Fractures
How should the patient with a shoulder or upper arm injury be positioned for assessment?
Sitting or standing
Who might experience compartment syndrome?
Burn patients, extensive insect bites, snakebites, massive infiltration of IV fluids, tight dressings or casts
Name two early signs of at embolism syndrome?
Hypoxemia, dyspnea, tachypnea
What is the most common cause of osteomyelitis?
Bacteria
Name one change in the musculoskeletal system related to aging?
Decreased bone density, increased bone prominence, kyphosis, widened gait, cartilage degeneration, decreased range of motion, muscle atrophy, slowed movement
What type of casting material is waterproof and dries within minutes?
Fiberglass
Name two interventions for the treatment of compartment syndrome?
Fasciotomy, bivalve cast
Which problem is most often a complication of hip fractures or any fracture in which there is displacement of bone?
Avascular necrosis
Name two labs that might be drawn if a patient is suspected of having osteomyelitis?
CBC, ESR
Should a patient use a cane on the injured side or the uninjured side?
Uninjured
What patient should not receive Demerol for pain management in musculoskeletal injuries?
Elderly patients
Name the 6 P's of compartment syndrome?
Pain, pressure, paralysis, paresthesia, pallor, pulselessness
You enter the room of a patient. You observe a decreased level of consciousness and see red-brown petechiae on the patient's neck and upper arms. What is your suspicion?
Fat embolism syndrome
Is this chronic or acute osteomyelitis?
Sinus tract formation
Localized pain
Chronic
A patient receives a grade 5 for muscle strength. What does this mean?
The ROM is normal.
A patient has an external fixator in place. The patient tells you he is concerned 24 hours after placement because there is clear fluid and crusting around his pins? What is your response?
This is normal in the first 48-72 hours as long as it is clear.
You are assessing the patient in a lower leg cast. On assessment, you are unable to palpate the dorsalis pedis pulse. What is your first action?
Obtain a doppler.
Other than hip fractures or displaced fractures, what is another risk for the development of avascular necrosis?
Hardware in surgical repairs and patient on long-term corticosteroids
Is this acute or chronic osteomyelitis?
Fever
Swelling
Erythema
Acute
What is a normal calcium range for adults?
9-10.5
What is an important risk for the patient having spinal surgery?
Blood loss
Describe what causes compartment syndrome?
Increased pressure within one or more compartments (that contain muscle, blood vessels, and nerves) reduces circulation to the lower leg or forearm
Name two abnormal labs found in fat embolism syndrome?
Decrease PaO2, Increased ESR, Decreased serum calcium, Decreased RBC and platelet counts, Increased serum level of lipids
What type of precautions should the nurse initiate for the patient with osteomyelitis?
Contact
Name two components of a neurovascular assessment?
Palpation of pulses, assessment of sensation, movement, color, temperature, pain