Muscle Skeletal system

How should a nurse postion a patient one dat post op from a hip replacement?

Keep hips abducted at all times

In traction is it okay for Knots in the rope to rest against the pulley? Why?

No, it will interfere with the traction

What is the pathophysiologic process of a Volkman contracture?

Obstructed arterial blood flow to the forearm and hand

What are some causes of hypertension immediately post op?

Pain, hypoxia, or bladder distention

As the nurse what is the first action for a compound fracture.

Place a sterile dressing over the bone

Buck's extension traction

Skin traction often applied after a hip fracture is reduced in surgery. It reduces muscle spasms and helps immobilize the fracture. (proximal femur)

Dunlops traction

The traction that is applied to an upper extremity for fractures of elbow, humorous and supracondylar fractures

Why should you not cover a cast with a blanket?

it will caused heat build up and prevent air circulation

Increased warmth, redness, swelling, and calf tenderness and s/s of what?

DVT

Russell's traction

- Modified Buck's extension with a sling under knees; note the risk of impaired circulation in the lower leg -used for lower leg fractures

What are the 3 functions of a brace?

1. Provide support 2. Control movements 3. Prevent additional injury

How often should a patient in traction do isometric exercises?

10 times an hour while awake

How much drainage is expected in a suction device after a total hip arthroplasty? In the first 24 hours

200-500ml

What is a normal WBC count?

4,000-10,000

A patient was brought to the ED after a fall. The patient is taken to the OR to receive a right hip prosthesis. In the immediate postoperative period, what health education should the nurse emphasize? A. Make sure you don't bring your knees close together B. Try to lie as still as possible for the first few days C. TO avoid bending your knees until next week D. Keep your legs higher than your chest whenever you can.

A. Make sure you don't bring your knees close together. (After receiving a prosthesis, the affected leg should be kept abducted. Mobility should be encouraged within safe limits. There is no need to avoid knee flexion and the patients legs do not need to be higher than the level of the chest.

A nurse is admitting a patient to the unit who presents with a lower extremity fracture. What signs and symptoms would suggest to the nurse that the patient may have a peroneal nerve injury? A. Numbness and burning of the foot B. Pallor to the dorsal surface of the foot C. Visible cyanosis in the toes D. Inadequate capillary refill to the toes

A. Numbness and burning of the foot (peroneal nerve injury may result in numbness, tingling and burning in the feet. Cyanosis, pallor, and decreased capillary refill are gins of inadequate circulation.)

After receiving a hip prothesis the effected leg should be kept _______________________.

Abducted

You are the nurse providing care for a patient who has limited mobility after a stroke. What would you do to access the patient for contractures?

Assess the patients range of motion

The orthopedic surgeon has prescribed balanced skeletal traction for a patient. What advantage is conferred by balanced traction? A. Balanced traction can be applied at night and removed during the day. B. Balanced traction allows for greater patient movement and independence than other forms of traction C. Balanced traction is portable and may accompany the patient's movements D. Balanced traction facilitates bone remodeling as little as 4 days

B. Balanced traction allows for greater patient movement and independence than other forms of traction (Often skeletal traction is balanced traction. Which supports the affected extremity, allows for some patient movement, and facilities patient independence and nursing care while maintaining effective traction. It is not portable, however and it cannot be removed. Bone remodeling takes longer than 4 days)

A patient is admitted to the unit in traction for a fractured proximal femur and requires traction prior to surgery. What is the most appropriate type of traction to apply to a fractured femur?

Buck's extension traction

The nurse just received a postoperative patient from the PACU to the medical-surgical unit. The patient is an 84-year-old woman who had surgery for a left hip replacement. Which of the following concerns should the nurse prioritize for this patient in the first few hours on the unit? A. early ambulation B. Maintaining a CLEAN dressing on the surgical site C. Close monitoring of the neurological status D. Resumption of normal oral intake

C. Close monitoring of the neurological status (Adequate ventilation, hemodynamic stability incisional pain, surgical site integrity, nausea and vomiting, neurological status, and spontaneous voiding are primary concerns. A patient who has had total hip replacement does not ambulate during the first few hours on the unit. Dressings are assessed but may have some drainage on them. Oral intake will take more time to resume.)

The nurse is caring for a patient who underwent a total hip replacement yesterday. What should the nurse do to prevent the dislocation of the new prosthesis? A. Keep the affected leg in a position of adduction B. Have the patient reposition himself independently C. Protect the affected leg from internal rotation D. Kepp the hip flexed by placing pillows under the patient's knee.

C. Protect the affected leg from internal rotation (Abduction of the hip helps to prevent dislocation of a new hip joint rotation and adduction should be avoided.)

The nurse is caring for a patient after abdominal surgery in the PACU. The patients blood pressure has increased and the patient is restless The patients oxygen saturation is 97%. What cause for this change in status should the nurse first suspect? A. The patient is hypothermic B. The patient is in shock C. The patient is in pain D. The patient is hypoxic

C. The patient is in pain (An increase in blood pressure and restlessness are symptoms of pain. The patients oxygen saturation is 97%, so hypothermia, hypoxia and shock are not likely causes of the patients restlessness.

How often should the pin insertion site of traction be assessed to prevent inflammation, infection, and skin break down.

Every 8 hours

Memory trick for how long Fibroblastic stage lasts and when it begins?

It begings on the 4th day and lasts 2-4 weeks

____________________is common in the immediate postoperative period secondary to sympathetic nervous system stimulation from pain, hypoxia, or bladder distenstion.

Hypertension