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Nurs 432 Ch. 54 Questions with Detailed Verified Answers (100% Correct Answers) /Already Graded A+

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Nurs 432 Ch. 54 Questions with Detailed Verified Answers (100% Correct Answers) /Already Graded A+

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Nurs 432 Ch. 54 Questions with Detailed Verified
Answers (100% Correct Answers) /Already Graded
A+
Fracture Classification

Ans: Extent of Break (complete/incomplete); Extent of Associated Soft Tissue
Damage (open, closed, grade 1, 2, 3); Pathologic (spontaneous); Fatigue/Stress;
Compression



Fracture

Ans: Break or disruption in the continuity of a bone



Fracture Grades

Ans: Grade 1: least severe

Grade 2: open fracture with skin/muscle contusion

Grade 3: muscle, skin, nerve tissue & blood



Stress Fracture

Ans: overuse injury; occurs when muscles become fatigued and can't absorb
shock; eventually muscle transposes stress to bone and causes tiny crack in
bone; women are more susceptible; 50% in lower leg; treatment: rest 6-8wks




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Stage 1 of Bone Healing

Ans: Hematoma formation within 24-72h after injury--hematoma formed at
fracture site



Stage 2 of Bone Healing

Ans: Occurs in 3d-2wks when granulation tissue begins to invade hematoma;
stimulating formation of fibrocartilage



Stage 3 of Bone Healing

Ans: Usually occurs within 2-6wks as a result of vascular & cellular
proliferation; fracture site is surrounded by vascular tissue known as a callus
that begins in the non-boney union



Stage 4 of Bone Healing

Ans: Usually takes 3-6 months; results in gradual reabsorption of the callus
with transformation into bone



Stage 5 of Bone Healing

Ans: May start as early as 6wks after fracture and can continue up to 1yr;
consists of bone consolidation & remodeling




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Acute Compartment Syndrome

Ans: Serious condition in which increased pressure within one or more
compartments causes massive compromise of circulation to the area; prevent
pressure buildup of blood or fluid accumulation; patho: sometimes referred to
ischemia-edema cycle; 6 Ps; begins in 6-8h after injury or up to 2d after



6 Ps of Acute Compartment Syndrome

Ans: pain, pressure, paralysis, paresthesia, pallor, pulselessness



Acute Compartment Syndrome Emergency

Ans: EMERGENCY SITUATION; within 4-6h after onset, neurovascular & muscle
damage are irreversible; limb may become useless in 24-48h;



Acute Compartment Syndrome Emergency Care

Ans: monitor pressures; fasciotomy may be performed to relieve pressure;
pack & dress wound after fasciotomy; nursing intervention: loosen dressing
immediately, if patient has a cast-know who can cut it off; notify MD ASAP



Potential Results of Acute Compartment Syndrome




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Ans: Infection; motor weakness; Volkmann's contractures (involve muscles of
forearm); myoglobinuric renal failure/rhabdomyolysis; Crush syndrome



Rhabdomyolysis

Ans: body breaks down muscle and excretes it through kidneys; may cause
kidney failure; give kayexelate PO or enema to decrease K



Crush Syndrome

Ans: Occurs from external crush injury that compresses 1+ compartments in
leg/arm/pelvis; potentially life-threatening due to hemorrhage & edema after
severe fracture



Crush Syndrome Causes

Ans: Twisting type injuries; natural disasters; work-related injury; drug or
alcohol overdose (could compress limb for prolonged period); older adults who
fall & can't get up



Crush Syndrome Tx

Ans: flood with IV fluids before removing object that is crushing limb; prevents
bleeding out & potentially saves limb & life




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