1. post op care for bone biopsy
    • inspect biopsy site for bleeding, swelling and hematoma formation
    • do not move area for 8 - 12 hrs to prevent bleeding
  2. activity after arthroscopy
    • no surgical repair: exercise the leg, including straight-leg raises, mild analgesic and regualar activity in 24 - 48 hrs
    • surgery: activity restriction and percocet
  3. complications associated with arthroscopy
    • thrombophlebitis
    • infection
    • increased joint pain
  4. which lab results indicate  bone cancer
    • elevated ALP; enzyme released when bone or liver tissue is damaged
    • elevated ESR; reflects osteoblast activity
  5. strains
    injury to muscles or tendon
  6. what is RICE
    • Rest, ice, compression, elevation
    • therapy used for strain injuries
  7. what is a sprain
    • excessive stretching of one or more ligaments
    • use RICE for mild sprains
    • causes joint instability
  8. what do you do if a pt has a dislocation
    • splint the extremity as it is found, apply ice and seek help
    • do not move the extremity; prevents damage to blood vessels, muscles and nerves
  9. what can cause bursitis
    • arthritis
    • gout
    • repetitive movement
    • sleeping on one's side
  10. methods of preventing bursitis
    • stretch and strengthen muscles
    • move frequently
    • avoid repetitive movements for long periods
    • use cushioned seats
    • avoid leaning on elbows
  11. bursitis treatment
    • RICE
    • ice for 20 minutes several times per day then switch to heat once joint warmth is gone
    • ultrasound
    • joint massage
    • NSAIDS
    • physical therapy
  12. signs and symptoms of carpal tunnel syndrome
    • slow-onset finger, hand, and arm pain and numbness
    • painful tingling and parasthesia
    • eventual development of fine motor deficits and muscle weakness
  13. diagnostic test to determine carpal tunnel syndrome
    positive phalen's test; numbness with wrist flexion
  14. nursing care for a pt with carpal tunnel syndrome
    • frequent short breaks during work day
    • intersperse ongoing tasks with repetitive movements throughout the day
    • use ergonomically appropriate devices
    • if post-op; no lifting for several weeks
  15. what can weaken bones/decrease bone density
    • bone disease
    • malnutrition
    • drinking carbonated beverages with phosphoric acid
  16. what happens with a hip fracture
    • pain in groin area or at the back of the knee
    • if complete fracture the limb shortens; contraction of muscles pulling on bone sections
  17. what happens to to the limb if it is broken?
    it shortens
  18. what should be done if crepitation (bone fragments rubbing after injury) is heard?
    do not move extremity
  19. avulsion fracture
    piece of bone torn away from main bone while still attached to a ligament or tendon
  20. comminuted fracture
    bone shattered into numerous fragments
  21. impacted fracture
    bone pushed into bone
  22. greenstick fracture
    • bone is bent and fractures on the outer arc of the bend
    • often seen in children
  23. interarticular fracture
    bones within a joint fractured
  24. longitudinal fracture
    occurs along length of bone
  25. goals of fracture management
    • reduction (realignment of bone ends)
    • immobilization
    • prevention of deformity or further injury
    • preserve or resore function
  26. closed reduction
    physician pulls on bones and realigns them
  27. when should a splint be used for a fracture
    • when fracture has some associated soft tissue damage
    • perform neurovascular assessments hourly until swelling has subsided
  28. promotion of drying for a plaster cast
    • keep it open to air and turn pt about every 2 hrs to expose all sides fo the cast to the air
    • turn every 1 - 2 hrs to prevent flattening
    • handle with palms of hands
    • takes 24 to 72 hrs
    • do not cover cast or use blow dryer
    • place on absorbent surfaces, not plasticized pillows
  29.  fiberglass cast
    • dry in less than 2 hrs
    • can be exposed to water but must be dryed completely afterwards
  30. what must be done after a limb is casted
    • elevate for 24 - 48 hrs
    • apply ice to reduce swelling
    • observe cast for dryness, tightness, drainage and odor
  31. purpose of traction
    • provide fracture reduction (alignment)
    • reduce movement
    • relieve pain
  32. bucks traction
    • traction using a velcro boot to relieve muscle spasms
    • indicated for pts with hip fractures; prevents further trauma while waiting for surgery
    • usualy 5 - 10 lb 
  33. care for a pt with traction
    • monitor neurovascular status for impaired blood flow, 
    • monitor skin for pressure points or irritation
    • inspect knots, ropes, weights and pulleys every 8 - 12 hrs
  34. a pt in skeletal traction has pin sites, is drainage expected
    yes; clear, odorless drainage is expected
  35. open reduction with internal fixation
    • common with a fractured hip
    • surgical incision used to reduce the fracture and internal metal plates and screws hold the bones in place
  36. when is external fixation used
    • severe bone damage (crushed or splintered)
    • ideal for pt with open fractre and soft tissue damage
  37. which signs and symptoms of a fracture should be reported to a physician
    • numbness and tingling
    • decreased sensation
    • decreased mobility
    • decreased or absent pulses
    • cool skin temp
    • dusky color
  38. compartment syndrome
    • pressure in one or more limb compartments increases, causing massive circulation impairment
    • pt reports severe, increasing pain not relieved by opiods
  39. signs and symptoms associated with compartment syndrome
    • six p's
    • pain
    • paresthesia
    • paralysis
    • pallor
    • pulselessness
    • poikilothermia
  40. fat embolism syndrome
    • fat globules released from yellow bone marrow travel to lung and cause respiratory distress
    • usually occurs in long bones
    • can occur up to 72 hrs after
  41. fasciotomy
    • incision into fascia to relieve pressure for a pt with compartment syndrome
    • allows compartment tissue to expand and relieve pressure
    • remain open until pressure decreases
  42. signs and symptoms of fat embolism
    • altered mental status
    • tachycardia
    • tachypnea
    • fever
    • htn
    • shortness of breath
    • petechiae
  43. nursing action for a pt with fat embolism
    • oxygen at 2 L/min
    • high fowlers
    • bedrest and minimize movement of extremity
    • prep for chest xray or lung scan
    • prep for arterial blood gas determination
    • give IV fluids as ordered
    • give corticosteroids
    • emotional support and calm environment
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