Mobility (Med Surg Exam 1)

fractures of the hip and femur

Buck's traction is most commonly used for:

d) petechiae around the neck and upper chest

The nurse suspects a fat embolism rather than a pulmonary embolism from a venous thrombosis in the patient with a fracture who develops: a) tachycardia and dyspnea b) a sudden onset of chest pain c) ECG changes and created PaO2 d) petechiae around the neck and upper chest

1, 2, 4

a 13 year old just returned from surgery for scoliosis. what nursing interventions are appropriate in the first 24 hours? (select all that apply)? 1. assess for pain 2. check neurological status 3. get the teen up to the bathroom 12 hours after surgery 4. logroll to change positions 5. monitor blood pressure

scoliosis

a condition known as a lateral s-shaped curvature of the thoracic and lumbar spine; unequal shoulder and scapula height is usually noted when the patient is observed from the back

fracture

a disruption or break in the continuity of the structure of bone

24-72 hours after injury

a fat embolism is most likely to occur:

a. 24-48 hours following a fractured tibia; fat embolism usually occur 24-48 hours after injury and are associated with fractures of long bone and multiple fractures related to pelvic injuries, including fractures of the femur, tibia, ribs and pelvis

a fat embolism is most likely to occur: a. 24-48 hours following a fractured tibia b. 36-72 hours following a skull fracture c. 4-5 days following a fractured femur d. 5-6 days following a pelvic fracture

d) neuromuscular checks below the site of the injury

a patient has fallen in the bathroom of the hospital room and complains of pain in the upper right arm and elbow; before splinting the injury, the nurse knows that the priority management of a possible fracture should include: a) elevation of the arm b) application of ice to the site c) notification of the health care provider d) neuromuscular checks below the site of the injury

b) the status of immunization

a patient is admitted with an open fracture of the tibia following a bicycle accident; during assessment of the patient, the nurse questions the patient specifically about: a) any previous injuries to the leg b) the status of tetanus immunization c) the use of antibiotics in the last month d) whether the injury was exposed to dirt or gravel

a) get the patient up to the chair the first postoperative day

a patient with a fractured right hip has an open reduction and internal fixation of the fracture; post-operatively, the nurse plans to: a) get the patient up to the chair the first postoperative day b) position the patient only on the back and inoperative side c) keep leg abductor splints on the patient except when bathing d) ambulate the patient with partial weight bearing by discharge

c) reduce pain and muscle spasms before surgery

a patient with an extra capsular hip fracture is admitted to the orthopedic unit and placed in Buck's traction; the nurse explains to the patient that the purpose of the traction is to: a) pull bone fragments back into alignment c) immobilize the leg until healing is complete c) reduce pain and muscle spasms before surgery d) prevent damage to the blood vessels at the fracture site

myoglobinuric renal failure

a patient with compartment syndrome suddenly begins having dysrhythmias and reports having dark,reddish brown urine: you suspect they are suffering from what complication of compartment syndrome?

myoglobinuric renal failure

a potentially fatal complication of compartment syndrome that occurs due to muscle breakdown is known as:

complete fracture

a type of fracture in which the break is completely through the bone

incomplete fracture

a type of fracture in which the break is partly across a bone shaft but the bone is still in one piece

prompt ORIF surgery

after an injury, how could you prevent FES?

true

applying ice directly over fracture site for the first 24 hours is an appropriate nursing intervention for someone with a broken bone, true or false

d) having a family member put on the patient's shoes and socks

discharge instructions for a patient following hip prothesis include: a) restriction walking for 2 to 3 months b) taking a bath rather than a shower to prevent falling c) keeping the leg internally roasted wile sitting and standing d) having a family member put on the patient's shoes and socks

true

elevating the extremity above the level of the heart for the first 48 hours is an appropriate nursing intervention for someone with a fracture, true or false?

false; do not apply ice with coolness and pallor, do not mobilize fracture!!

if someone has a fracture and you assess pallor and coolness of the skin distal to the fracture site, you should reposition the break and apply ice, and then assess again in an hour, true or false?

immobilize the extremity in the position in which it is found

if you suspect a fracture, you should:

don't apply ice, don't elevate above heart level, traction weight reduction

if you suspect compartment syndrome, what therapeutic interventions should you avoid?

closed (simple) fracture

in this type of fracture, the skin has not been ruptured and remains intact

open (compound) fracture

in this type of fracture, the skin is broken, exposing the bone and causing soft tissue injury

b) bone growth can be affected by this type of fracture

kristin, 10 years of age, sustained a fracture in the epiphyseal plate in her right fibula when she fell out of a tree; when discussing this injury with her parents, the nurse should consider that: a) healing is usually delayed in this type of fracture b) bone growth can be affected by this type of fracture c) this is an unusual fracture site in young children d) this type of fracture is inconsistent with a fall

a) fasciotomy

surgical treatment indicated for compartment syndrome is: a) fasciotomy b) amputation c) internal fixation d) release of tendons

b) abduct, adduct, and oppose the fingers, and pronate and supinate the hand

to assess for neurologic status in a patient with a fractured humerus, the nurses ask the patient to a) evert, invert, dorsiflex, and plantar flex the foot b) abduct, adduct, and oppose the fingers, and pronate and supinate the hand c) assess the location, quality and intensity of pain below the site of injury d) assess the color, temperature, capillary refill, peripheral pulses and presence of edema in the extremity

fever > 103, petechiae (neck, anterior chest wall, axilla, buccal membrane and conjunctive of the eye), rapid and acute course, feeling of impending disaster, client may become comatose in a short time

what are clinical manifestations of FES?

24-36; therapeutic is 46-70

what are the Heparin lab values for aPTT:

0.75-1.25; therapeutic is 2-3

what are the INR lab values of coumadin treatment?

11-16; therapeutic is 1.5-2x the control

what are the coumadin PT labs values?

1) pain and point of tenderness 2) pulses 3) pallor 4) paresthesia: sensation distal to the fracture site; pins and needles 5) paralysis: movement distal to the fracture site 6) pressure

what are the six Ps of neurovascular assessment:

growth plate (physeal plate)

what is the weakest part of the long bones?

fat embolism syndrome

when emboli travels to the lungs and the signs and symptoms are caused by poor oxygen exchange is known as

c. assess for hip contractors

which action will the nurse take in order to evaluate the effectiveness of buck's traction for a 62-year-old patient who has an intracapsular fracture of the right femur? a. check peripheral pulses b. ask about hip pain level c. assess for hip contractors d. monitor for hip dislocation