Podcast
Questions and Answers
What is a common assessment finding in cases of dislocation?
What is a common assessment finding in cases of dislocation?
- Increased pain upon movement only
- Abnormal joint movement
- Popping sound during injury (correct)
- Severe muscle swelling
Which management technique should be applied during the first 24 to 48 hours after a strain or sprain?
Which management technique should be applied during the first 24 to 48 hours after a strain or sprain?
- Active range of motion exercises
- Immediate heat application
- Intermittent application of cold packs (correct)
- Immediate surgical intervention
Which symptom is NOT typically associated with compartment syndrome?
Which symptom is NOT typically associated with compartment syndrome?
- Severe pain that increases with muscle stretching
- Numbness
- Loss of active movement in the arm (correct)
- Tingling or burning sensation in the skin
Which diagnostic method is NOT typically used for assessing strains and sprains?
Which diagnostic method is NOT typically used for assessing strains and sprains?
What does the acronym 'RICE' stand for in the context of managing strains and sprains?
What does the acronym 'RICE' stand for in the context of managing strains and sprains?
What is a primary management strategy for treating dislocations or subluxations?
What is a primary management strategy for treating dislocations or subluxations?
Which condition is characterized as a claw-like deformity?
Which condition is characterized as a claw-like deformity?
What is the primary risk associated with dislocation that involves increased pressure in a compartment?
What is the primary risk associated with dislocation that involves increased pressure in a compartment?
Which of the following is NOT a typical assessment finding in tendonitis?
Which of the following is NOT a typical assessment finding in tendonitis?
What is a common cause of carpal tunnel syndrome?
What is a common cause of carpal tunnel syndrome?
Which sign is associated with carpal tunnel syndrome diagnosis?
Which sign is associated with carpal tunnel syndrome diagnosis?
What is a key nursing management strategy for tendinitis?
What is a key nursing management strategy for tendinitis?
Which is NOT a recommended management approach for tendonitis?
Which is NOT a recommended management approach for tendonitis?
What symptom is indicated by both Tinel’s sign and Phalen’s sign?
What symptom is indicated by both Tinel’s sign and Phalen’s sign?
Which of the following is a non-surgical management option for tendonitis?
Which of the following is a non-surgical management option for tendonitis?
What is a common assessment finding in a rotator cuff tear?
What is a common assessment finding in a rotator cuff tear?
What is the primary surgical method used for repairing a rotator cuff?
What is the primary surgical method used for repairing a rotator cuff?
Which of the following is a symptom of a ruptured Achilles tendon?
Which of the following is a symptom of a ruptured Achilles tendon?
What is a common non-surgical management strategy for a meniscal injury?
What is a common non-surgical management strategy for a meniscal injury?
What form of diagnostic imaging can be used to assess ligament injuries?
What form of diagnostic imaging can be used to assess ligament injuries?
What type of fracture classification is primarily concerned with the type and extent of the injury?
What type of fracture classification is primarily concerned with the type and extent of the injury?
What is typically the first step in the healing process right after a bone fracture?
What is typically the first step in the healing process right after a bone fracture?
Which procedure involves reattaching a torn tendon with a nearby tendon?
Which procedure involves reattaching a torn tendon with a nearby tendon?
Which of the following is a common assessment finding in fractures?
Which of the following is a common assessment finding in fractures?
What is a key component of nursing management following ligaments or meniscal injuries?
What is a key component of nursing management following ligaments or meniscal injuries?
What is the role of osteoblasts in bone healing?
What is the role of osteoblasts in bone healing?
What is a potential complication of a fracture that can result in blood clots traveling to the lungs?
What is a potential complication of a fracture that can result in blood clots traveling to the lungs?
How long does it generally take for remodeling of a properly aligned fracture site to complete?
How long does it generally take for remodeling of a properly aligned fracture site to complete?
Which type of fracture is characterized by a break in a straight horizontal line?
Which type of fracture is characterized by a break in a straight horizontal line?
What treatment options are included in the medical and surgical management of fractures?
What treatment options are included in the medical and surgical management of fractures?
What is a common symptom to monitor for in clients with fat embolism?
What is a common symptom to monitor for in clients with fat embolism?
Which assessment finding is NOT typically associated with a fractured femur?
Which assessment finding is NOT typically associated with a fractured femur?
Delayed healing of a fracture can lead to which of the following complications?
Delayed healing of a fracture can lead to which of the following complications?
What is a complication associated with hip fractures?
What is a complication associated with hip fractures?
What is a common symptom of a fractured hip?
What is a common symptom of a fractured hip?
Which surgical management option is indicated for a hip fracture?
Which surgical management option is indicated for a hip fracture?
What is a recommended safety measure to prevent falls at home?
What is a recommended safety measure to prevent falls at home?
Which of the following is NOT a typical assessment finding in a fractured hip?
Which of the following is NOT a typical assessment finding in a fractured hip?
What is an assessment finding that could indicate a fractured hip?
What is an assessment finding that could indicate a fractured hip?
Which of the following scenarios could lead to a fractured hip?
Which of the following scenarios could lead to a fractured hip?
Which of the following steps can aid in the management of a fractured hip?
Which of the following steps can aid in the management of a fractured hip?
What is a key assessment finding associated with dislocations?
What is a key assessment finding associated with dislocations?
What is the primary purpose of applying cold packs during the first 24 to 48 hours after an injury?
What is the primary purpose of applying cold packs during the first 24 to 48 hours after an injury?
Which of the following accurately describes a characteristic of a strain?
Which of the following accurately describes a characteristic of a strain?
Which of the following injuries can lead to compartment syndrome?
Which of the following injuries can lead to compartment syndrome?
What does the management strategy of immobilization aim to achieve in injuries like strains and sprains?
What does the management strategy of immobilization aim to achieve in injuries like strains and sprains?
Which symptom is most closely associated with compartment syndrome?
Which symptom is most closely associated with compartment syndrome?
What is a common assessment finding in tendonitis?
What is a common assessment finding in tendonitis?
Which management strategy is primarily used to prevent complications after a dislocation?
Which management strategy is primarily used to prevent complications after a dislocation?
What is a common cause of epicondylitis, also known as tennis elbow?
What is a common cause of epicondylitis, also known as tennis elbow?
Which option is an appropriate intervention in the management of tendonitis?
Which option is an appropriate intervention in the management of tendonitis?
Which of the following statements about Tinel’s and Phalen’s signs is correct?
Which of the following statements about Tinel’s and Phalen’s signs is correct?
What is the primary nursing management strategy for patients experiencing tendinitis?
What is the primary nursing management strategy for patients experiencing tendinitis?
Which of the following treatments is NOT typically recommended for managing tendonitis?
Which of the following treatments is NOT typically recommended for managing tendonitis?
In the context of carpal tunnel syndrome, which method is primarily used to confirm the diagnosis?
In the context of carpal tunnel syndrome, which method is primarily used to confirm the diagnosis?
Which nursing recommendation is crucial for alleviating pain associated with carpal tunnel syndrome?
Which nursing recommendation is crucial for alleviating pain associated with carpal tunnel syndrome?
What characterizes a third-degree strain?
What characterizes a third-degree strain?
What is the primary cause of a sprain?
What is the primary cause of a sprain?
What common symptom is associated with a second-degree sprain?
What common symptom is associated with a second-degree sprain?
Which stage characterizes the healing process immediately after a fracture?
Which stage characterizes the healing process immediately after a fracture?
What is a key characteristic of a first-degree sprain?
What is a key characteristic of a first-degree sprain?
What is a common consequence of a third-degree sprain?
What is a common consequence of a third-degree sprain?
Which of the following types of muscle injury occurs due to overuse or excessive stress?
Which of the following types of muscle injury occurs due to overuse or excessive stress?
What type of strain involves significant pain and limited motion without complete loss of function?
What type of strain involves significant pain and limited motion without complete loss of function?
What is a common surgical procedure used for severe rotator cuff injuries?
What is a common surgical procedure used for severe rotator cuff injuries?
Which assessment finding is commonly associated with meniscal injuries?
Which assessment finding is commonly associated with meniscal injuries?
What initial phase of healing occurs immediately after a bone fracture?
What initial phase of healing occurs immediately after a bone fracture?
Which option is a common non-surgical management strategy for a ruptured Achilles tendon?
Which option is a common non-surgical management strategy for a ruptured Achilles tendon?
What type of assessment finding is usually experienced during a ruptured Achilles tendon?
What type of assessment finding is usually experienced during a ruptured Achilles tendon?
Which of the following methods is effective for diagnosing ligament injuries?
Which of the following methods is effective for diagnosing ligament injuries?
What is a key objective of nursing management for patients with shoulder injuries?
What is a key objective of nursing management for patients with shoulder injuries?
What common symptom indicates a possible meniscal injury?
What common symptom indicates a possible meniscal injury?
Which surgical option is utilized for a severe tear in the rotator cuff?
Which surgical option is utilized for a severe tear in the rotator cuff?
In what condition might patients experience difficulty bearing weight due to instability?
In what condition might patients experience difficulty bearing weight due to instability?
What is the primary goal in the medical and surgical management of fractures?
What is the primary goal in the medical and surgical management of fractures?
Which complication can arise from a fracture that involves insufficient blood supply?
Which complication can arise from a fracture that involves insufficient blood supply?
In what timeframe does a callus with bone cells typically form after a fracture?
In what timeframe does a callus with bone cells typically form after a fracture?
What is the surgical procedure called that involves incision of the fascia to relieve pressure from compartment syndrome?
What is the surgical procedure called that involves incision of the fascia to relieve pressure from compartment syndrome?
What is a significant risk associated with pulmonary embolism following fracture surgery?
What is a significant risk associated with pulmonary embolism following fracture surgery?
What is the likely outcome if a fractured bone has not been accurately aligned during healing?
What is the likely outcome if a fractured bone has not been accurately aligned during healing?
What are the common assessment findings of a fractured femur?
What are the common assessment findings of a fractured femur?
What factors can influence the healing process of a fracture?
What factors can influence the healing process of a fracture?
What are the classic symptoms of compartment syndrome that indicate increased pressure in a limb?
What are the classic symptoms of compartment syndrome that indicate increased pressure in a limb?
How does Volkmann's contracture develop following extension injuries?
How does Volkmann's contracture develop following extension injuries?
What preventative measures can be taken during athletic activities to avoid tendonitis?
What preventative measures can be taken during athletic activities to avoid tendonitis?
What is the role of neurovascular checks in the management of dislocation?
What is the role of neurovascular checks in the management of dislocation?
What are the two primary signs used to diagnose carpal tunnel syndrome?
What are the two primary signs used to diagnose carpal tunnel syndrome?
What type of medication is commonly recommended for managing tendonitis?
What type of medication is commonly recommended for managing tendonitis?
What is the impact of repeated stress injuries like epicondylitis on joint function?
What is the impact of repeated stress injuries like epicondylitis on joint function?
In the context of nursing management for tendonitis, what is one important comfort measure?
In the context of nursing management for tendonitis, what is one important comfort measure?
What is the role of well-planned exercise in medical management for tendon injuries?
What is the role of well-planned exercise in medical management for tendon injuries?
What might surgical intervention for tendon injuries address?
What might surgical intervention for tendon injuries address?
What are the primary assessment findings associated with a strain or sprain?
What are the primary assessment findings associated with a strain or sprain?
How does a dislocation differ from a subluxation?
How does a dislocation differ from a subluxation?
What immediate treatment methods are recommended for strains and sprains?
What immediate treatment methods are recommended for strains and sprains?
What possible complications can arise from a dislocation due to increased compartment pressure?
What possible complications can arise from a dislocation due to increased compartment pressure?
What nursing management strategies should be employed following a sprain or strain injury?
What nursing management strategies should be employed following a sprain or strain injury?
What is the primary difference between a strain and a sprain?
What is the primary difference between a strain and a sprain?
How do the grades of a strain differ in terms of injury severity?
How do the grades of a strain differ in terms of injury severity?
Identify a common sign associated with a third-degree sprain.
Identify a common sign associated with a third-degree sprain.
Explain the significance of recognizing the stages of bone healing after a fracture.
Explain the significance of recognizing the stages of bone healing after a fracture.
What potential complication can arise from an untreated severe strain?
What potential complication can arise from an untreated severe strain?
Describe a common nursing management approach for clients with a sprain.
Describe a common nursing management approach for clients with a sprain.
What characterizes a first-degree muscle strain in assessment findings?
What characterizes a first-degree muscle strain in assessment findings?
What is an avulsion fracture, and how is it related to sprains?
What is an avulsion fracture, and how is it related to sprains?
What are two common assessment findings in a ruptured Achilles tendon?
What are two common assessment findings in a ruptured Achilles tendon?
What non-surgical management techniques are commonly advised for rotator cuff injuries?
What non-surgical management techniques are commonly advised for rotator cuff injuries?
What is the initial step in the bone healing process after a fracture?
What is the initial step in the bone healing process after a fracture?
Describe a key difference between arthroscopic tendon repair and open tendon repair.
Describe a key difference between arthroscopic tendon repair and open tendon repair.
What role does physical therapy play in the management of ligament injuries?
What role does physical therapy play in the management of ligament injuries?
What is an important nursing management strategy for patients after rotator cuff surgery?
What is an important nursing management strategy for patients after rotator cuff surgery?
What is the purpose of removing a bone spur during rotator cuff surgery?
What is the purpose of removing a bone spur during rotator cuff surgery?
In the context of knee injuries, what does the term 'RICE' stand for?
In the context of knee injuries, what does the term 'RICE' stand for?
What are the typical surgical options available for managing meniscal injuries?
What are the typical surgical options available for managing meniscal injuries?
What assessment finding often accompanies fractures immediately after an injury?
What assessment finding often accompanies fractures immediately after an injury?
What are the primary roles of osteoblasts in the bone healing process?
What are the primary roles of osteoblasts in the bone healing process?
What is the typical timeframe for a callus to form after a fracture?
What is the typical timeframe for a callus to form after a fracture?
Identify two potential complications that can arise from a fracture.
Identify two potential complications that can arise from a fracture.
How does a fasciotomy relate to compartment syndrome?
How does a fasciotomy relate to compartment syndrome?
What factors can influence the medical and surgical management of fractures?
What factors can influence the medical and surgical management of fractures?
What is the main goal of managing fractures effectively?
What is the main goal of managing fractures effectively?
What type of fracture is characterized by an angled break?
What type of fracture is characterized by an angled break?
What are the signs that may indicate the presence of a fat embolism?
What are the signs that may indicate the presence of a fat embolism?
Flashcards
Hematoma
Hematoma
A collection of blood outside of blood vessels, often caused by trauma.
Contusion
Contusion
Soft tissue injury from a blow or blunt trauma, not involving a muscle tear.
Avulsion Fracture
Avulsion Fracture
Fracture where a piece of bone is pulled away by a ligament or tendon.
Strain
Strain
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Sprain
Sprain
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RICE
RICE
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Dislocation
Dislocation
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Subluxation
Subluxation
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Compartment Syndrome
Compartment Syndrome
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Ecchymosis
Ecchymosis
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Neurovascular Checks
Neurovascular Checks
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Immobilization
Immobilization
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Volkmann's Contracture
Volkmann's Contracture
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Compartment Syndrome
Compartment Syndrome
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Compartment Syndrome Symptoms
Compartment Syndrome Symptoms
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Dislocation/Subluxation
Dislocation/Subluxation
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Tendonitis
Tendonitis
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Epicondylitis
Epicondylitis
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Ganglion Cyst
Ganglion Cyst
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Carpal Tunnel Syndrome
Carpal Tunnel Syndrome
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Carpal Tunnel Syndrome
Carpal Tunnel Syndrome
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Tinel's Sign
Tinel's Sign
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Phalen's Sign
Phalen's Sign
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Tendinitis
Tendinitis
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Diagnostic Findings (Tendinitis)
Diagnostic Findings (Tendinitis)
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Nursing Management (Tendinitis)
Nursing Management (Tendinitis)
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Medical Management (Tendinitis)
Medical Management (Tendinitis)
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Surgical Intervention (Tendinitis)
Surgical Intervention (Tendinitis)
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Rest (Tendinitis Treatment)
Rest (Tendinitis Treatment)
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Rotator Cuff Tear
Rotator Cuff Tear
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Rotator Cuff Repair
Rotator Cuff Repair
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Ligament and Meniscal Injuries
Ligament and Meniscal Injuries
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Achilles Tendon Rupture
Achilles Tendon Rupture
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Fracture
Fracture
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Bone Healing Stages
Bone Healing Stages
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Bone Healing Process
Bone Healing Process
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Procallus formation
Procallus formation
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Callus Formation
Callus Formation
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Remodeling
Remodeling
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Complete Healing Time
Complete Healing Time
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Complications of Fractures
Complications of Fractures
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Delayed Healing
Delayed Healing
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Nonunion
Nonunion
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Avascular Necrosis
Avascular Necrosis
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Infection
Infection
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Fractured Femur
Fractured Femur
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Transverse Fracture
Transverse Fracture
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Oblique Fracture
Oblique Fracture
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Spiral Fracture
Spiral Fracture
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Comminuted Fracture
Comminuted Fracture
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Compound Fracture
Compound Fracture
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Open Fracture
Open Fracture
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Fractured Hip
Fractured Hip
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Hip Fracture Symptoms
Hip Fracture Symptoms
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Hip Fracture Diagnosis
Hip Fracture Diagnosis
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Hip Fracture Treatment
Hip Fracture Treatment
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Hip Fracture Complications
Hip Fracture Complications
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Hip Fracture Nursing Care
Hip Fracture Nursing Care
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Home Safety for Seniors
Home Safety for Seniors
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Strain Definition
Strain Definition
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Sprain Definition
Sprain Definition
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Strain Grade 1
Strain Grade 1
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Strain Grade 2
Strain Grade 2
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Strain Grade 3
Strain Grade 3
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Sprain Grade 1
Sprain Grade 1
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Sprain Grade 2
Sprain Grade 2
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Sprain Grade 3
Sprain Grade 3
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Hematoma
Hematoma
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Contusion
Contusion
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Avulsion Fracture
Avulsion Fracture
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Strain
Strain
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Sprain
Sprain
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RICE
RICE
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Dislocation
Dislocation
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Subluxation
Subluxation
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Assessment Findings (Dislocation/Subluxation)
Assessment Findings (Dislocation/Subluxation)
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Compartment Syndrome
Compartment Syndrome
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Volkmann's Contracture
Volkmann's Contracture
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Compartment Syndrome
Compartment Syndrome
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Compartment Syndrome Symptoms
Compartment Syndrome Symptoms
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Dislocation/Subluxation
Dislocation/Subluxation
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Tendonitis
Tendonitis
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Epicondylitis
Epicondylitis
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Ganglion Cyst
Ganglion Cyst
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Carpal Tunnel Syndrome
Carpal Tunnel Syndrome
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Rotator Cuff Tear
Rotator Cuff Tear
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Rotator Cuff Repair
Rotator Cuff Repair
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Ligament and Meniscal Injuries
Ligament and Meniscal Injuries
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Achilles Tendon Rupture
Achilles Tendon Rupture
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Fracture
Fracture
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Bone Healing Stages
Bone Healing Stages
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Assessment Findings (Fracture)
Assessment Findings (Fracture)
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Diagnostic Findings (Fracture)
Diagnostic Findings (Fracture)
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Tinel's Sign
Tinel's Sign
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Phalen's Sign
Phalen's Sign
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Carpal Tunnel Syndrome
Carpal Tunnel Syndrome
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Ganglion Cyst
Ganglion Cyst
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Tendinitis
Tendinitis
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Rest (Tendinitis Treatment)
Rest (Tendinitis Treatment)
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Diagnostic Findings (Tendinitis)
Diagnostic Findings (Tendinitis)
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Nursing Management (Tendinitis)
Nursing Management (Tendinitis)
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Medical Management (Tendinitis)
Medical Management (Tendinitis)
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Surgical Intervention (Tendinitis)
Surgical Intervention (Tendinitis)
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Bone Healing Stages
Bone Healing Stages
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Procallus Formation
Procallus Formation
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Callus Formation
Callus Formation
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Remodeling
Remodeling
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Complete Healing Time
Complete Healing Time
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Complications of Fractures
Complications of Fractures
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Delayed Healing
Delayed Healing
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Nonunion
Nonunion
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Avascular Necrosis
Avascular Necrosis
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Infection
Infection
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Fractured Femur
Fractured Femur
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Transverse Fracture
Transverse Fracture
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Oblique Fracture
Oblique Fracture
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Spiral Fracture
Spiral Fracture
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Strain
Strain
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Sprain
Sprain
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Strain Grade 1
Strain Grade 1
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Strain Grade 2
Strain Grade 2
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Strain Grade 3
Strain Grade 3
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Sprain Grade 1
Sprain Grade 1
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Sprain Grade 2
Sprain Grade 2
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Sprain Grade 3
Sprain Grade 3
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Contusion
Contusion
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Dislocation
Dislocation
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Subluxation
Subluxation
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Hematoma
Hematoma
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Contusion
Contusion
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Avulsion Fracture
Avulsion Fracture
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Strain
Strain
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Sprain
Sprain
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RICE
RICE
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Dislocation
Dislocation
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Subluxation
Subluxation
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Assessment Findings (Dislocation/Subluxation)
Assessment Findings (Dislocation/Subluxation)
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Compartment Syndrome
Compartment Syndrome
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Assessment Findings (Strain)
Assessment Findings (Strain)
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Diagnostic Findings (Strain)
Diagnostic Findings (Strain)
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Medical and Surgical Management (Strain)
Medical and Surgical Management (Strain)
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Nursing Management (Strain)
Nursing Management (Strain)
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Volkmann's Contracture
Volkmann's Contracture
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Compartment Syndrome
Compartment Syndrome
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Compartment Syndrome Symptoms
Compartment Syndrome Symptoms
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Dislocation/Subluxation
Dislocation/Subluxation
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Tendonitis
Tendonitis
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Epicondylitis
Epicondylitis
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Ganglion Cyst
Ganglion Cyst
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Carpal Tunnel Syndrome
Carpal Tunnel Syndrome
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Tendinitis
Tendinitis
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Rest (Tendinitis Treatment)
Rest (Tendinitis Treatment)
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Diagnostic Findings (Tendinitis)
Diagnostic Findings (Tendinitis)
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Nursing Management (Tendinitis)
Nursing Management (Tendinitis)
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Medical Management (Tendinitis)
Medical Management (Tendinitis)
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Surgical Intervention (Tendinitis)
Surgical Intervention (Tendinitis)
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Carpal Tunnel Syndrome
Carpal Tunnel Syndrome
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Tinel's Sign
Tinel's Sign
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Phalen's Sign
Phalen's Sign
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Rotator Cuff Tear
Rotator Cuff Tear
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Rotator Cuff Repair
Rotator Cuff Repair
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Ligament and Meniscal Injuries
Ligament and Meniscal Injuries
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Achilles Tendon Rupture
Achilles Tendon Rupture
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Fracture
Fracture
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Bone Healing Stages
Bone Healing Stages
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Assessment Findings (Fracture)
Assessment Findings (Fracture)
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Diagnostic Findings (Fracture)
Diagnostic Findings (Fracture)
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Bone Healing Stages
Bone Healing Stages
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Procallus Formation
Procallus Formation
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Callus Formation
Callus Formation
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Remodeling
Remodeling
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Complete Healing Time
Complete Healing Time
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Complications of Fractures
Complications of Fractures
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Delayed Healing
Delayed Healing
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Nonunion
Nonunion
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Avascular Necrosis
Avascular Necrosis
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Infection
Infection
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Fractured Femur
Fractured Femur
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Transverse Fracture
Transverse Fracture
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Oblique Fracture
Oblique Fracture
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Spiral Fracture
Spiral Fracture
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Study Notes
Introductory Medical-Surgical Nursing, 13e - Chapter 62: Caring for Clients With Traumatic Musculoskeletal Injuries
- Learning Objectives: Differentiate strains, contusions, and sprains; Define joint dislocations; Discuss nursing management of sports/work-related injuries; Identify stages of bone healing after a fracture; Describe signs/symptoms of a fracture; Explain nursing management for various fractures; Discuss methods to prevent fracture complications; Discuss potential complications of a fractured hip.
Strains and Sprains
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Etiology: Injury to muscles or ligaments, stretched or pulled beyond capacity. Strains result from overuse or excessive stress, causing tiny tears in muscle fibers.
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Types of Strains:
- First Degree: Mild; some edema and muscle spasm; no loss of function; pain with full range of motion.
- Second Degree: Partial tearing of muscle or tendon; inability to bear weight; limited motion; edema, muscle tenderness, spasm, and bruising.
- Third Degree: Severe muscle and/or tendon tearing; severe pain; muscle spasm; ecchymosis; edema; loss of function.
Sprains, Contusions
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Sprain: Injury to ligaments surrounding a joint, caused by twisting or hyperextension. Graded similarly to strains (first, second, or third degree). First degree is mild edema, edema, and joint pain. Second degree involves partial tearing of the ligament with joint instability and some loss of function. Third degree is complete ligament tears or ruptures, potentially with bone fragment detachment (Avulsion Fracture). Presents with hematoma, severe pain, edema, and abnormal joint movement.
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Contusion: Soft tissue injury from blunt trauma; does not involve muscle.
Dislocations/Subluxation
- Pathophysiology and Etiology: Ligaments supporting joints are torn, stretched, or relaxed. Usually affects hip, knee, or shoulder.
- Subluxation: Partial dislocation.
- Assessment Findings: Popping sound; sudden instability; pain; altered shape; limited range of motion (ROM); swelling; coolness; numbness; tingling; pale or dusky color of distal tissue.
- Risks: Compartment syndrome; increased pressure in a compartment; blood cannot supply muscles and nerves with oxygen and nutrients. Volkmann's contracture (claw-like deformity).
Compartment Syndrome
- Symptoms: Deep aching pain in arm or leg (short-duration); Swelling and tightness; numbness; pin-and-needle type of pain; visible muscle bulging; tingling or burning sensation in the skin; severe pain increasing with muscle stretching; difficulty in moving the foot/foot drop.
Volkmann's Contracture
- Causation: Severe trauma resulting in vascular injury to the elbow or forearm, with or without compartment syndrome.
Tendonitis
- Pathophysiology and Etiology: Trauma or repeated stress.
- Types of Tendonitis: Recurrent injuries (e.g., epicondylitis or tennis elbow); ganglion cysts (mass near tendon sheaths); carpal tunnel syndrome (repetitive motion).
- Assessment Findings: Pain, inflammation, sensation loss, tenderness.
- Diagnostic findings: Electromyography; X-rays; Carpal tunnel syndrome: Tinel's sign, Phalen's sign.
- Management: Information about medication (NSAIDs); ROM exercises, ADLs, or job responsibilities; comfort measures (rest, elevate, ice), shaking hands to reduce pain; Fluid from carpal tunnel. Medical and Surgical Management: ice +heat; rest; well-planned exercise; NSAIDs or other medications; splinting; physical therapy, surgery.
Fractures
- Pathophysiology and Etiology: Sudden direct force; bone weakness; bone healing process; complications.
- Classification (See Box 62-1): Type and extent of fracture.
- Assessment Findings: Immediately after fracture, muscles spasm; flaccid muscles; loss of function; deformity; false motion; crepitus; edema; nerve damage; pain.
- Diagnostic Findings: Radiography; bone scan (Stop think and Respond 62-2).
Stages of Bone Healing
- Immediately After: Blood seeps into the area, hematoma forms.
- 1 Week: Osteoblasts form, clot retracts.
- 3 Weeks: Procallus forms, stabilizes fracture.
- 6-12 Weeks: Callus (with bone cells) forms, osteoblasts begin to remodel.
- 12 Months: Complete Remodeling (if accurately aligned).
- Delayed healing: Nonunion; infection; avascular necrosis (bone death from insufficient blood supply).
Complications of Fractures
- Shock: Hypovolemic (blood loss).
- Pulmonary Embolism (PE): Clot to the lung; common after surgery to repair fractures (especially in legs).
- Compartment Syndrome: Tissue swelling; fasciotomy (surgical incision).
- Fat Embolism: Fat globules from pelvis or long bones; emboli in lungs or brain.
Medical and Surgical Management of Fractures
- Goal: Reestablish functional continuity of bone.
- Treatment options: Traction; closed reduction; open reduction; internal fixation; external fixation; casting.
- Factors: Location, severity of fracture; age; overall client physical condition.
Fractured Femur
- Etiology: Auto accidents; falls; trauma-related multiple injuries.
- Assessment Findings: Severe pain; swelling; ecchymosis; hip/knee immobility; compound fractures.
- Diagnostic Findings: Radiography.
- Medical/Surgical Management: Traction, spica cast.
- Nursing Management: Neurovascular assessment; analgesics; comfort measures; mobility; casting.
Types of Fractures
- Transverse: Straight horizontal line.
- Oblique: Angled line.
- Spiral: Encircles the shaft.
- Comminuted: Broken into three or more pieces.
- Compound: Bone fragments sticking out through the skin.
- Open: Wound penetrates to the broken bone.
Reduction of Injury
- Methods to realign the fractured bones (images of a person's legs/hips).
Fractured Hip
- Etiology: Falls; bone disorders; trauma.
- Assessment Findings: Severe pain; shortening of the leg; external rotation; blood loss; extensive bruising; edema; contained bleeding.
- Diagnostic Findings: Radiography.
- Medical/Surgical Management: Total hip arthroplasty; hemiarthroplasty.
- Nursing Management: Wound care; pain management; preventing dislocation; ambulation; Deep vein thrombosis (DVT) (Evidence-Based Practice 62-1).
Anatomy of Hip (diagram)
- Extracapsular area; Intracapsular area; Trochanteric region; Subtrochanteric region; Head; Neck.
Hip Fracture (diagram)
- Types of hip fracture surgeries: Hemiarthroplasty; Total Arthroplasty.
Complications (Table 62-1 Summary)
- Shock; Fat embolism; Pulmonary embolism; Deep vein thrombosis (DVT); Compartment syndrome; Delayed bone healing; Infection; Avascular necrosis.
Safety Suggestions
- Adjusting the home: Sleeping space and commode adjustments; elimination of tripping hazards; handrails and stairs improvements; ensuring good lighting; keeping accessible items.
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