Part 1: When a fracture becomes an emergency 2

NUR 433: Adult Health II: MCUSON; Mrs. Cooper

___-___ days minimum of anticoagulant prophylaxis after orthopedic surgery to prevent the predictable complication of venous thromboembolism (VTE)

10-14

after __ hours, start chemoprophylaxis after spinal cord injury (SCI) unless bleeding to prevent the predictable complication of venous thromboembolism (VTE)

72

start day ___ mechanical prophylaxis (SCDs) starts on admission after spinal cord injury (SCI) to prevent the predictable complication of venous thromboembolism (VTE)

1

patients with hip fractures, pelvic fractures, total hip replacements (THR), total knee replacement (TKR), spinal cord injury (SCI), and any immobility is at risk for _____ _____

venous thromboembolism (VTE)

list some drugs that treat venous thromboembolism (VTE)

• low molecular weight heparin (LMWH) like enoxaparin

• factor Xa inhibitors like rivaroxaban and apixaban

• warfarin

• aspirin

administer _____ if kidney function is poor for a patient with venous thromboembolism

heparin

list some mechanical prevention methods for venous thromboembolism (VTE)

• sequential compression devices (SCDs)

• compression stockings

• ankle pumps

• ROM on the unaffected limb

list some pulmonary embolism (PE) cues

• sudden dyspnea

• pleuritic chest pain

• tachycardia

• anxiety

• falling SpO2

an older adult after a fall is at risk for a _____ _____

hip fracture

with a hip fracture, the patient’s affected leg will be shortened and _____ rotated

externally

a patient with a hip fracture will have _____ or _____ pain and will not be able to bear weight

groin; hip

_____ _____ may be used before surgery for a patient with a hip fracture

Buck’s traction

list some risks for a patient with a hip fracture

• venous thromboembolism (VTE)

• delirium

• pneumonia

• pressure injury

reduce a traumatic hip dislocation fast to prevent _____ _____

avascular necrosis

posterior hip replacement precautions: no hip flexion past ___ degrees (raised toilet seat, no low chairs)

90

posterior hip replacement precautions: no _____ legs (use an abduction pillow)

crossing

posterior hip replacement precautions: no _____ rotation (toes pointed in)

internal

***posterior hip replacement precautions: dislocation is an emergency:

• sudden severe pain

• shortening

• rotation

• can’t move the leg

• keep NPO

• check neurovascular status

• call the surgeon

for the first 24 hours of a traumatic amputation: keep a ____ at the bedside

tourniquet

for the first 24 hours of a traumatic amputation: watch the dressing for _____

hemorrhage

for the first 24 hours of a traumatic amputation: _____ the residual limb only per order, usually the first 24 hours

elevate

how to prevent a contracture in a traumatic amputation: lie _____-_____ several times a day

face-down

how to prevent a contracture in a traumatic amputation: no _____ under the residual limb after 24 hours

pillow

how to prevent a contracture in a traumatic amputation: avoid long periods of sitting with _____ flexed

hips

teach and support for a traumatic amputation: _____ limb pain is real; treat it

phantom

teach and support for a traumatic amputation: _____-_____ elastic wrap shapes the limb for a prosthesis

figure-8

***teach and support for a traumatic amputation: inspect skin daily; address body image and grief

spot the traction error using CAROL P. SMITH. what does the C mean

continuous

spot the traction error using CAROL P. SMITH. what does the A mean

alignment

spot the traction error using CAROL P. SMITH. what does the R mean

resistance removed

spot the traction error using CAROL P. SMITH. what does the O mean

opposing traction

spot the traction error using CAROL P. SMITH. what does the L mean

line of pull

spot the traction error using CAROL P. SMITH. what does the P mean

pulse

spot the traction error using CAROL P. SMITH. what does the S mean

sensation

spot the traction error using CAROL P. SMITH. what does the M mean

motion

spot the traction error using CAROL P. SMITH. what does the I mean

interspace (skin)

spot the traction error using CAROL P. SMITH. what does the T mean

temperature

spot the traction error using CAROL P. SMITH. what does the H mean

hue (color)