment swells due to severe trauma or compression of cast. Contracture deformity of hand or foot. |
| FRACTURES - VOLKMAN CONTRACTURE - S/S (5p'S) | 1) Sharp pain 2) Inability to flex fingers and toes 3) Numbness 4) Coldness of extremity 5) No pulse |
| FRACTURES - VOLKMAN CONTRACTURE -TREATMENT | emergency treatment = surgical fasciotomy to release pressure |
| FRACTURES - FASCIOTOMY | incision into the fascia |
| AMPUTATIONS - | BKA (below knee amputation) AKA (above knee amputation) |
| AMPUTATIONS - REASONS FOR | a) Malignant bone tumor b) Injury (arms) c) Diabetic gangrene (lack of circulation) d) Any condition that threatens a person’s life e) Emergency procedure that severely injured the part. |
| AMPUTATIONS - IMPORTANT NOTES | a. If dressing is soaked, 1st thing to do is reinforce the dressing. b Diabetic – look between toes during physical assessment. C. If less than 4 hrs, drs can reattach limb (microsurgery) |
| AMPUTATIONS - IMPORTANT NOTES | a. Most common cause of lower extremity amputation is vascular disease! B. Most important part of artificial limb is SOCKET! C. When AKA, lying supine in bed, the stump should be flat! |
| AMPUTATIONS - PRE OP | (a) Labs: EKG, CBC, XRAY (Chest), urinalysis b) Might start IV’s or blood transfusion if anemic c) Pt’s are fitted with rigid temporary prosthesis immediately after or when stump is healed and sutures are removed. |
| AMPUTATIONS - Post-op/Nursing Interventions | a) Vital signs q15 mins -> shock! b) Check dressing (put pressure, call dr!) c) Placed in ICU (might be) d) Elastic compression bandages to help shrink and shape stump e) Avoid infection |
| AMPUTATIONS - Post-op/Nursing Interventions | f) Make sure urine/feces does not go in stump g) Foot of bed is usually elevated for 1st 24 hours h) If in prone position, put pillow under lower trunk. |
| AMPUTATIONS - HEALING | (i) 2-3 weeks after surgery, they are usually partially weight bearing with prosthesis. (ii) @ 6 weeks, full weight bearing (iii) @ 3 months, permanent prosthesis |
| AMPUTATIONS - Patient Teaching: Discharge | (a) Wash and dry stump thoroughly daily until healing is complete. |
| AMPUTATIONS - Phantom Limb pain | frequently occurs during the 1st few weeks after surgery. (i) Reason: pre-op limb pain is associated with phantom limb pain. (a) Most intense the 1st 6 month after amputation (b) Use the TENS unit |
| AMPUTATIONS - PROSTHETICS | an artificial device extension that replaces a missing body part. |
| AMPUTATIONS - PROSTHESIS | the surgery; the replacement of a missing bodily part with an artificial substitute |
| AMPUTATIONS - PROSTHETIST | is a person who measures, designs, fabricates, fits, or services a prosthesis |
| CASTS - | Most common fixation device! |
| CASTS - Cast Care | 1) Usually take at least 48 hrs to dry! 2) Handle w palms to prevent indentations 3) Elevate on pillows until surface is dry 4) After completely dry, check to make sure there is no indentation 5) No powder!causes infection 6) No urine or feces on cast! |
| CASTS - Nursing Observations | 1) Check for any bloody drainage 2) Circle, date, time on drainage/dressing if oozing. Must report it! 3) No scratching the itch with hanger, pencil 4) If there is a gauze, allowed to pull to scratch the itch |
| CASTS - Types of Casts - HIP SPICA | worn for long periods of time (7 months). Extends from below the axilla to entire length of one or both legs. |
| CASTS - Types of Casts - BODY CAST | extends from neck or upper chest to groin or thigh. (a) Used mainly for spinal fractures, treat scoliosis |
| CASTS - Cast Syndrome | cast too tight & superior mesenteric artery presses on or obstructs part of the duodenum. |
| CASTS - Cast Syndrome | Usually casts have a window placed over the diaphragm to allow for lung expansion & to prevent “cast syndrome”. |
| CASTS - Cast Syndrome - TREATMENT | change cast to relieve pressure |
| CASTS - Bivalved Cast | cut into halves to relieve cast pressure. |
| CASTS - Skeletal Pin External Fixation | (1) Pin care – pins are inserted into the bone and comes out through the skin. Pin care is done every 8 hours. (a) Check VS for s/s of infection b) Done with sterile technique |
| CASTS - Cast Removal | i) Cast cutting done with electrical vibrating saw rather than a cutting saw so little risk for injury. |
| TRACTION - | putting extremity, bone or group of muscles under tension by means of weights and pulleys. |
| TRACTION - Reason for: | 1) To align and stabilize a fracture 2) Relieve pressure on nerves (herniated disc) 3) Maintain correct position 4) Prevent deformities 5) Relieve muscle spasms |
| TRACTION - Kinds of traction: - Skeletal Traction | applied directly to the bones by wires and pins. (b) Used for a fractured tibia/femur/humerus/cervical spine. (i) Check for pulleys; make sure they are in the correct grooves |
| TRACTION - Kinds of traction: - SKIN TRACTION | accomplished by wt pulling on sponge rubber moleskin, elastic bandage w adherent or plastic materials attached to skin below site of fracture w pull exerted on limb |
| TRACTION - Kinds of traction: - Bucks Traction | straight pull on extremity to provide temporary comfort. Usually for hip fractures until they can have surgery. |
| TRACTION - Kinds of traction: - Russell’s Traction | similar to Bucks but it uses a sling to support the leg. |
| TRACTION - Kinds of traction: - Bryant’s Traction | used in pediatrics for a fractured femur. |
| TRACTION - Kinds of traction: - Cervial Tx, Crutchfield Tongs, Halo Tx | to stabilize cervical fracture. |
| TRACTION - NURSING INTERVENTION | (8) Ortho Beds: a) Stryker frame b) Circo frame c) Rotorest |
Created by:
jekjes
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