Orthopedic Nursing Care Exam
Complete Solutions
What is the most commonly reported injuries? - ANS-Contusions, Strains, and Sprains.
Contusion - ANS-Blunt force-bleeding into soft tissue, but skin remains intact. (Swelling,
discoloration of skin) Least serious
Strain - ANS-Stretching injury to a muscle or a muscle-tendon unit. Caused by
mechanical overloading. (Pain, limited motion, muscle spasms/weakness, swelling.)
Most common: lower abck and Hamstring muscle
Sprain - ANS-Stretch/tear of ligaments surrounding joint. (Loss of the ability to move or
use the joint, feeling a "pop" or tear, discoloration, pain, rapid swelling.) Most common:
ankles and knees
RICE - ANS-Rest Ice Compression Elevation 24-48hrs do RICE.
Joint dislocation - ANS-Trauma or illness forces ends of the bones from normal position.
(Pain, deformity, limited motion, shorter limb) Care: Reduction by manual traction or
surgery immobilization, hip dislocation requires immediate reduction to prevent
complications to prevent necrosis.
Subluxation - ANS-partial dislocation is which the bones of the joint remain in partial
contact
Necrosis - ANS-Death of bone tissue
Electrical Bone Stimulation - ANS-Used to treat fractures that aren't healing
appropriately, increases migration of osteoblasts and osteoclasts to fracture
site.Application of an electrical current
What to do for fracture of the skull? - ANS-Assess patient for neurologic changes,
document LOC, depressed skull fracture can cause neurologic damage.
Fracture Care - ANS-Emergency Care: Immobilize the fracture, maintain tissue
perfusion, prevent infection. Medications: Analgesics, NSAIDs,
antibiotics,anticoagulants, stool softeners, antacids. Surgery: External fixation device,
ORIF
, Fracture of the Face - ANS-Manifestations: Hematoma, pain, edema, bony deformity.
Focus on airway, assess neurologic, body image disturbance, assess pain
Fracture of the Spine - ANS-Cervical, lumbar, thoracic, or sacral...damage to spinal
cord. MOST SEVERE, can result in ischemia and cause permanent paralysis.
Fracture of the Clavicle - ANS-Usually midclavicular, can damage subclavian vessels or
lung. Seen most common with falls
Fracture of Humerus - ANS-Complications: nerve and ligament damage, frozen or stiff
joints, and malunion--fractured fragments are not in good position... Fractures of the
proximal humerus are more common in older adults.
Fracture of the Elbow - ANS-Usually distal humerus, common complications: nerve or
artery damage, hemiartrosis, Volkmann's contracture (claw deformity of hand and
fingers). Fall or direct blow is main report.
Fracture of the radius and/or ulna - ANS-Complication: compartment syndrome, delayed
healing, decreased wrist and finger movement, infection. Care: alleviate pain,
immobilization, education. ***Tell MD if changes in sensation
Wrist Fractures - ANS-Colle's Fracture: the distal radius fractures after a fall onto an
outstretched hand. Patient presents with bony deformity, pain, numbness, weakness,
decreased ROM of fingers.
Hand Fractures - ANS-Usually metacarpals and phalanges (Pain, edema, decreased
ROM) Complications: compartment syndrome, nerve damage, ligament damage,
delayed union.
Fracture of the Ribs - ANS-Blunt chest trauma, Can damage the spleen, liver,
subclavian artery, or vein. Flail chest; Complications: pulmonary contusion,
pnuemothorax and or hemothorax, pneumonia, intra-abdominal bleeding
Flail Chest - ANS-results from the fracture of two or more adjacent ribs in two or more
places and the formation of a free-floating segment that moves in the opposite direction
of the rib cage.Care: coughing, deep breathing, and splinting.
Fracture of the Pelvis - ANS-Caused by trauma, patient presents with back or hip pain.
Complications: hemorrhage, damage to pelvic and extra-pelvic organs. Care: Tx
discomfort, maintaining immobilization, and identify potential complications.
Fracture of the Shaft of the femur - ANS-Edema, deformity, pain in the thigh, inability to
move hip or knee. Complications: hypovolemia, fat embolism, hip and/or knee
dislocation, muscle atrophy, ligament damage. Provide pain meds, provide reassurance
and decreasing anxiety, assist with exercises of the lower legs, feet, and toes.
Complete Solutions
What is the most commonly reported injuries? - ANS-Contusions, Strains, and Sprains.
Contusion - ANS-Blunt force-bleeding into soft tissue, but skin remains intact. (Swelling,
discoloration of skin) Least serious
Strain - ANS-Stretching injury to a muscle or a muscle-tendon unit. Caused by
mechanical overloading. (Pain, limited motion, muscle spasms/weakness, swelling.)
Most common: lower abck and Hamstring muscle
Sprain - ANS-Stretch/tear of ligaments surrounding joint. (Loss of the ability to move or
use the joint, feeling a "pop" or tear, discoloration, pain, rapid swelling.) Most common:
ankles and knees
RICE - ANS-Rest Ice Compression Elevation 24-48hrs do RICE.
Joint dislocation - ANS-Trauma or illness forces ends of the bones from normal position.
(Pain, deformity, limited motion, shorter limb) Care: Reduction by manual traction or
surgery immobilization, hip dislocation requires immediate reduction to prevent
complications to prevent necrosis.
Subluxation - ANS-partial dislocation is which the bones of the joint remain in partial
contact
Necrosis - ANS-Death of bone tissue
Electrical Bone Stimulation - ANS-Used to treat fractures that aren't healing
appropriately, increases migration of osteoblasts and osteoclasts to fracture
site.Application of an electrical current
What to do for fracture of the skull? - ANS-Assess patient for neurologic changes,
document LOC, depressed skull fracture can cause neurologic damage.
Fracture Care - ANS-Emergency Care: Immobilize the fracture, maintain tissue
perfusion, prevent infection. Medications: Analgesics, NSAIDs,
antibiotics,anticoagulants, stool softeners, antacids. Surgery: External fixation device,
ORIF
, Fracture of the Face - ANS-Manifestations: Hematoma, pain, edema, bony deformity.
Focus on airway, assess neurologic, body image disturbance, assess pain
Fracture of the Spine - ANS-Cervical, lumbar, thoracic, or sacral...damage to spinal
cord. MOST SEVERE, can result in ischemia and cause permanent paralysis.
Fracture of the Clavicle - ANS-Usually midclavicular, can damage subclavian vessels or
lung. Seen most common with falls
Fracture of Humerus - ANS-Complications: nerve and ligament damage, frozen or stiff
joints, and malunion--fractured fragments are not in good position... Fractures of the
proximal humerus are more common in older adults.
Fracture of the Elbow - ANS-Usually distal humerus, common complications: nerve or
artery damage, hemiartrosis, Volkmann's contracture (claw deformity of hand and
fingers). Fall or direct blow is main report.
Fracture of the radius and/or ulna - ANS-Complication: compartment syndrome, delayed
healing, decreased wrist and finger movement, infection. Care: alleviate pain,
immobilization, education. ***Tell MD if changes in sensation
Wrist Fractures - ANS-Colle's Fracture: the distal radius fractures after a fall onto an
outstretched hand. Patient presents with bony deformity, pain, numbness, weakness,
decreased ROM of fingers.
Hand Fractures - ANS-Usually metacarpals and phalanges (Pain, edema, decreased
ROM) Complications: compartment syndrome, nerve damage, ligament damage,
delayed union.
Fracture of the Ribs - ANS-Blunt chest trauma, Can damage the spleen, liver,
subclavian artery, or vein. Flail chest; Complications: pulmonary contusion,
pnuemothorax and or hemothorax, pneumonia, intra-abdominal bleeding
Flail Chest - ANS-results from the fracture of two or more adjacent ribs in two or more
places and the formation of a free-floating segment that moves in the opposite direction
of the rib cage.Care: coughing, deep breathing, and splinting.
Fracture of the Pelvis - ANS-Caused by trauma, patient presents with back or hip pain.
Complications: hemorrhage, damage to pelvic and extra-pelvic organs. Care: Tx
discomfort, maintaining immobilization, and identify potential complications.
Fracture of the Shaft of the femur - ANS-Edema, deformity, pain in the thigh, inability to
move hip or knee. Complications: hypovolemia, fat embolism, hip and/or knee
dislocation, muscle atrophy, ligament damage. Provide pain meds, provide reassurance
and decreasing anxiety, assist with exercises of the lower legs, feet, and toes.
