Chapter 67: musculoskeletal trauma and orthopedic surgery
how long should prophylactic anticoagulant drugs be given post op ortho surgery?
10-14 days
How long is cold compression used for?
24-48 hrs
pelvic fracture account for how many adult fractures?
3%
How heavy are skin traction weights?
5-10 lb
How heavy are skeletal traction weights?
5-45 lb
A patient who had open reduction and internal fixation (ORIF) of left lower leg fractures continues to report severe pain in the leg 15 minutes after receiving the prescribed IV morphine. The nurse determines pulses are faintly palpable and the foot is cool to the touch. Which action would the nurse take next? A. Notify the health care provider. B. Assess the incision for redness. C. Reposition the left leg on pillows. D. Check the patient's blood pressure.
A
A patient who has a right lower leg fracture will be discharged home with an external fixation device in place. Which statement would the nurse including in discharge teaching? A. "Check and clean the pin insertion sites daily." B. "Remain on bed rest until bone healing is complete." C. "Remove the external fixator for your daily shower." D. "Take prophylactic antibiotics until the fixator is removed."
A
A patient who has had open reduction and internal fixation (ORIF) of a hip fracture tells the nurse he is ready to get out of bed for the first time. Which action would the nurse take? A. Check the patient's prescribed weight-bearing status. B. Use a mechanical lift to transfer the patient to the chair. C. Wean down the pain medication before getting the patient up. D. Have the assistive personnel (AP) transfer the patient to a chair.
A
After being hospitalized for 2 days with a right femur fracture, a patient suddenly develops shortness of breath and tachypnea. The patient tells the nurse, "I feel like I am going to die!" Which action would the nurse take first? A. Administer prescribed PRN O2 at 4 L/min. B. Check the patient's legs for swelling or tenderness. C. Notify the health care provider about the symptoms. D. Stay with the patient and offer reassurance to the family.
A
For a patient who has had right hip arthroplasty, which nursing action can the nurse delegate to experienced assistive personnel (AP)? A. Reposition the patient every 1 to 2 hours. B. Assess for skin irritation on the patient's back. C. Teach the patient quadriceps-setting exercises. D. Determine the patient's pain intensity and tolerance.
A
Which action would the nurse take to evaluate the effectiveness of Buck's traction for a patient who has a fracture of the right femur? A. Assess for hip pain. B. Check for contractures. C. Palpate peripheral pulses. D. Monitor for hip dislocation.
A
Which recommendation would the occupational health nurse provide to a patient whose job involves many hours of typing? A. Obtain a keyboard pad to support the wrist. B. Do stretching exercises before starting work. C. Wrap the wrists with compression bandages each morning. D. Avoid using nonsteroidal antiinflammatory drugs (NSAIDS).
A
a patient with a humeral fracture is returning for a 4-week checkup. the nurse explains that initial evidence of healing on x-ray is indicated by A. formation of callus B. complete bone union C. hematoma at the fracture site D. presence of granulation tissue
A
the nurse teaches the patient with an above-the-knee amputation that the residual limb should not be routinely elevated because this position promotes A. hip flexion contracture B. clot formation at the incision C. skin irritation and breakdown D. increased risk for wound dehiscence
A
the nurse would monitor a patient with a pelvic fracture for A. changes in urine output B. petechiae on the abdomen C. a palpable lump in the buttock D. sudden increase in blood pressure
A
what are the signs and symptoms of fat embolism syndrome (FES)?
ARDS; chest pain, tachypnea, cyanosis, dyspnea, apprehension, tachycardia, hypoxemia
What symptoms may a patient have if the developer superior mesenteric artery syndrome?
Abdominal pain and pressure, nausea, and vomiting
How to test for Phalen sign?
Allowing the wrist to fall freely to maximum flexion and maintain the position for longer than 60 seconds
When is cold most useful?
Applied immediately after injury
How should the body jacket brace be applied?
Around the chest and abdomen, extending from above the nipple line to the pubis
What is the main nursing priority with skin traction?
Assess skin for pressure points and breakdown
What manifestations occur in the late stages of carpal tunnel syndrome?
Atrophy of the muscles around the base of the thumb resulting in recurrent pain and eventual dysfunction of the hand
A 60-yr-old patient had open reduction and internal fixation (ORIF) for an open, displaced tibial fracture. Which patient problem would the nurse identify? A. Fatigue B. Risk for infection C. Activity intolerance D. Impaired bowel elimination
B
A patient who arrives at the emergency department with severe left knee pain is diagnosed with a patellar dislocation. Which information would the nurse plan to teach the patient first? A. Use of a knee immobilizer B. Monitored anesthesia care C. Physical activity restrictions D. Performance of gentle knee flexion
B
A patient who is to have no weight bearing on the left leg is learning to use crutches. Which observation by the nurse indicates the patient can safely ambulate independently? A. The patient moves the right crutch with the right leg and then the left crutch with the left leg. B. The patient advances the left leg and both crutches together and then advances the right leg. C. The patient uses the bedside chair to assist in balance as needed when ambulating in the room. D. The patient keeps the padded area of the crutch firmly in the axillary area when ambulating.
B
A tennis player has an arthroscopic repair of a rotator cuff injury performed in same-day surgery. Which information will the nurse include in postoperative teaching? A. "You will not be able to serve a tennis ball again." B. "You will begin exercises with a physical therapist tomorrow." C. "Keep the shoulder immobilizer on for the first 6 months to minimize pain." D. "The surgeon will use the drop arm test to determine the success of surgery."
B
The day after having a right below-the-knee amputation, a patient reports pain in the missing right foot. Which action is most important for the nurse to take? A. Explain the reasons for the pain. B. Administer prescribed analgesics. C. Reposition the patient to ensure good alignment. D. Tell the patient that the pain will diminish over time.
B
The nurse would instruct a patient with a nondisplaced fractured left radius that the cast will need to remain in place for what amount of time? A. Two weeks B. At least six weeks C. Until swelling of the wrist has resolved D. Until x-rays show complete bony union
B
The second day after admission with a fractured pelvis, a patient suddenly develops confusion. Which action would the nurse take first? A. Take the blood pressure. B. Check the O2 saturation. C. Assess patient orientation. D. Observe for facial asymmetry.
B
Which information would the nurse include in discharge teaching for a patient who has had a repair of a fractured mandible? A. Administration of nasogastric tube feedings B. How and when to cut the immobilizing wires C. The importance of high-fiber foods in the diet D. The use of sterile technique for dressing changes
B
Which statement by a patient who has had an above-the-knee amputation indicates the nurse's discharge teaching has been effective? A. "I should elevate my residual limb on a pillow 2 or 3 times a day." B. "I should lie flat on my abdomen for 30 minutes 3 or 4 times a day." C. "I should change the limb sock when it becomes soiled or each week." D. "I should use lotion on the stump to prevent skin drying and cracking."
B
A patient with osteoarthritis is scheduled for total hip arthroplasty. The nurse explains the purpose of this procedure is to (select all that apply) a. fuse the joint. b. replace the joint. c. prevent further damage. d. improve or maintain ROM. e. decrease the amount of destruction in the joint.
B, D
What is a common type of skeletal traction?
Balanced suspension traction
What device is used for immobilization and support for stable spine injuries of the thoracic or tumble spine
Body jacket brace
What causes superior mesenteric artery syndrome?
Brace that is too tight
What is a type of skin traction sometimes used for the patient with a hip, knee, or femur fracture?
Buck's traction
what is used to help immobilize the affected extremity following a hip fracture?
Buck's traction
A patient arrived at the emergency department after tripping over a rug and falling at home. Which finding would the nurse identify as most important to communicate to the health care provider? A. There is bruising at the shoulder area. B. The patient reports arm and shoulder pain. C. The right arm appears shorter than the left. D. There is decreased shoulder range of motion.
C
A patient is being discharged 4 days after hip arthroplasty using the posterior approach. Which patient action requires intervention by the nurse? A. Using crutches with a swing-to gait B. Sitting upright on the edge of the bed C. Leaning over to pull on shoes and socks D. Bending over the sink while brushing teeth
C
A patient who slipped and fell in the shower at home has a proximal left humerus fracture immobilized with a sling. Which intervention would the nurse include in the plan of care? A. Use surgical net dressing to hang the arm from an IV pole. B. Immobilize the fingers of the left hand with gauze dressings. C. Assess the left axilla and change absorbent dressings as needed. D. Assist the patient in passive range of motion (ROM) for the right arm.
C
A patient with a complex pelvic fracture from a motor vehicle crash is on bed rest. Which assessment finding indicates a potential complication of the fracture? A. The patient states the pelvis feels unstable. B. The patient reports pelvic pain with palpation. C. Abdomen is distended and bowel sounds are absent. D. Ecchymoses are visible across the abdomen and hips.
C
A patient with ulnar drift caused by rheumatoid arthritis (RA) is scheduled for arthroplasty of several joints in the left hand. Which patient statement to the nurse indicates a realistic expectation for the surgery? A. "This procedure will correct the deformities in my fingers." B. "I will not have to do as many hand exercises after the surgery." C. "I will be able to use my fingers with more flexibility to grasp things." D. "My fingers will appear more normal in size and shape after this surgery."
C
A pedestrian who was hit by a car is admitted to the emergency department with possible right lower leg fractures. Which initial action would the nurse take? A. Elevate the right leg. B. Splint the lower leg. C. Assess the pedal pulses. D. Verify tetanus immunization.
C
After a motorcycle accident, a patient arrives in the emergency department with severe swelling of the left lower leg. Which action would the nurse take first? A. Elevate the leg on 2 pillows. B. Apply a compression bandage. C. Assess leg pulses and sensation. D. Place ice packs on the lower leg.
C
After the health care provider recommends amputation for a patient who has nonhealing ischemic foot ulcers, the patient tells the nurse that he would rather die than have an amputation. Which initial response would the nurse provide? A. "You are upset, but you may lose the foot eventually." B. "Many people are able to function with a foot prosthesis." C. "Tell me what you know about your options for treatment." D. "If you do not want an amputation, you do not have to have it."
C
The nurse is caring for a patient who has a pelvic fracture and an external fixation device. Which method would the nurse use to assess pressure areas and provide skin care to the patient's back and sacrum? A. Ask the patient to turn to the side independently. B. Defer back assessment until the patient is ambulatory. C. Have the patient lift the back and buttocks using a trapeze bar. D. Roll the patient over to the side by pushing on the patient's hips.
C
Which discharge instruction would the emergency department nurse include for a patient with a sprained ankle? A. Keep the ankle loosely wrapped with gauze. B. Apply a heating pad to reduce muscle spasms. C. Use pillows to elevate the ankle above the heart. D. Gently move the ankle through the range of motion.
C
Which information would the nurse include in discharge instructions for a patient with comminuted left forearm fractures and a long-arm cast? A. Keep the left shoulder elevated on a pillow or cushion. B. Avoid nonsteroidal antiinflammatory drugs (NSAIDs). C. Call the health care provider for numbness of the hand. D. Keep the hand immobile to prevent soft tissue swelling.
C
Which information would the nurse teach older adults at a community recreation center about ways to prevent fractures? A. Tack down scatter rugs on the floor in the home. B. Expect most falls to happen outside the home in the yard. C. Buy supportive nonskid shoes that are comfortable to wear. D. Get instruction in range-of-motion exercises from a physical therapist.
C
Which patient statement indicates understanding of the nurse's teaching about a new short-arm synthetic cast? A. "I can remove the cast in 4 weeks using industrial scissors." B. "I should avoid moving my fingers until the cast is removed." C. "I will apply an ice pack to the cast over the fracture site off and on for 24 hours." D. "I can use a cotton-tipped applicator to rub lotion on any dry areas under the cast."
C
a patient with a comminuted fracture of the tibia is to have an open reduction with internal fixation (ORIF) of the fracture. the nurse explains that ORIF is indicated when A. the patient cannot tolerate prolonged immobilization B. the patient cannot tolerate the surgery for a closed reduction C. other nonsurgical methods cannot achieve adequate alignment D. a temporary cast would be too unstable to provide normal mobility
C
the nurse suspects a neurovascular problem based on assessment of A. exaggerated stretch with movement B. increased redness and heat below the injury C. decreased sensation distal to the fracture site D. purulent drainage at the site of an open fracture
C
what is used to help discern between bone and soft tissue facial injuries?
CT scan
As a. Jess you should stress the importance of adequate intake of what for bone health?
Calcium and viramin D
The nonsurgical manual realignment of bone fragments to their anatomic position usually including casts, splints, or braces
Closed reduction
External fixation is mostly used for what type of fracture?
Complex
Fracture alignment depends on?
Correct positioning and alignment of the patient while the traction forces stay constant
A factory line worker has developed repetitive strain injury in the left elbow. Which topic would the nurse plan to include in patient teaching? A. Surgical options B. Elbow injections C. Wearing a left wrist splint D. Modifying arm movements
D
A patient is to be discharged from the hospital 4 days after insertion of a femoral head prosthesis using a posterior approach. Which patient statement to the nurse indicates that additional teaching is needed? A. "I should not cross my legs while sitting." B. "I will use an elevated toilet seat." C. "I will have someone else put on my shoes and socks." D. "I can sleep in any position that is comfortable for me."
D
A young adult arrives in the emergency department with ankle swelling and severe pain after twisting the ankle playing basketball. Which prescribed action will the nurse implement first? A. Send the patient for ankle x-rays. B. Give acetaminophen with codeine. C. Administer oral naproxen (Naprosyn). D. Elevate the ankle and apply an ice pack.
D
Which action would the nurse include in the plan of care for a patient who had a cemented right total knee arthroplasty? A. Avoid extension of the right knee beyond 120 degrees. B. Use a compression bandage to keep the right knee flexed. C. Teach about the need to avoid weight bearing for 4 weeks. D. Start progressive knee exercises to obtain 90-degree flexion.
D
a patient is scheduled for total ankle replacement. the nurse should tell the patient that after surgery he should avoid A. lifting heavy objects B. sleeping on the back C. abduction exercises of the affected ankle D. bearing weight on the affected leg for 6 weeks
D
a patient with a stable, closed humeral fracture has a temporary splint with bulky padding applied with an elastic bandage. the nurse suspects early compartment syndrome when the patient has A. increasing edema of the limb B. muscle spasms of the lower arm C. bounding pulse at the fracture site D. pain when passively extending the fingers
D
the nurse in urgent care suspects an ankle sprain when a patient describes A. being hit by another soccer player during a game B. having ankle pain after sprinting around the track C. dropping a 10-lb weight on his lower leg at the health club D. twisting his ankle while running bases during a baseball game
D
What should you as a nurse assess for with cast syndrome?
Decreased bowel sounds, respiratory status, bowel and bladder function, areas of pressure over bony prominences (iliac crest)
Too much weight added to the traction can cause?
Delayed union or nonunion
What are the factors that influence the time needed to complete fracture healing?
Displacement and site of the fracture, blood supply, other local tissue injury, immobilization, and use of internal fixation devices
Compression of an injury helps decrease _____
Edema and pain
How often should you assess pressure points on a patient with skin traction?
Every 2-4 hr
Composed of metal pins and wires that are inserted into the bone and attached to external rods to stabilize the fracture while it heals
External fixation
What is used when a cast or traction is not appropriate for healing a fracture?
External fixation
What is the treatment for cast syndrome?
Gastric decompression and suctioning
cardiovascular problems in a patient with fat embolism syndrome (FES) are often managed how?
IV fluids, pulmonary vasodilators, peripheral vasoconstrictors, and inotropic drugs
What are the manifestations of carpal tunnel syndrome?
Impaired sensation, pain, numbness, or weakness in the distribution of the median nerve
What is the main risk of open reduction?
Infection
What are the main causes of ossification be slowed or stopped?
Infection and poor nutrition
What is a major complication of skeletal traction?
Infection at the pin insertion site and effects of prolonged immobility
what are common causes of facial fractures?
MVC, assault, or fall
stable vertebral fractures are usually caused by?
MVCs, falls, diving, or sports injuries
How long should ice be applied at a time?
No longer than 20-30 min
arthroplasty is most often done on patients with?
OA, RA, avascular necrosis, congenital deformities, or dislocations
The correction of bone alignment through surgery usually including wires, screws, pins, plates, or nails
Open reduction
What is traction used for?
Prevent or reduce pain and muscle spasm, immobilize a joint or part of the body. Reduce a fracture or dislocation, treat a pathological joint condition
what does a physical therapy assess in a patient following hip surgery?
ROM, ambulation, and adherence to the exercise program
What are the patient teachings to prevent musculoskeletal problems and falls in older adults
Remove throw rugs, use shoes with good support, do not walk on uneven and wet surfaces, ensure adequate lighting, maintain clear path to bathroom at night time
What is RICE?
Rest, ice, compression, elevation
Type of traction that provides long-term pull that keeps injured bones and joints aligned
Skeletal
Type of traction used to align injured bones and joints or to treat joint contractures and congenital hip dysplasia
Skeletal traction
Type of traction usually used for short term treatment (48-72 hr)
Skin
What are the most common types of traction?
Skin and skeletal
To prevent edema and encourage fluid return, how should a bandage be wrapped?
Starting distally (furthest from trunk of body) and progress proximally (toward the trunk of body)
What should you as a nurse assess for when applying a body jacket brace?
Superior mesenteric artery syndrome
How do you elicit the Tinel sign?
Tapping over the median nerve as it passes through the carpal tunnel in the wrist
What is a positive Tinel sign?
Tingling sensation in the distribution of the median nerve
What is a positive Phalen sign?
Tingling sensation in the distribution of the median nerve over the hand
What is manually applied to bone fragments during closed reeducation to restore position, length, and alignment?
Traction or counter traction
What should be done before exercising and vigorous activity to significantly reduce the risk for sprain and strains?
Warming up muscles and stretching
what can be used to help manage painful muscle spasms in a patient with a hip fracture?
analgesics or muscle relaxants, traction
where do fat globules collect with fat embolism syndrome (FES)?
areas with abundant blood vessels; lungs and brain
reconstruction or replacement of a joint to relieve pain, improve or maintain ROM, and correct deformity
arthroplasty
how should a patient with a facial injury be treated?
as if the have a cervical injury
you should maintain latency of any drain systems using?
aseptic technique
what might a chest x ray show in a patient with fat embolism syndrome (FES)?
bilateral pulmonary infiltrates
hormonal changes caused by trauma or sepsis stimulate systemic release of free fatty acids that form the fat emboli
biochemical theory
what should you observe dressings for post of high fracture surgery?
bleeding
as a nurse you should frequently observe dressings or casts for what post op?
bleeding or drainage
what should be assessed for a patient with a pelvic fracture?
bowel and urinary elimination, distal neuromuscular assessment, and back care
what supplements are given to patients with osteopenia or osteoporosis?
calcium and vitamin D
what manifestation of FES causes by hypoxemia is common?
changes in mental status
what cleaner is used for pin care cleaning?
chlorhexidine
what are the surgical options for a patient with a hip fracture?
closed reduction with pinning, internal fixation devices, replacement of femoral head with prosthesis, total hip replacement
what should you assess the extremity for post of hip fracture surgery?
color, temperature, capillary refill, distal pulses, edema, sensation, motor function, and pain
what is used right after a knee arthroplasty to immobilize the knee in extension?
compression dressing
increasing patient activity post op can help prevent what?
constipation
death after a fracture is usually due to?
damage to underlying organs and vascular structures
what are the signs and symptoms of rhabdomyolysis (breakdown of skeletal muscle)?
dark reddish brown urine
what should you encourage the patient to do post op hip fracture surgery?
deep breathing and coughing
if spinal ligaments are significantly disrupted, what can occur?
dislocation of the vertebrae
a displaced femoral neck fracture may _____, resulting in _____ of the femoral head.
disrupt blood supply, avascular necrosis
when would discharge teaching be done following a hip fracture?
early, in the ED
how can you decrease edema in a patient post of hip fracture surgery?
elevate the leg when patient is in bed or chair
homes can be made safe for a patient following hip surgery by?
eliminating tripping hazards, adding grab bars inside and outside the shower and beside the toilet, adding railings on both sides of the stairs, better lighting
cementless total hip arthroplasty may provide longer stability by doing what?
enabling growth of new bone tissue into the porous surface coating of the prosthesis
what is the treatment for complex or displaced pelvic fractures?
external fixation
what are the clinical manifestations of a hip fracture?
external rotation, muscle spasm, shortening of the affected extremity, and severe pain and tenderness around fracture site
what should be assessed in a patient with a facial fracture/injury?
eye muscles and cranial nerves III, IV, and VI
vitreous humor forced out of the eye, brown tissue on the surface or penetrating through a laceration, off-center or teardrop-shaped pupil are signs of what?
eye-globe rupture
what laboratory abnormalities may be present with fat embolism syndrome (FES)?
fat cells in blood, urine, or sputum, decrease of PaO2 < 60 mm Hg, decreased platelet count and hematocrit, high ESR
when is a patient usually out of bed following hip fracture surgery?
first post op day
what are the "Do Nots" to teach a patient post op hip fracture surgery?
flex hip greater than 90 degrees, bring legs together at knees, turn toward planted foot on affected side, cross legs at knees or ankles, put on own shoes and stockings without adaptive devices, sit on chairs without arms
how do mirror therapy and virtual reality help phantom limb sensation?
give visual information to the brain, replacing sensory feedback expected from the missing limb
how can you decrease the effects of rapid deconditioning of the cardiopulmonary system post op?
have the patient sit on the side of the bed, allowing their lower limbs to dangle over the bedside
following what type of fracture puts a patient at high risk for a VTE?
hip
vertebral bodies are usually protected from displacement by?
intact spinal ligaments
what can cause bowel and bladder problems in a patient with a vertebral fracture?
interruption of the autonomic nervous system nerves or injury to the spinal cord
fat embolism syndrome (FES) can occur after?
joint replacement, burns, pancreatitis, liposuction, crush injuries, and bone marrow transplantation
where is the blood retrieved from for a blood salvage and reinfusion system?
joint space or cavity
what should be included in patient teaching for a stable vertebral fracture?
keep the spine straight when turning by moving the shoulders and pelvis together, learn how to logroll
What is Dowager's hump?
kyphosis deformity, flexion angulation of thoracic vertebrae
what is the treatment for a stable, non displaced pelvic fracture?
little intervention
what bone fractures are more likely to cause FES?
long bones, ribs, rib, and pelvis
what veins are at high risk for a VTE?
lower extremities and pelvis
what is the main priority throught the recovery period of a facial fracture/injury?
maintain a patent airway and adequate nutrition
what is priority as a nurse after a facial injury?
maintain patent airways and provide adequate ventilation
fat emboli originate from fat released from the marrow of injured bone. as fat droplets become stuck in small blood vessels, local ischemia and inflammation occur
mechanical theory
what is the treatment for phantom limb sensation?
mirror therapy and virtual reality
how many vertebral compression fractures do patients with osteoporosis have?
more than 700,000
what type of fractures are considered a medical emergency?
open fracture, fractures with severe blood loss, and fractures that damage vital organs
Rapid deconditioning of the cardiopulmonary system post op can result in?
orthostatic hypotension and decreased lung capacity
what is the primary nursing goal for a patient following a total hip or knee arthroplasty?
pain management
what are the home care considerations following hip surgery?
pain management, monitoring for infection, VTE prevention
what is the treatment for a stable vertebral fracture?
pain medication, early mobilization, bracing, firm mattress
what are the signs and symptoms of compartment syndrome?
pain, increasing pressure, paresthesia, pallor, paralysis, pulselessness
what clinical manifestation can help discern FES from other problems?
petechiae on the neck, anterior chest wall, axilla, and head
how can you maintain limb alignment in a patient post op hip fracture surgery?
pillows between patient's knees when turning to the nonoperative side
what should you as a nurse teach a patient about following a external fixation?
pin care
signs and symptoms of acute respiratory distress syndrome (ARDS) with patients with fat embolism syndrome (FES) are caused by?
poor O2 exchange
what should you keep in mind when educating an older adult following a hip fracture?
presence of chronic health problems; diabetes, heart disease
Rapid deconditioning of cardiopulmonary system post op can occur from?
prolonged bed rest
what makes assessment of facial injuries difficult?
related soft tissue injury
Buck's traction may be used for 24 to 48 hours to _____.
relieve painful muscle spasms
what can develop from bone demineralization due to reduced mobility post op?
renal stones
in a total hip arthroplasty, what does a prosthesis do?
replaces the ball and socket joint formed by the upper shaft of the femur and pelvis
what may a patient feel when experiencing phantom limb sensation?
shooting, burning, crushing, feelings of coldness, heaviness, and cramping
what does a sudden loss of function below a vertebral fracture indicate?
spinal cord impingement and paraplegia
what should you do if an eye-globe rupture is suspected?
stop and place a protective shield over the eye
what is the rationale behind having a firm mattress for a stable vertebrae fracture?
support the spinal column, relax muscles, decrease edema, and prevent compression on nerve roots
what are the type of arthroplasty?
surgical reshaping of the bones of the joints, replacement of part of a joint, and total joint replacement
an abdominal assessment following a pelvic fracture may show?
swelling, tenderness, deformity, unusual pelvic movement, and bruising
what are the signs and symptoms of a venous thromboembolism (VTE)?
tenderness to pressure, venous distention, edema, deep reddish color to area (venous congestion)
why are patients worried about phantom limb sensation?
they still perceive pain in the missing part of the limb
what are the main reasons for a total hip or knee arthroplasty?
unrelieved pain and instability due to severe deterioration
what are the "Do's" to teach a patient post op hip fracture surgery?
use an elevated toilet seat, place chair inside the shower and remain seated, use a pillow between legs for first 6 weeks when lying, keep hip in a neutral position
what is used to determine the extent of a facial injury?
x ray
how are pelvic fracture diagnosed?
x ray and CT scan
proper alignment and bone healing following internal fixation is evaluated regularly by?
x rays
what group of patients are cementless devices usually better suited for?
young more active and with good bone quality