Medical-Surgical Nursing
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| What is a disruption or break in the continuity of bone? | A fracture
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| What is a pathologic fracture? | A fracture occurring secondary to a disease process (e.g., osteoporosis)
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| Type of Fracture: Skin is broken and bone exposed, causing soft tissue injury. | Open fracture
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| Type of Fracture: Skin remains intact. | Closed fracture.
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| What is a fracture termed if the break goes all the way through the bone? | Complete
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| What is a fracture termed if the break occurs partly across a bone shaft but the bone is still intact? | Incomplete
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| What are the 5 directional terms to describe a fracture line? | Linear, oblique, transverse, longitudinal, and spiral fractures
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| What is fracture termed if the two ends of the broken bone are separated from one another and out of their normal positions? | Displaced
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| What type of fracture does the periosteum remain intact across the fracture and the bone fragments are in alignment? | Nondisplaced
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| What are two classifications of displaced fractures? | Oblique and comminuted (more than 2 fragments)
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| What are 3 classifications of nondisplaced fractures? | Transverse, spiral, or greenstick
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| What is a greenstick fracture? | An incomplete fracture with one side splintered and the other side bent.
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| Which type of fracture line extends across the bone shaft at a right angle to the longitudinal axis? | Transverse fracture
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| What are the 6 stages of bone healing? | Fracture hematoma, granulation tissue, callus formation, ossification, consolidation, and remodeling.
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| What are manifestations of fracture? | Edema and swelling, pain, tenderness, muscle spasm, deformity, contusion, loss of function, and crepitation.
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| When does a fracture hematoma form? | Usually in the first 72 hours after injury
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| What is the healing process of bone called? | Union
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| In which stage of bone healing does active phagocytosis occur? | Granulation tissue
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| What is new bone substance? | Osteoid
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| When does granulation tissue form in bone healing? | During days 3-14 after injury
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| What minerals are associated with callus formation? | Calcium, phosphorus, and magnesium
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| What is callus primarily composed of? | Cartilage, osteoblasts, calcium, and phosphorus.
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| When does a callus usually appear after injury? | By the end of the second week
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| When does the callus ossify? | 3 weeks to 6 months after injury
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| Is a fracture still evident on x-ray during the ossification stage? | Yes
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| When can a patient be allowed limited mobility or maybe have the cast removed? | During the ossification stage
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| What phase of bone healing is equated with radiologic union? | Consolidation
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| How long does it take consolidation to occur? | Up to 1 year after injury
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| What occurs in the remodeling stage? | Excess bone tissue is resorbed and union is complete
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| What is Wolff's law? | Bone remodels in response to physical loading stress
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| Does healing time for fractures increase with age? | Yes
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| How long does it take an uncomplicated midshaf femur fracture to heal in a newborn? An adult? | 3 weeks for a newborn; 20 weeks for an adult
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| What are complications of fracture healing? | Delayed union; nonunion; malunion; angulation; pseduoarthritis; refracture; myositis ossificans. See page 1470 in Lewis Med-Surg
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| What is the nonsurgical, manual realignment of bone fragments? | Closed reduction
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| Is closed reduction performed with anesthesia? | Yes; general or local
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| Do you immobilize the injured body part with closed reduction until healing occurs? | Yes
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| What is the correction of bone alignment through a surgical incision? | Open reduction
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| What form of open reduction facilitates early ambulation? | Open reduction internal fixation (ORIF)
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| What is the application of a pulling force to an injured or diseased body part or extremity? | Traction
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| What form of treatment is generally used for short term treatment (48-72 hours)? | Skin traction
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| What are weight limits limited to for skin traction? | 5-10 lbs.
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| What is Buck's traction used for? | Preoperatively for the patient with a hip fracture to reduce muscle spasms
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| How often should you assess pressure points in skin traction? | Every 2-4 hours
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| What is skeletal traction used for? | To align injured bones and joints or to treat joint contractures and congenital hip dysplasia.
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| What are the weight ranges for skeletal traction? | 5-45 lbs.
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| What can using too much weight in skeletal traction result in? | Nonunion or delayed union
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| What are the major complications of skeletal traction? | Infection at pin insertion site and complications from prolonged immobility
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| What commonly supplies countertraction? | Patient's body weight or by weights pulling in the opposite direction
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| True or False: Weights can be allowed to lay on the floor. | False; they must be off the floor and hanging freely
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| Should a casted extremity be kept below or above heart level? Why? | Above heart level to help decrease edema
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