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109 ch. 67
Musculoskeletal Care Modalities
| Question | Answer |
|---|---|
| what are classifications of fractures | complete, incomplete comminuted by location |
| what is compartment syndrome | incr tissue pressure in limited space(cast) that compromised circulation, cast must be bivalved |
| What causes footdrop? | injury to peroneal nerve due to pressure,Especially in traction..can't flex foot. |
| What should the nurse do to monitor for cast syndrome | cast syndrome has psychological and physiological effects. Nurse should note bowel sounds Q 4 to 8 hrs. Check for distention, nausea, vomiting - TREATMENT: nasogastric intubation with suction and IV fluid til motility restored |
| Home care with a cast | control swelling- elevate to heart level |
| What are immobiliztion techniques for fractures | cast/splint, traction, external, internal fixators |
| what do external fixators do? | manage open fractures and provide stable support for comminuted fractures. |
| what is purpose of traction? | to minimize muscle spasms, reduce, align, reduce deformity, incr space in opposing surfaces |
| types of traction: manual, skin and skeletal | manual skin: Bucks(lower leg), cervical, pelvic. No more than 4.5 to 8lbs, 10-20 on pelvic. Asses circ. Q15m then Q1-2hrs Skeletal: thomas splint, halo. 15-25lbs. Balanced, must maintain alignment |
| Complications of traction | pin site infection, CMS/peroneal nerve damage, joint stiffness, arthritis, mal-union |
| what is ORIF | open reduction with internal fixation, |
| Prophylactic antibiotics before surgery is best when given how soon before? | 60 min. prior to incision |
| what are some complications of total hip replacement surgery | dislocation, wound drainage, thromboembolism, infecftion, heel pressure ulcer |
| what should the nurse do to prevent dislocation of hip | positoin leg in abduction with wedge pillow, never flex over 90 degrees, head of bed 60 or less, avoid internal/ext rotation, hyperextension |
| with post surgery, what is a major risk? | pin site infection, CMS/peroneal nerve damage, joint stiffness, arthritis, mal-union |
| what is ORIF | open reduction with internal fixation, |
| Temp elevations within 48 hours after surgery can indicate waht? | atelectasis/resp problems |
| Prophylactic antibiotics before surgery is best when given how soon before? | 60 min. prior to incision |
| Temp changes in next few days indicates what? In 4-6 days? | urinary tract infections Superficial wound infection |
| what are some complications of total hip replacement surgery | dislocation, wound drainage, thromboembolism, infecftion, heel pressure ulcer |
| what should the nurse do to prevent dislocation of hip | positoin leg in abduction with wedge pillow, never flex over 90 degrees, head of bed 60 or less, avoid internal/ext rotation, hyperextension |
| with post surgery, what are some major risks? | hypovolemic shock- incr pulse(>100), incr resp,decr BP <90/60, narrow pulse press <20 Venous thromboembolus (MOST DNAGEROUS)- calf swelling, tenderness, warmth, redness FBS- fat emboli syndrome- resp distress, delirium, skin rashes(petechiae) |
| Temp elevations within 48 hours after surgery can indicate waht? | atelectasis/resp problems |
| Temp changes in next few days indicates what? In 4-6 days? | urinary tract infections Superficial wound infection |
Created by:
palmerag
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