Bone Fractures and Osteoporosis Overview

Study Notes

Fractures

Open fracture: Bone breaks through the skin.
Closed fracture: Bone does not break through the skin.
Transverse fracture: Horizontal fracture line across the bone.
Oblique fracture: Angled fracture line.
Spiral fracture: Twisting motion causes a helical break.
Greenstick fracture: Incomplete fracture, bone bends and cracks (common in children).
Comminuted fracture: Bone shatters into multiple pieces.

Osteoporosis

Prevention: Weight-bearing exercise and a high calcium diet (dairy products).
Mechanism: Bone reabsorption exceeds bone deposition (more osteoclasts than osteoblasts).
Characteristics: Lower bone mass/mineral density and fragility.

Osteomyelitis

Cause: Most commonly caused by Staphylococcus bacteria (sta ph).
Occurrence: Comorbidities (other health problems) can increase risk.
Diagnosis: Complex, involving physical exam, medical history, imaging, blood tests, and biopsies.
Complications: Fat embolism can be fatal.

Gout

Dietary Management: Follow a diet low in purines. Avoid foods high in purines (red meat, shellfish).
Definition: Arthritis caused by uric acid crystal deposits in joints.
Symptoms: Sudden severe pain accompanied by common arthritis symptoms.

Compartment Syndrome

Clinical Presentation: Pain, pallor, paresthesia, paralysis, pressure, pulselessness.
Cause: Increased pressure in compartments around bones, often due to fractured bones (like ORIF - open reduction internal fixation).
Consequence: Cuts off circulation causing tissue death.

Rhabdomyolysis

Mechanism: Muscle wasting/breakdown releases myoglobin into the urine (blood-colored urine).
Lab Finding: Increased creatinine kinase levels.

Deep Vein Thrombosis (DVT)

Diagnosis: Doppler ultrasound of the affected leg.
Treatment: Anticoagulants, compression stockings (SCDs), early ambulation, and leg/foot exercises.

Perioperative Care

Patient Education (pre-op/post-op/discharge):
- Pre-op: NPO status before surgery, smoking cessation, concerning signs/symptoms.
- Post-op (inpatient): Pain management, bowel movements, nausea, ambulation, coughing, deep breathing, incentive spirometer.
- Discharge: Start discharge teaching before surgery and right away.
Post-op Complications (Prevention/Management): Pneumonia, DVTs - Encourage early ambulation, use of incentive spirometer, coughing, and repositioning.
Pain Management: IV medications (faster onset), oral medications (slower onset). Administer IV meds 30 mins after administration, oral 1 hour.
Informed Consent: Nurse can witness consent signing, but the doctor must obtain consent. Patient must be involved in the decision.

Sleep Apnea

Signs/Symptoms: Snoring, daytime sleepiness, stopping breathing, waking during night gasping for air, high blood pressure.
Treatment: Positional therapy, oral appliances, weight loss, CPAP, BiPAP.

Sleep Deprivation

Signs/Symptoms: Impaired immune system, irritability, trouble thinking/focusing/remembering, headache, slow reaction time.

Sleep Hygiene

Best Practices: Avoid caffeine and alcohol 4-6 hours before bed.

Heart Rate Changes (Age/Fitness)

More in shape = slower resting heart rate, irrespective of age.

Nutrition (Parenteral & Enteral Feedings)

Parenteral Feedings (PPN/TPN):
- Safety: Aspiration prevention: Keep head of bed elevated 30+ degrees, educate on why, cap for 30-60 minutes.
- PPN: Peripheral Parenteral Nutrition, short-term, given through normal IV, normal protein/calorie requirements, supplements oral intake.
- **TPN (total/central):**Long-term, central line, higher infection risk, high calorie/protein needs.

Metabolic Syndrome

Diagnosis: Lab values: fasting glucose, vital signs, HDL.
Criteria: Elevated blood pressure (>130/85), high triglycerides (>150), large waist circumference (men >40 inches, women >35 inches), low HDL (men).

Description

Explore the key types of bone fractures, including open, closed, and spiral fractures. Learn about osteoporosis, its prevention, and its mechanisms. Additionally, understand the causes and diagnosis of osteomyelitis, a condition affecting bone health.

Bone Fractures and Osteoporosis Overview

Choose a study mode

Podcast

Questions and Answers

Which type of fracture results in the bone breaking through the skin?

What is a characteristic feature of a greenstick fracture?

What dietary change is recommended to manage gout?

Which condition involves bone reabsorption exceeding bone deposition?

What is the most common cause of osteomyelitis?

Which symptom is NOT typically associated with compartment syndrome?

What is a common causative factor for osteomyelitis?

Which diagnostic test is typically used for confirming deep vein thrombosis (DVT)?

What is the primary risk of total parenteral nutrition (TPN)?

What should be monitored closely during postoperative care to prevent complications such as pneumonia?

Which of the following is an effective non-CPAP intervention for treating sleep apnea?

Which of the following dietary habits should be avoided to promote better sleep hygiene?

What should nursing staff begin immediately for a patient who will undergo surgery?

What might indicate sleep deprivation during a patient's assessment?

What is the main purpose of using an incentive spirometer post-surgery?