Fractures
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| Pathological/Spontanious fractures occur from what> | *Tumors of the bone *Malnutrition *Cushing syndrome *Long-term steroid use *Osteoporosis *Metastatic Cancer
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| What is a displaced fracture? | The bone ends are separated at the fracture line
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| What is a Incomplete fracture? | Bone breaks through only one cortex
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| What is a Greenstick fracture? | Incomplete fracture one side of a bone is broken and the other side is bent, primarily occur in children
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| 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
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| 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
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| What is an Impacted (Buckle) fracture? | One bone fragment is forcibly wedged into another. Common in children.
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| What is a Transverse fracture? | break runs directly across the bone, at right angle of the bones axis
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| What is an Oblique fracture? | a slanted fracture of the shaft along the bone's long axis
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| What is a Spiral fracture? | (torsion fracture) break coils around the bone
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| 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
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| 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
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| How long after fracture does the callus form? | 6-10 days
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| The blood clots and fibrin network that forms between the fractured bone ends changes into what? | Granulation tissue
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| What is used to determine presence or absence of pulse in a fracture PT? | Doppler device
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| What is closed reduction? | manual manipulations, moving bony fragments into position by applying traction and pressure to distal fragments
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| 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
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| What is maxillomandibular fixation (MMF)? | Wiring of the jaw shut in Tx of fractures
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| 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
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| 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
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| 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
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| 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
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| 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
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| 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)
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| What is a Burst Fracture? | an injury to the spine in which the vertebral body is severely compressed in all directions
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| What is a Compression Fracture? | An injury to the spine where the vertibrae is only crush on one side and becomes wedge shaped
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| When my pain from a spinal fracture NOT be present? | if fracture has altered the spinal cord
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| 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
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| How long will a PT with a pelvic fracture be on bed rest? | 3 weeks
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| How long will a PT with a pelvic fracture require crutches? | 6 weeks
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| How long will a PT with a pelvic fracture have to ambulate without weight bearing? | 3 months
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| Compartment syndrome be treated with a fasciotomy within how long before nerve and muscle ischemia results in permanent damage? | 12-24 hours
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| How often must vital signs be completed with a PT in shock? | q15 min
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| Within how long after injury can gas gangrene set in? | 1-14 days
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| What bacteria is involved in gas gangrene? | Clostridium bacteria - C. perfringens (anaerobic).
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| What are the S/Sx of gas gangrene? | *Pain- sudden/severe *Toxic delerium *Skin gas bubbles *Crepitation *Foul odor
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| What is the medical/surgical management of gas gangrene? | *Establish a larger wound to admit air to promote drainage *Antibiotic- PCN, Keflin
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| The affected area of a thromboembolus feels how on palpation (Objective and Subjective)? | Affected area become cold, numb and cyanotic
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| A Thromboebolus of the lung causes what S/Sx? | *sudden, sharp thoracic or upper abdominal pain *dyspnea *fever *cough *hemoptysis
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| What fractures is a thromboembolus a high risk for? | Pelvic and Hip
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| What device is used in Tx of Infected fractures and infected unstable joints? | Skeletal pin external fixation
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| 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
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| How long should a PT who recieved a cast keep the affected limb elevated to reduce the chances of edema? | 24-48 hours
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| 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.
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| How long does it take a fiberglass cast to dry? | Dries immediately
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| How long does it take a plaster cast to dry? | 24-48 hours
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| 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.
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| 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
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| 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.
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| What are the two types of fracture? | Skeletal and skin
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| What are the three types of skin traction? | Buck’s, Russell’s, and Bryant’s
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| 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
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| What is Bucks traction? | Straight traction on the leg while the leg is flat on the bed.
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| What is Russells traction? | Distal leg elevated parallel to bed with knee flexed and straight traction of foot.
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| What is Bryants traction? | Legs raised perpendicular to bed with traction pulling up
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| What skin traction is a temporary measure to maintain the reduction of a hip fracture before surgery? | Bucks traction (Bucks extension)
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| What is the skin traction used in pediatrics for small children with fractured femurs? | Bryants traction
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| What are inserted into the skull and provides traction in cases of fracture of the cervical spine? | Crutchfield tongs
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| What is most common form of skeletal traction for treatment of patients with fractures of the femoral shaft or humerus? | Balanced suspension traction
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| What is used to position the unaffected leg of the PT in traction? | Trochanter roll
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| What kind of bed enables bedpan and linen changes without moving pt? | Bradford frame
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| 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
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