NURS 311: Lab 4 - Fractures

What are common causes and risk factors for fractures?

Bed rest, osteoporosis, steroid use, and trauma.

What are the clinical manifestations of a fracture?

Edema, pain, muscle spasms, possible bone deformity, ecchymosis, loss of function, and crepitation.

What are the classifications of fractures?

Open or closed, complete or incomplete, and based on the direction of the fracture line (linear, oblique, transverse, longitudinal, spiral).

What is a complete fracture?

A fracture in which the break is across the entire width of the bone in such a way that the bone is divided into two distinct sections.

What is an incomplete fracture?

A fracture which does not divide the bone into two portions because the break is through only part of the bone.

What is an open (compound) fracture?

A fracture in which the broken bone penetrates through the skin.

What is a closed (simple) fracture?

A fracture that doesn't extend through the skin and therefore has no visible wound.

What is an impacted fracture?

A fracture in which the broken bone ends are forced into each other.

What is a comminuted fracture?

A fracture in which the bone breaks into many fragments.

What is a displaced spiral fracture?

A fracture in which the bone twists and rotates, causing the fractured ends to separate and no longer line up correctly.

What is a displaced transverse fracture?

A fracture that occurs horizontally across the bone's shaft, and the broken ends of the bone have shifted out of their proper alignment.

What is a greenstick fracture?

A fracture where the bone bends and splits, causing a crack or incomplete break.

What is an avulsion fracture?

A fracture where a fragment of bone tears away from the main mass of bone as a result of physical trauma.

What is an interarticular fracture?

A fracture that involves bones within a joint.

What is a stress/fatigue fracture?

A break caused by abnormal trauma to a bone.

What are the stages of bone healing after a fracture?

1. Bleeding and hematoma formation, 2. Organization of hematoma, 3. Invasion of osteoblasts, 4. Callus formation, 5. Remodeling.

What are the goals of collaborative care for fractures?

Fracture reduction, immobilization, drug therapy for pain, preventing infection, and improving mobility.

What are key components of a nursing assessment for fractures?

History, physical assessment, neurovascular assessment, lab work, diagnostic imaging, and psychosocial assessment.

What are some common lab work signs for bone fractures?

Low HGB and increased WBC or ESR.

What is the main diagnostic imaging used for fractures?

X-rays.

What are the 4 main nursing priorities for fractures?

Acute pain, decreased mobility, risk for neurovascular compromise, and infection.

What nursing management is required for an open fracture?

Administer tetanus vaccine, IV antibiotics within one hour, and monitor labs to prevent infection.

What are important considerations for cast care?

Perform frequent neurovascular checks, ice and elevate for the first 24-28 hours, and report any breaks in cast integrity.

What does the CAST acronym stand for?

Clean and dry, above the heart, scratch an itch, and take it easy.

What is traction?

The application of a pulling force to a part of the body to provide bone reduction or as a last resort to decrease muscle spasm.

What is the purpose of traction in fracture management?

To pull the ends of the bone apart and reduce muscle spasms.

What do you need to make sure of when caring for fractures using traction?

Ensure there are no frayed ropes and loose knots, ropes are in grooves, pulley clamps securely fastened, weight is hanging freely, and there is appropriate ody alignment.

What should generally be done for post-operative care for fractures?

Vital signs, focused assessments, dressing assessments, prevention of complications of immobility, and frequent CSM checks

What are common complications of fractures?

Bone non-union, infection, venous thrombosis, fat embolism syndrome, and compartment syndrome.

What is fat embolism syndrome (FES)?

A rare but serious condition that occurs when fat particles enter the bloodstream and cause systemic symptoms.

What are s/s of FES?

Altered mental status; increased respirations, pulse, temperature; chest pain; dyspnea; crackles; decreased SpO2; petechiae; and mild thrombocytopenia.

What is compartment syndrome?

A painful and serious condition that occurs when pressure builds up within a closed muscle compartment in the body.

What are the 6 P's of compartment syndrome?

Pain, Pressure, Pallor, Pulselessness, Paresthesia, and Paralysis.

You should apply ice and raise the affected limb above heart level if compartment syndrome is suspected. (True/False)

False

1 multiple choice option

What should be done if compartment syndrome is suspected for a casted fracture?

Compare extremities, loosen bandages, split the cast, reduce traction weight, and perform a fasciotomy.

What are some nonpharmacological methods that can assist in pain management for fractures?

Physical therapy, heat/cold application, and relaxation techniques.

What are the potential complications of immobility after a fracture?

Pressure injuries, osteoporosis, constipation, weight changes, muscle atrophy, atelectasis, VTE, urinary system calculi, depression, changes in sleep, and sensory deprivation.

What is the importance of mobility in fracture recovery?

Promotes healing, prevents complications, and improves overall patient outcomes.

What should be done if a patient reports feeling 'bad' after a fracture?

Conduct a psychosocial assessment to understand their emotional state and provide support.

What is a delayed union fracture?

When a fracture has not healed within 6 months.

What is a nonunion fracture?

A fracture that never completely heals.

What is a malunion fracture?

A fracture that healed incorrectly.

What is open reduction?

Involves surgical exposure of the bone for bone realignment.

What is closed reduction?

Involves manipulating bone for bone realignment without damaging the skin.

What is external fixation?

Involves fracture immobilization using percutaneous pins and wires that are attached to a rigid external frame and penetrate the skin

What is internal fixation?

Involves fracture immobilization using percutaneous pins, scres, plates, or rods that are surgically implanted inside the bone.