Chapter 51
The nurse is teaching a patient regarding care after a cast has been removed from the patient's arm. Which patient statements indicate a need for further learning? Select all that apply.
- "I should remove any dead skin by scrubbing the area slowly." - "I should inform the nurse immediately if I have a decreased range of motion."
The nurse is creating a nursing plan for management of a pelvic fracture. For which complications will the nurse monitor this patient? Select all (4) that apply
- Arterial bleeding - Blood volume loss - Abdominal rigidity - Blood in urine and stool
Which are initial nursing interventions for a patient with a distal radius fracture? Select all (4) that apply.
- Elevate - Immobilize - Assess - Remove Jewelry (edema)
A patient accidentally severed a finger while working in the kitchen. Which emergency care interventions are needed for this patient? Select all that apply. Correct1 Elevate the extremity above the heart level.
- Elevate extremity above the heart - Apply direct pressure with dry gauze at amputation site - Ensure the severed finger does not come into contact w/water
Which complications can result from a fracture? Select all (4) that apply.
- Infection - Hemorrhage - CRUSH syndrome - Compartment Syndrome
Facts about amputations (Upper vs Lower MC) (Syme, Lisfranc, Chopart) (@ risk populations)
- MC = LE - MC in Trauma = UE - Lisfrant and Chopart = midfoot - Syme = ankle saved, foot removed - Black/Hispanics
What are the major concerns related to pelvic fractures? Select all (3) that apply.
- Venous oozing - Arterial Bleeding - Hypovolemic Shock essentially blood loss
Which topics are included in patient teaching following a leg amputation? Select all that apply
- Wrap limp - ROM - Exercises - Turn independently - Inspect for inflammation
A 73-year-old patient is being discharged after falling and fracturing the radius and ulna. What can the nurse tell the patient regarding the length of healing time?
Complete Healing = 3 mo+
Which physiologic change related to compartment syndrome is responsible for symptoms of flexed posture and unequal pulses in a patient?
Increased production of lactic acid
A student nurse is caring for an older adult who is recovering from hip replacement. The patient has recently spiked a high temperature and appears confused. For which complication should the nurse assess this patient?
Infection
What is the major concern related to pelvic injury?
Loss of blood volume
What is an early manifestation of fat embolism syndrome?
Low arterial O2
A 70-year-old male patient who underwent an open reduction internal fixation (ORIF) surgery experiences a seizure after 24 hours. Which drug can cause seizures related to its toxic metabolites?
Meperidine
Which complication is associated with compartment syndrome?
Myoglobinuria renal failure
The nurse advises a patient with a lower extremity fracture to take a multivitamin with iron after eating to prevent which condition?
Nausea
To which resource should the nurse refer the patient to for upper extremity rehabilitation after trauma?
Occupational therapy
Which motor clinical manifestation may be seen in a patient with complex regional pain syndrome (CRPS)?
Paresis
The serum calcium level of a patient with a femoral fracture is 12 mg/dL. What type of fracture does the nurse suspect that the patient has?
Pathologic fracture - (>10g/dl Ca+ from Osteoporosis)
A chemical sympathetic nerve block may be used to manage complex regional pain syndrome (CRPS). Which drug, administered intravenously, is used to block sympathetic nerve receptors?
Phentolamine
Which description accurately defines a closed reduction?
Process where the ends of the bones are manually pulled and realigned
Which type of fracture has the highest incidence in older adults?
Proximal Humeral head
A patient sustains a tibial fracture, and a cast is applied. The primary health care provider advises that a window is cut on the cast. What is the objective of this action?
To inspect the skin
Which procedure to treat a vertebral compression fracture involves injecting bone cement through the skin directly into the fracture site, allowing the patient to go home the next day?
Vertebroplasty
A patient has a Buck extension traction. What type of injury does the patient most likely to have?
Fracture of the hip before surgery
Which type of fracture is most commonly complicated by delayed union because of poor perfusion?
Fractures of the tibia and fibula
Which musculoskeletal trauma occurs after minimal trauma to a bone that has been weakened due to disease?
Fragility fracture
Which type of fracture does not divide the bone into two portions because the break is through only part of the bone?
Incomplete
A patient sustains a stable fracture of the distal radius. Which type of cast is most suitable?
short arm cast
A patient with a fracture asks the nurse about the difference between a compound fracture and a simple fracture. Which statement by the nurse is correct?
"Compound fracture involves a break in the bone, with damage to the skin."
The nursing instructor is teaching a group of nursing students about emergency care for extremity fractures. What statement made by a participant indicates a need for further teaching?
"I should not apply direct pressure on the affected area." In emergency care for extremity fracture - Apply Direct Pressure
What might be the consequence of early ambulation of a patient who underwent open reduction internal fixation (ORIF) surgery?
Surgical site healing
What is the appropriate minimum weight of the pulling force in skeletal traction?
15 pounds
What is the MC UE fracture in young adults?
Colle's Fracture - Distal radius fracture
A patient reports a history of wrist pain after an attempt to break a fall by landing on the heel of the hand with an extended wrist. Which type of fracture should the nurse suspect?
Colle's fracture - Distal forearm
Which patient is at the highest risk for a fatigue fracture?
A patient who runs every day
Which type of fracture has the highest incidence in young and young middle-aged adults?
Femoral shaft fracture
Which complication of fractures can be treated with minimally invasive surgical sympathectomy?
CRPS
The nurse refers a patient with an amputation and the patient's family to which community resource?
Amputee Coalition of America (ACA)
A patient's short-leg cast has been removed. What should the nurse teach the patient about caring for the extremity after cast removal?
Apply elastic bandages around the extremity
The nurse admits an older adult patient who sustained a left hip fracture and is in considerable pain. The nurse anticipates that the patient will be placed in which type of traction?
Buck's Traction
The nurse is caring for a patient with complex regional pain syndrome (CRPS). Which clinical sign of CRPS is a manifestation of autonomic nervous system dysfunction seen in this complication?
Edema
A 40-year-old patient who is 36 hours into recovering from a fractured pelvis begins experiencing hypoxemia, dyspnea, and tachypnea. For which complication should the nurse first assess the patient?
Fat embolism
When differentiating between fat embolism and blood clot embolism, which statement is true?
Fat embolism is more likely to occur with fractures of the long bones. - Fat Embolism within 48hrs (Blood anytime) - Fat Embolism have petechiae (Blood doesn't)
Which type of fracture is seldom immobilized by casting and requires surgical treatment with nails, rods, or screws?
Femoral
Which type of fracture is most common in the general adult population?
Rib fractures
Which fracture may occur when a person land's FOOSH
Smith's Fracture - Schaphoid
Which area of the body is most likely to be treated surgically with a genetically engineered item?
Spine and Tibia
Which stage of bone healing occurs in 3days-2weeks?
Stage 2 = Granulation Fibrocartilage formation
In which stage of bone healing is callus formed?
Stage three
Osteomyelitis MC pathogen
Staph. A