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68wm6 p2 Fractures

Fractures

QuestionAnswer
Pathological/Spontanious fractures occur from what> *Tumors of the bone *Malnutrition *Cushing syndrome *Long-term steroid use *Osteoporosis *Metastatic Cancer
What is a displaced fracture? The bone ends are separated at the fracture line
What is a Incomplete fracture? Bone breaks through only one cortex
What is a Greenstick fracture? Incomplete fracture one side of a bone is broken and the other side is bent, primarily occur in children
What is a Complete fracture? the fracture line extends entirely through the bone, through both cortices, with periosteum disrupted on both sides of the bone
What is a Comminuted fracture? the bone is splintered into three or more small fragments at the fracture site with the bone ends separated and usually misaligned
What is an Impacted (Buckle) fracture? One bone fragment is forcibly wedged into another. Common in children.
What is a Transverse fracture? break runs directly across the bone, at right angle of the bones axis
What is an Oblique fracture? a slanted fracture of the shaft along the bone's long axis
What is a Spiral fracture? (torsion fracture) break coils around the bone
What is a Colles Fracture? fracture- fractures of the distal portion of the radius within 1 inch of the joint of the wrist, commonly occurs from the attempt to break a fall by putting the arms down
What is a Potts Fracture? fracture at the distal end of the fibula, chipping off a piece of the medial malleolus with a displacement of the foot outward
How long after fracture does the callus form? 6-10 days
The blood clots and fibrin network that forms between the fractured bone ends changes into what? Granulation tissue
What is used to determine presence or absence of pulse in a fracture PT? Doppler device
What is closed reduction? manual manipulations, moving bony fragments into position by applying traction and pressure to distal fragments
What is an Open reduction with internal fixation (ORIF)? surgical procedure allowing fracture alignment under direct visualization using various internal fixation devices applied to the bone
What is maxillomandibular fixation (MMF)? Wiring of the jaw shut in Tx of fractures
What is Mandibular Reduction Internal Fixation? wires and/or screws and plates are placed in the bony segments of the jaw to hold them in their correct relationship
For a PT who received surgery for a mandibular fracture, what should be taped to the head of the patient’s bed and tied to a string around the patient's neck when they are OOB? Wire cutters
What is a Intermedullary rod (kuntscher nail)? A metel rod that is placed in the (intramedullary shaft) center of the femur bone with wires around the bone for stabilization in Tx of hip fractures
How should the bed be placed for a PT with a post-operative hip fracture? HOB is elevated a maximum of 45 degrees to avoid acute flexion of the hip and strain on the fixation device
Why should a post-op hip fracture PT not cross his/her legs? crossing the legs can adduct the affected extremity and dislocate the hip
How often should post-op hip fracture PT be rotated, and how? Turn patient q 2 hours per MD orders. This can be accomplished by using log rolling procedure with the assistance of two nurses.( A pillow is placed between the legs to maintain abduction while rolling)
What is a Burst Fracture? an injury to the spine in which the vertebral body is severely compressed in all directions
What is a Compression Fracture? An injury to the spine where the vertibrae is only crush on one side and becomes wedge shaped
When my pain from a spinal fracture NOT be present? if fracture has altered the spinal cord
What is a Halo Brace? A "halo" metal ring is secured to the skull with pins and to two metal rods attached to a well-fitted plastic jacket
How long will a PT with a pelvic fracture be on bed rest? 3 weeks
How long will a PT with a pelvic fracture require crutches? 6 weeks
How long will a PT with a pelvic fracture have to ambulate without weight bearing? 3 months
Compartment syndrome be treated with a fasciotomy within how long before nerve and muscle ischemia results in permanent damage? 12-24 hours
How often must vital signs be completed with a PT in shock? q15 min
Within how long after injury can gas gangrene set in? 1-14 days
What bacteria is involved in gas gangrene? Clostridium bacteria - C. perfringens (anaerobic).
What are the S/Sx of gas gangrene? *Pain- sudden/severe *Toxic delerium *Skin gas bubbles *Crepitation *Foul odor
What is the medical/surgical management of gas gangrene? *Establish a larger wound to admit air to promote drainage *Antibiotic- PCN, Keflin 
The affected area of a thromboembolus feels how on palpation (Objective and Subjective)? Affected area become cold, numb and cyanotic
A Thromboebolus of the lung causes what S/Sx? *sudden, sharp thoracic or upper abdominal pain *dyspnea *fever *cough *hemoptysis
What fractures is a thromboembolus a high risk for? Pelvic and Hip
What device is used in Tx of Infected fractures and infected unstable joints? Skeletal pin external fixation
How often are pins in a Skeletal pin external fixation device cleaned, and with what? 1 to 2 times daily with hydrogen peroxide or alcohol, using surgical asepsis
How long should a PT who recieved a cast keep the affected limb elevated to reduce the chances of edema? 24-48 hours
A PT who just received a cast tells you that it feels very warm, almost hot. What should you as a nurse do? Inform the PT that its normal for a cast to feel warm or hot as it dries, and that once dried it will end.
How long does it take a fiberglass cast to dry? Dries immediately
How long does it take a plaster cast to dry? 24-48 hours
True or False: The abductor bar is placed in a spica cast to aid in turning and moving of the PT. False. The abductor bar is placed to keep the extremity in a functional position while healing. Do NOT grasp it.
How will the skin under the cast appear once the cast is removed? mottled and it may be covered by a yellow crust composed of exudate, oil, and dead skin
True or False: When handling a fresh undry cast you are incouraged to use only your fingertips to reduce pressure on the cast. False. That increases the chances of causing indentations and thus pressure. You must use your palms and/or pillows to reduce the chance of indentation.
What are the two types of fracture? Skeletal and skin
What are the three types of skin traction? Buck’s, Russell’s, and Bryant’s
How much traction weight can be safely applied for skin traction, and how long? Only 5 to 10 lbs of force can safely be applied to the patient's skin for a period of 3 to 4 weeks
What is Bucks traction? Straight traction on the leg while the leg is flat on the bed.
What is Russells traction? Distal leg elevated parallel to bed with knee flexed and straight traction of foot.
What is Bryants traction? Legs raised perpendicular to bed with traction pulling up
What skin traction is a temporary measure to maintain the reduction of a hip fracture before surgery? Bucks traction (Bucks extension)
What is the skin traction used in pediatrics for small children with fractured femurs? Bryants traction
What are inserted into the skull and provides traction in cases of fracture of the cervical spine? Crutchfield tongs
What is most common form of skeletal traction for treatment of patients with fractures of the femoral shaft or humerus? Balanced suspension traction
What is used to position the unaffected leg of the PT in traction? Trochanter roll
What kind of bed enables bedpan and linen changes without moving pt? Bradford frame
What is a bradford frame? rectangular steel with two pieces of canvas stretched tightly and laced to the frame. A space is left in the buttocks area for toileting and hygiene
Created by: Shanejqb