Orthopedic Nursing Exam 114 Questions with Verified Answers,100% CORRECT

Orthopedic Nursing Exam 114 Questions with Verified Answers Closed reduction - CORRECT ANSWER is a procedure to set (reduce) a broken bone without cutting the skin open. The broken bone is put back in place, which allows it to grow back together. It works best when it is done as soon as possible after the bone breaks. traction - CORRECT ANSWER set of mechanisms for straightening broken bones or relieving pressure on the spine and skeletal system. traction-countertraction - CORRECT ANSWER The resistance, or back-pull, made to traction or pulling on a limb continuous-traction - CORRECT ANSWER is applied for up to several hours at a time. This long duration requires that only small amounts of weight be used. intermittent traction (ITT) - CORRECT ANSWER a method in which the traction force and time are changed to make the therapy more effective skin traction - CORRECT ANSWER applying splints, bandages, or adhesive tapes to the skin directly below the fracture, weights are fastened to it. buck's traction - CORRECT ANSWER a temporary type of lightweight traction applied to the distal end of a fractured lower limb; the foot of the bed is raised so that the body makes counterextension; often used to reduce muscle spasm. cervical traction - CORRECT ANSWER is a modality that is applied to your neck to gently stretch it and separate the disc and joint surfaces in your cervical spine. pelvic traction - CORRECT ANSWER the pelvic traction belt is wrapped around the pelvic portion with the traction straps hanging below on the bottom side. the rings on the traction straps are hooked a pelvic traction spreader bar pelvic. ... the age weight and the ailment of the patient usually one-eighth of the body weight is used traction skeletal traction/bone traction - CORRECT ANSWER Skeletal traction involves placing a pin, wire, or screw in the fractured bone. After one of these devices has been inserted, weights are attached C A R O L - CORRECT ANSWER C-continuous, A-alignment, R-resistance, O-opposing, L-line crutchfield tongs - CORRECT ANSWER A traction device whose pins are inserted into the skull to distract and/or immobilize the neck. CMS checks - CORRECT ANSWER circulation-motion-sensation halo traction - CORRECT ANSWER The halo traction equipment is made up of three pieces: a ring around your head, a special vest. Weights attached to the halo at head end of bed over a pulley system. open reduction - CORRECT ANSWER incision into the skin, down to the bone to expose the bone. a device is attached to the bone to stabilize it. skeletal traction external fixation device - CORRECT ANSWER device may be used to keep fractured bones stabilized and in alignment. The device can be adjusted externally to ensure the bones remain in an optimal position during the healing process. (KEEP CLEAN!) pin care - CORRECT ANSWER use soap & water..wash from pin outward (away from pin entrance) O R I F - CORRECT ANSWER Open Reduction Internal Fixation (ORIF) is a type of surgery used to fix broken bones. ...an internal fixation device is placed on the bone. Percutaneous hip pinning complications - CORRECT ANSWER DVT/PE, UTI, urinary retention, mental status changes, wound infection, immobility complications, delayed/nonunion Diagnostic Tests - CORRECT ANSWER can show growth deformity, tumors, & fractures standard AP, X-ray - CORRECT ANSWER An X-ray picture in which the beams pass from front-to-back (anteroposterior). standard PA, X-ray - CORRECT ANSWER (posteroanterior) film in which the rays pass through the body from back-to-front. bone scan - CORRECT ANSWER uptake of a radioactive substance is measured in bone to see any area(s) of concern...called "hot spots" computed tomography (CT) - CORRECT ANSWER a diagnostic imaging test used to create detailed images of internal organs, bones, soft tissue and blood vessels. magnetic resonance imaging (MRI) - CORRECT ANSWER is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body in both health and disease. 2D/3D, with or w/out contrast arthroscopy - CORRECT ANSWER the visual examination of the internal structure of a joint DEXA scan - CORRECT ANSWER procedure that measures bone mineral density (BMD) to examine for osteoporosis strain - CORRECT ANSWER A condition resulting from damaging a muscle or tendon sprain - CORRECT ANSWER injury to a ligament Dislocation - CORRECT ANSWER displacement of a bone from its joint ECCHYMOSIS - CORRECT ANSWER bruise Stages of bone healing - CORRECT ANSWER 1) clot formation at fx site 2) fibroblasts & osteoblasts arrive 3) fibrocartilage callus forms 4) new bone forms 5) repair & bone remodeling until bone intact malunion fracture - CORRECT ANSWER when the two bony ends of the fracture fails to heal together correctly avascular necrosis - CORRECT ANSWER an area of bone tissue death caused by insufficient blood flow infection of the bone - CORRECT ANSWER osteomyelitis Fat embolism - CORRECT ANSWER Freely floating fat globule in the blood stream, which can obstruct blood circulation to vital organs (e.g., heart, brain). Usually caused by injury to subcutaneous tissue or a bone fracture that allows fat release. Compartment Syndrome - CORRECT ANSWER involves the compression of nerves and blood vessels due to swelling within the enclosed space created by the fascia that separates groups of muscles Acute Compartment Syndrome (ACS) - CORRECT ANSWER A serious condition in which increased pressure within a compartment compromises circulation to the area. Can be from internal or external source. • Blood or fluid accumulate in compartment • Causes: reduction of compartment size (i.e. cast too tight, bulky dressings), an increase in muscle compartment contents because of edema or hemorrhage i.e. crushing injuries • Forearm and leg- most often involved • Muscle damage is irreversible in 4-6 hours; nerve damage is irreversible in 12-24 hours. the main compartments in the lower leg are: - CORRECT ANSWER 1) anterior compartment 2) lateral compartment 3) deep posterior compartment 4) superficial posterior compartment the main compartments of the forearm are: - CORRECT ANSWER F= Superficial Flexor F= Deep Flexor E= Extensor (compartment syndrome) internal factors - CORRECT ANSWER fracture, bleeding, blunt trauma, vascular occlusion, burns, surgical positioning,snake bite, drug injections,IV/A-lines /IO infusion, (infant) (compartment syndrome) external factors - CORRECT ANSWER cast, tight bandage, lying on a limb Volkman's Ischemic Contracture - CORRECT ANSWER flexion deformity of the wrist and fingers secondary to vascular damage or forearm compartment syndrome (compartment syndrome) THE 7 P's - CORRECT ANSWER Pins & needles feeling Pain Puffiness (edema) Pallor or pink Polor (cold to touch) Pulselessness Paralysis CMS aka Neurovascular - CORRECT ANSWER Circulation=pulses/capfill Motion=ROM Sensation=feeling anything?? peroneal nerve sensation/motion - CORRECT ANSWER prick the web space between the great toe and second/have patient dorsiflex ankle and great toes at the metatarsal phalangeal joints tibial nerve sensation/motion - CORRECT ANSWER prick the medial & lateral surfaces of the sole of the foot/have patient planter flex ankles & toes radial nerve sensation/motion - CORRECT ANSWER prick the web space between the thumb & index finger/have patient hyperextend thumb then wrist & hyperextend the four fingers at the MCP joints ulnar nerve sensation/motion - CORRECT ANSWER prick the distal fat pad of the small finger/have patient abduct all fingers Intra-Compartment Pressure Monitoring - CORRECT ANSWER -normal pressure is roughly 0-10mmHg of mercury -concern comes when the pressure is above 30mmHG After a fasciotomy... - CORRECT ANSWER -exposed muscle is typically covered with a bulky damp saline gauze dressing which is changed q 6-8h using sterile technique -as swelling subsides the wound will be closed either by secondary intention or tertiary intention (surgical closure) Why do you not elevate with compartment syndrome? - CORRECT ANSWER place the affected limb or limbs at the level of the heart. Elevation is contraindicated because it decreases arterial flow and narrows the arterial-venous pressure gradient What is racemic epinephrine? - CORRECT ANSWER acts on adrenergic receptor sites causing reduction in airway inflammation and edema. What is racemic epinephrine commonly used for? - CORRECT ANSWER Croup and when stridor is present. What is Iprtropium and what is is used to treat? - CORRECT ANSWER Anticholinergic used to treat asthma and COPD. What is Sameterol and what is it used for? - CORRECT ANSWER Long acting beta agonisht used to treat asthma and COPD. What is Theophylline and what is it used for? - CORRECT ANSWER Xanthine derivative and is used to treat apnea of prematurit and sometimes COPD or asthma. ORIF - CORRECT ANSWER utilizes open surgery to set the fracture followed by the use of plates, pins, and screws to hold the bones in place. total hip replacement - CORRECT ANSWER involves surgically removing both the femoral head and acetabular cartilage, and replacing them with an artificial femoral head and acetabular cup. anterior - CORRECT ANSWER This incision starts at the top of the pelvic bone (iliac crest) and extends down toward the top of the thigh Usually no or minimal muscles are cut posterior - CORRECT ANSWER A curved incision on the side of the hip, just behind the greater trochanter to the top of the femur Muscles are cut anterior - CORRECT ANSWER Shorter hospital stay Shorter recovery No hip precautions Posterior - CORRECT ANSWER Longer hospital stay Longer recovery Hip precautions ORIF - CORRECT ANSWER No abduction pillow needed WB as ordered No Hip Precautions Rapid mobility and ambulation as tolerated total hip replacement - CORRECT ANSWER Abduction pillow needed WB as ordered Full hip precautions minimally for 6 weeks Rapid mobility and ambulation as tolerated NWB - CORRECT ANSWER ◦0%-no pressure (injured leg off the floor) TTWB (toe touch) - CORRECT ANSWER 20%- Do not place any body weight on the leg. Imagine there is an egg under the foot that you are not to crush. PWB - CORRECT ANSWER ◦50%-The doctor will decide on the amount of weight. Often it is less than half your weight. FWB - CORRECT ANSWER ◦100%-Full body weight may be placed leg or arm total hip replacement - CORRECT ANSWER Can full weight bear Long Posterior incision Worry is dislocation ◦Must watch flexion and adduction screws - CORRECT ANSWER CANNOT full weight bear Small lateral incision Pillow under knee for comfort Displaced/Nondisplaced - CORRECT ANSWER Treated the same: ◦Hold fragments together ◦Let them heal on their own Cannot bear full weight ◦Screw can cut through bone ◦Usually 3 small incision ◦Pillow under the knee for comfort ◦Thigh may swell thigh after hip surgery calf after knee surgery - CORRECT ANSWER where is DVT most common after replacements Anticoagulants (heparin) Thrombolytics - CORRECT ANSWER treatment of DVT ◦-Anticoagulants ◦-Thrombolytics ◦ - Embolectomy ◦ - Placement of IVC filter - CORRECT ANSWER treatment of PE 5 - CORRECT ANSWER Range of motion highest score Patient - CORRECT ANSWER Who does the active ROM? Nurse - CORRECT ANSWER Who does the passive ROM? Fall resistance - CORRECT ANSWER 5 ROM Some resistance - CORRECT ANSWER 4 ROM No resistance - CORRECT ANSWER 3 ROM Weak - CORRECT ANSWER 2 ROM No - CORRECT ANSWER 1 ROM Isometric exercise - CORRECT ANSWER Active exercise through contraction Quadriceps Gluteal setting Kegels exercises - CORRECT ANSWER List of isometric exercises Hip level and angle of the elbow - CORRECT ANSWER Height of cane Hip level - CORRECT ANSWER Height of walker 3 point gait - CORRECT ANSWER What type of gait is used if 1 leg is amputated? If patient is with poor coordination - CORRECT ANSWER When do we use swhing through and to gait? Immobilization - CORRECT ANSWER Purpose of casting Expose to dry, no fan drying - CORRECT ANSWER How to dry cast? Circulation, motion, sensation - CORRECT ANSWER CMS acronym Bivalving - CORRECT ANSWER Cast is too tight Reduce spasm and pain Prevent deformities Immobilization - CORRECT ANSWER Purpose of traction - CORRECT ANSWER Examples of skin traction Buck traction - CORRECT ANSWER Immobilize leg in a fractured hip Balance skeletal traction - CORRECT ANSWER Immobilize the hips, fracture of the femur Foot plate - CORRECT ANSWER How to prevent foot drop in traction Sprain - CORRECT ANSWER stretch or tear of a ligament Ligament - CORRECT ANSWER Bone to bone Tendon - CORRECT ANSWER bone to muscle Strain - CORRECT ANSWER stretch or tear of a muscle or tendon Dislocation/Subluxation - CORRECT ANSWER partial dislocation or incomplete dislocation Carpal Tunnel - CORRECT ANSWER pressure on median nerve in wrist Rotator cuff - CORRECT ANSWER a group of tendons and muscles in shoulder Meniscus - CORRECT ANSWER cartilage that acts as a cushion in the knee joint Bursitis - CORRECT ANSWER Irritation and inflammation of the bursa (elbow pad) Bursa - CORRECT ANSWER fluid filled sac Contusion - CORRECT ANSWER results from direct blow causing capillary bleeding into subcutaneous layer Simple or closed fracture - CORRECT ANSWER no break in skin Compound or open fracture - CORRECT ANSWER fracture breaking skin Greenstick fracture - CORRECT ANSWER bend like fracture in children Stress fracture - CORRECT ANSWER a fracture caused by underlying diseases Gas Gangrene - CORRECT ANSWER necrosis with formation of gas bubbles and edema