NSG 255 ORTHOPEDICS EVALUATION QUESTIONS WITH
SOLUTIONS 2025 GRADED A+
✔✔Fat embolism - ✔✔s/s: shortness of breath, pain, decrease PaO2, petechiae
- raise the head of bed, notify Doctor
✔✔Traction - ✔✔a pull to the arm or leg muscles to bring a bone back into place when it
is dislocated or fractured
✔✔Skin traction (Bucks) - ✔✔a boot attached to 5 - 10 pound weight used to relieve
muscle spasm pain from a hip or proximal femur fracture.
✔✔advantages to skin traction - ✔✔-easy to apply
-use for short periods
-relieves muscle spasms post fracture
✔✔disadvantages to skin traction - ✔✔Weight limit is less than 10 pounds
✔✔skin traction care - ✔✔-remove boots/splints each shift to inspect
-assess for tenderness/redness
-check under bony prominences
-be sure no pressure areas noted
-check CSM
-skin intact?
- back care
✔✔skeletal traction - ✔✔-use long term
-Weight ranges 5 to 45 pounds
-has muscle spasms decreased so does weights
-involves pins and wires directly through the bone
-universally is continuous unless ordered for intermittent
-Pin care!!
✔✔skeletal traction care - ✔✔1. external fixation device
2. free hanging weight can be applied via external device
3. pin site care - cleansing skin insertion sites using sterile gauze with NS
4. observe for S&S of infection - serous/serosanguineous drainage is normal (purulent =
infection & report to HCP)
5. prevent friction
6. when moving up in bed, use a second person to support the weight.
7. never elevate the head of bed above 45°
✔✔traction pneumonic - ✔✔T- Temperature (extremity infection)
R- Ropes hang freely
A- Alignment
, C- Circulation check (5 Ps)
T- Type and Location of fracture
I- Increased fluid intake
O- Overhead Trapeze
N- No weights on bed/floor
✔✔external fixation - ✔✔a fracture treatment procedure in which pins are placed
through the soft tissues and bone so that an external applicance can be used to hold
the pieces of bone firmly in place during healing
-can be chosen if surgeries to life-threatening, or if loss of bone
✔✔internal fixation - ✔✔involves surgery, applies plates, screws, and pins to hold
together, often combined with open reduction
-you don't have to immobilize joints to keep fracture stable
✔✔osteoporosis - ✔✔involves a decrease of or loss of bone mass, leading to skeletal
fragility and increase fractures
-chronic and progressive
✔✔primary osteoporosis - ✔✔occurs due to loss of estrogen and its protective effects
on bone
-post menopausal women
✔✔secondary osteoporosis - ✔✔other causes like medication's, tobacco, steroids,
anticonvulsants, PPIs, which interfere with calcium and bone metabolism
-Comorbidities that have medication's that interfere with bone strength
✔✔senile osteoporosis - ✔✔Called Type II
- loss of bone mass due to aging
-lots of osteoclasts that destroy bone which don't get replaced with blasts
✔✔osteoporosis can lead to - ✔✔fractures, loss of teeth, kyphosis
✔✔what is osteoporosis sometimes called - ✔✔A silent thief because it has little to no
symptoms and is seen on bone density measurements, or x-ray
✔✔when does bone mass peak and then reverse? - ✔✔bone mass peaks at 20 and
maintains itself until 35 then reverses as bone reabsorption is faster than bone growth
✔✔Risk factors for osteoporosis - ✔✔-Age
-Small frames
-Family history
-post menopausal
-decrease calcium intake
-lactose intolerant
SOLUTIONS 2025 GRADED A+
✔✔Fat embolism - ✔✔s/s: shortness of breath, pain, decrease PaO2, petechiae
- raise the head of bed, notify Doctor
✔✔Traction - ✔✔a pull to the arm or leg muscles to bring a bone back into place when it
is dislocated or fractured
✔✔Skin traction (Bucks) - ✔✔a boot attached to 5 - 10 pound weight used to relieve
muscle spasm pain from a hip or proximal femur fracture.
✔✔advantages to skin traction - ✔✔-easy to apply
-use for short periods
-relieves muscle spasms post fracture
✔✔disadvantages to skin traction - ✔✔Weight limit is less than 10 pounds
✔✔skin traction care - ✔✔-remove boots/splints each shift to inspect
-assess for tenderness/redness
-check under bony prominences
-be sure no pressure areas noted
-check CSM
-skin intact?
- back care
✔✔skeletal traction - ✔✔-use long term
-Weight ranges 5 to 45 pounds
-has muscle spasms decreased so does weights
-involves pins and wires directly through the bone
-universally is continuous unless ordered for intermittent
-Pin care!!
✔✔skeletal traction care - ✔✔1. external fixation device
2. free hanging weight can be applied via external device
3. pin site care - cleansing skin insertion sites using sterile gauze with NS
4. observe for S&S of infection - serous/serosanguineous drainage is normal (purulent =
infection & report to HCP)
5. prevent friction
6. when moving up in bed, use a second person to support the weight.
7. never elevate the head of bed above 45°
✔✔traction pneumonic - ✔✔T- Temperature (extremity infection)
R- Ropes hang freely
A- Alignment
, C- Circulation check (5 Ps)
T- Type and Location of fracture
I- Increased fluid intake
O- Overhead Trapeze
N- No weights on bed/floor
✔✔external fixation - ✔✔a fracture treatment procedure in which pins are placed
through the soft tissues and bone so that an external applicance can be used to hold
the pieces of bone firmly in place during healing
-can be chosen if surgeries to life-threatening, or if loss of bone
✔✔internal fixation - ✔✔involves surgery, applies plates, screws, and pins to hold
together, often combined with open reduction
-you don't have to immobilize joints to keep fracture stable
✔✔osteoporosis - ✔✔involves a decrease of or loss of bone mass, leading to skeletal
fragility and increase fractures
-chronic and progressive
✔✔primary osteoporosis - ✔✔occurs due to loss of estrogen and its protective effects
on bone
-post menopausal women
✔✔secondary osteoporosis - ✔✔other causes like medication's, tobacco, steroids,
anticonvulsants, PPIs, which interfere with calcium and bone metabolism
-Comorbidities that have medication's that interfere with bone strength
✔✔senile osteoporosis - ✔✔Called Type II
- loss of bone mass due to aging
-lots of osteoclasts that destroy bone which don't get replaced with blasts
✔✔osteoporosis can lead to - ✔✔fractures, loss of teeth, kyphosis
✔✔what is osteoporosis sometimes called - ✔✔A silent thief because it has little to no
symptoms and is seen on bone density measurements, or x-ray
✔✔when does bone mass peak and then reverse? - ✔✔bone mass peaks at 20 and
maintains itself until 35 then reverses as bone reabsorption is faster than bone growth
✔✔Risk factors for osteoporosis - ✔✔-Age
-Small frames
-Family history
-post menopausal
-decrease calcium intake
-lactose intolerant
