Immobility Background & Prep U

-Administer oxygen The client is demonstrating clinical manifestations consistent with a fatty embolus. Administering oxygen is the top priority

A client is hospitalized for open reduction of a fractured femur. During the postoperative assessment, the nurse notes that the client is restless and observes petechiae on the client's chest. Which nursing action is indicated first? -Elevate the affected extremity. -Contact the nursing supervisor. -Administer oxygen. -Contact the health care provider.

Pneumonia Necrosis of the humerus Skin breakdown Sepsis Delirium

A 75-year-old client had surgery for a left hip fracture yesterday. When completing the plan of care, the nurse should include assessment for which complications? Select all that apply.

casted

A _______ extremity should be elevated frequently to heart level to prevent swelling

pathologic

A _________ fracture is a fracture that occurs through an area of diseased bone and can occur without trauma or a fall.

compound

A __________ fracture is a fracture in which damage also involves the skin or mucous membranes.

-wrap in compression dressing -extend/elevate joint -apply cold/ice pack

What are interventions following an arthroscopy?

-Long/pelvic bone fracture -Crushing injuries

What causes fat emboli to occur most often?

hallux valgus

commonly called a bunion, a deformity in which the great toe deviates laterally

impacted

An ________ fracture is a fracture in which a bone fragment is driven into another bone fragment.

reparative

During fracture healing, a callus is deposited in during the _________ stage

CNS

Multiple sclerosis is an immune-mediated, progressive demyelinating disease of the ______.

amputation

The initial pressure dressing usually remains in place for 48 to 72 hours after ________ surgery.

flaccid

Word that describes a muscle that is limp and without tone

Buck's

______ extension is used for fractures of the proximal femur

Russell's

__________ traction is used for lower leg fractures

Morton's Neuroma

inflammation of the nerve typically between the 3rd and 4th metatarsals; a swelling of the third (lateral) branch of the median plantar nerve

densiometry

Bone ________ is used to detect bone density and can be used to assess the risk of fracture in osteoporosis

skeletal

Crutchfield tongs, a Thomas splint, or balanced suspension traction are types of _______ traction.

S/S of Parkinson's disease

Early signs include stiffness, referred to as rigidity, and tremors of one or both hands, described as pill-rolling (a rhythmic motion of the thumb against the fingers). The hand tremor is obvious at rest and typically decreases when movement is voluntary, such as picking up an object. Bradykinesia, slowness in performing spontaneous movements, develops. Clients have a masklike expression, stooped posture, hypophonia (low volume of speech), and difficulty swallowing saliva. Weight loss occurs. A shuffling gait is apparent, and the client has difficulty turning or redirecting forward motion. Arms are rigid while walking

avulsion

Fracture in which ligament tears off part of the bone

PNS

Guillain-Barré, myasthenia gravis, and Bell's palsy are _______ disorders.

arthritis

The leading cause of musculoskeletal-related disability in the US is _________

vertigo

The most incapacitating symptom of Ménière's disease is ________

-calcitriol -calcitonin -cortisol -thyroid hormone -parathyroid hormone -growth hormone -estrogen -testosterone

What are the hormones involved in the balance between bone resorption & formation?

After covering the arthroscope insertion site with a bulky dressing and elevating the client's entire leg, the nurse needs to apply a cold pack at the site to minimize any chances of swelling.

What is the appropriate nursing intervention required in caring for a client who has undergone arthroscopy?

Clonus

What is the term for a rhythmic contraction of a muscle?

shouldn't

While drying, the cast ______ be placed on a hard surface

nutrition, genetics

________ has a profound effect on bone density, especially later in life. ________ are also an important factor but not as profound

Calcium

________ supplements should be taken with meals or with a beverage high in vitamin C for increased absorption

Dunlop's

_________ traction is applied to the upper extremity for supracondylar fractures of elbow and humererus

Osteoarthritis

__________ is characterized by early morning stiffness that decreases with activity. Large joints are usually involved, Joint pain is a constant

Alkaline phosphatase

___________ _________ is elevated during early fracture healing and in diseases with increased osteoblastic activity (ie, metastatic bone tumors)

Avascular necrosis

_____________ refers to the death of the bone from insufficient blood supply, typically manifested by complaints of increased pain and decreased function

ganglion

a collection of gelatinous material near the tendon sheaths and joints, appears as a round, firm compressible cystic swelling, usually on the dorsum of the wrist

arthrodesis

a fusion of a joint for stabilization and pain relief and is usually done on a wrist or knee

Crepitus

a grating or crackling sound or sensation that may occur with movement of ends of a broken bone or irregular joint surface

Total arthroplasty

a replacement of both articular surfaces within one joint

Raloxifene

a selective estrogen receptor modulation medication; contraindicated in clients with a history of deep vein thrombosis

petechiae

a small red or purple spot caused by bleeding into the skin.

fasciotomy

a surgical incision through the fascia to relieve tension or pressure; treatment option for compartment syndrome

Disseminated Intravascular Coagulation (DIC)

a systemic disorder that results in widespread hemorrhage and microthrombosis with ischemia

plantar fasciitis

an inflammation of the foot-supporting fascia, present as an acute onset of heal pain experienced with the first steps in the morning

oblique

bone fracture in which fracture line runs along an angle to shaft of the bone

communited fracture

bone is splintered or crushed into several pieces

malunion

condition in which the two bony ends of a fracture fail to heal together correctly; growth of the fragments of a fractured bone in a faulty position, forming an imperfect union

Volkmann's contracture

contracture and damage caused by obstructed arterial blood flow to the forearm and hand

nonunion

failure of fragments of a fractured bone to heal together; client reports persistent discomfort and movement at the fracture site

Fat embolism syndrome (FES)

occurs when the fat globules released when the bone is fractured occludes the small blood vessels that supply the lungs, brain, kidneys, and other organs.

sensation

parathesia is related to _______

osteostomy

the cutting and removal of a wedge of bone to change the bone's alignment, thereby improving function and relieving pain.

Hemiarthroplasty

the replacement of one of the articular surfaces in a joint, such as the femoral head but not the acetabulum

arthroscopy

the visual examination of the internal structure of a joint; a radiopaque contrast agent or air is injected into the joint cavity to visualize the joint structures

As soon as tolerated, after a reasonable period of immobilization Limitation of motion and stiffness of the shoulder occur with disuse. Therefore, pendulum exercises begin as soon as tolerated by the patient. In pendulum or circumduction exercises, the physical therapist instructs the patient to lean forward and allow the affected arm to hang in abduction and rotate.

A patient sustains a fracture of the arm. When does the nurse anticipate pendulum exercise should begin? As soon as tolerated, after a reasonable period of immobilization In 2 to 3 weeks, when callus ossification prevents easy movements of bony fragments In about 4 to 5 weeks, after new bone is well established In 2 to 3 months, after normal activities are resumed

Remodeling

After a fracture, during which stage or phase of bone healing is devitalized tissue removed and new bone reorganized into its former structural arrangement?

anticoagulant, ambulation

An ________ therapy and early ________ are important for clients who undergo a knee or hip replacement.

inhibit

Factors that _____ fracture healing include diabetes, smoking, local malignancy, bone loss, extensive local trauma, age greater than 40, and infection.

enhance

Factors that _____ fracture healing include proper nutrition, vitamin D and calcium, exercise, maximum bone fragment contact, proper alignment, and immobilization of the fracture.

hip

Manifestations of a dislocated _________ prosthesis are increased pain at the surgical site, acute groin pain in the affected leg, shortening of the leg, abnormal external or internal rotation, and limited movement of the fractured leg. The client may report a "popping" sensation in the hip.

24

Stump elevation for the first ___ hours after surgery helps reduce edema and pain by increasing venous return and decreasing venous pooling at the distal portion of the extremity.

hip replacement

The client following post ______________ should not cross the legs, even at the ankle. He or she should avoid bending forward when sitting in a chair, avoid flexing the hip when dressing, and use a raised toilet seat. A pillow should be placed between the legs when side-lying.

compartment syndrome

Two days after application of a cast to treat a fractured femur, the client reports severe, deep, and constant pain in the leg. What will the nurse suspect?