Hip Fracture Headquarters
A patient arrives with a shortened, externally rotated leg after a fall. What injury should the nurse suspect?
What is Hip fracture?
Shortening and external rotation are classic findings.
What are the three components of Virchow's triad?
Venous stasis, endothelial injury, and hypercoagulability.
What protein deficiency or dysfunction is associated with Duchenne muscular dystrophy?
Dystrophin
Which organism is the most common cause of osteomyelitis?
Staphylococcus aureus.
What does SLE stand for?
Systemic lupus erythematosus.
A patient has a displaced femoral neck fracture. What complication is particularly associated with disruption of blood supply to the femoral head?
What is Avascular necrosis?
Intracapsular femoral neck fractures can compromise femoral head perfusion.
A patient has a pelvic fracture, tachycardia, and hypotension but no visible bleeding. What complication should be suspected?
Internal hemorrhage causing hypovolemic shock.
A child pushes against their thighs to stand from the floor. What is this finding called?
Gowers' sign.
A patient with cancer develops a fracture after minimal trauma through a weakened bone. What type of fracture is this?
Pathologic fracture.
A patient with SLE has new proteinuria, edema, and hypertension. What complication should the nurse suspect?
Lupus nephritis.
A patient undergoes hemiarthroplasty. Which part of the hip remains native, unlike in total hip arthroplasty?
The acetabulum.
A patient with a femoral shaft fracture develops hypoxemia, confusion, and petechiae after 36 hours. What syndrome is suspected?
Fat embolism syndrome.
A crush-injury patient develops tea-colored urine and elevated CK. What substance is responsible for the urine discoloration?
Myoglobin
Chronic osteomyelitis produces a sequestrum and involucrum. Which is dead bone and which is new bone?
Sequestrum is dead bone; involucrum is new bone.
A patient has positive ANA and anti-Smith antibodies. Which antibody is more specific for SLE?
Anti-Smith.
A patient awaiting hip fracture surgery is placed in Buck's traction. What is its primary therapeutic purpose?
Reduce painful muscle spasms.
A patient with a pelvic fracture has blood at the urethral meatus. What procedure should be withheld pending urethral evaluation?
Blind urethral catheterization.
A patient with rhabdomyolysis has an elevated CK and potassium of 6.5 mEq/L. Which abnormality poses the more immediate cardiac danger?
Hyperkalemia
A diabetic patient has a nonhealing foot ulcer, normal initial X-ray, and suspected early osteomyelitis. Which imaging test is especially useful?
MRI.
A patient taking hydroxychloroquine asks why eye examinations are needed. What complication is being monitored?
Retinal toxicity.
Two patients have hip fractures: one displaced subcapital and one intertrochanteric. Which has the greater risk of avascular necrosis, and why?
The displaced subcapital fracture.
It is intracapsular and more likely to interrupt the vessels supplying the femoral head.
After a fracture, a patient has severe pain with passive stretching but palpable distal pulses. What complication must still be considered?
Acute compartment syndrome.
Preserved pulses do not exclude dangerous increases in compartment pressure.
A patient with rhabdomyolysis has declining CK but decreasing urine output and rising creatinine. Does this demonstrate renal recovery?
No; it suggests worsening acute kidney injury
A patient with metastatic bone disease has constipation, polyuria, weakness, and confusion. Which electrolyte disturbance best explains the combination?
Hypercalcemia
A client with SLE taking prednisone develops fever, joint pain, elevated anti-dsDNA, and decreased C3/C4. What must the nurse rule out before assuming a lupus flare?
Infection.
Rationale: Immunosuppression increases infection risk, and infection can mimic a lupus flare.