ACCURACY IS GUARANTEED
Nurs 432 Ch. 54 Questions with Detailed Verified
Answers for Accuracy
Fracture Classification
✓✓ Extent of Break (complete/incomplete); Extent of
Associated Soft Tissue Damage (open, closed, grade 1, 2, 3);
Pathologic (spontaneous); Fatigue/Stress; Compression
Fracture
✓✓ Break or disruption in the continuity of a bone
Fracture Grades
✓✓ Grade 1: least severe
Grade 2: open fracture with skin/muscle contusion
Grade 3: muscle, skin, nerve tissue & blood
Stress Fracture
✓✓ 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
Stage 1 of Bone Healing
✓✓ Hematoma formation within 24-72h after injury--
hematoma formed at fracture site
Stage 2 of Bone Healing
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✓✓ Occurs in 3d-2wks when granulation tissue begins to
invade hematoma; stimulating formation of fibrocartilage
Stage 3 of Bone Healing
✓✓ 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
✓✓ Usually takes 3-6 months; results in gradual reabsorption
of the callus with transformation into bone
Stage 5 of Bone Healing
✓✓ May start as early as 6wks after fracture and can continue
up to 1yr; consists of bone consolidation & remodeling
Acute Compartment Syndrome
✓✓ 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
✓✓ pain, pressure, paralysis, paresthesia, pallor, pulselessness
Acute Compartment Syndrome Emergency
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✓✓ EMERGENCY SITUATION; within 4-6h after onset,
neurovascular & muscle damage are irreversible; limb may
become useless in 24-48h;
Acute Compartment Syndrome Emergency Care
✓✓ 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
✓✓ Infection; motor weakness; Volkmann's contractures
(involve muscles of forearm); myoglobinuric renal
failure/rhabdomyolysis; Crush syndrome
Rhabdomyolysis
✓✓ body breaks down muscle and excretes it through kidneys;
may cause kidney failure; give kayexelate PO or enema to
decrease K
Crush Syndrome
✓✓ 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
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✓✓ 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
✓✓ flood with IV fluids before removing object that is crushing
limb; prevents bleeding out & potentially saves limb & life
If lower leg crush injury & pt complains of numbness/tingling,
what is your 1st intervention?
✓✓ Assess pedal pulse.
Complications of Fractures
✓✓ Shock due to blood loss; Fat embolism syndrome; Venous
thromboembolism; Infection; Chronic complications: ischemic
necrosis, delayed union
Fat Embolism Syndrome
✓✓ serious complication of fracture; fat globules released from
yellow bone marrow into bloodstream; S/S: confusion,
tachypnea, resless; Intevention: administer O2 via nasal
cannula
Musculoskeletal Assessment
Nurs 432 Ch. 54 Questions with Detailed Verified
Answers for Accuracy
Fracture Classification
✓✓ Extent of Break (complete/incomplete); Extent of
Associated Soft Tissue Damage (open, closed, grade 1, 2, 3);
Pathologic (spontaneous); Fatigue/Stress; Compression
Fracture
✓✓ Break or disruption in the continuity of a bone
Fracture Grades
✓✓ Grade 1: least severe
Grade 2: open fracture with skin/muscle contusion
Grade 3: muscle, skin, nerve tissue & blood
Stress Fracture
✓✓ 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
Stage 1 of Bone Healing
✓✓ Hematoma formation within 24-72h after injury--
hematoma formed at fracture site
Stage 2 of Bone Healing
, ACCURACY IS GUARANTEED
✓✓ Occurs in 3d-2wks when granulation tissue begins to
invade hematoma; stimulating formation of fibrocartilage
Stage 3 of Bone Healing
✓✓ 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
✓✓ Usually takes 3-6 months; results in gradual reabsorption
of the callus with transformation into bone
Stage 5 of Bone Healing
✓✓ May start as early as 6wks after fracture and can continue
up to 1yr; consists of bone consolidation & remodeling
Acute Compartment Syndrome
✓✓ 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
✓✓ pain, pressure, paralysis, paresthesia, pallor, pulselessness
Acute Compartment Syndrome Emergency
, ACCURACY IS GUARANTEED
✓✓ EMERGENCY SITUATION; within 4-6h after onset,
neurovascular & muscle damage are irreversible; limb may
become useless in 24-48h;
Acute Compartment Syndrome Emergency Care
✓✓ 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
✓✓ Infection; motor weakness; Volkmann's contractures
(involve muscles of forearm); myoglobinuric renal
failure/rhabdomyolysis; Crush syndrome
Rhabdomyolysis
✓✓ body breaks down muscle and excretes it through kidneys;
may cause kidney failure; give kayexelate PO or enema to
decrease K
Crush Syndrome
✓✓ 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
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✓✓ 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
✓✓ flood with IV fluids before removing object that is crushing
limb; prevents bleeding out & potentially saves limb & life
If lower leg crush injury & pt complains of numbness/tingling,
what is your 1st intervention?
✓✓ Assess pedal pulse.
Complications of Fractures
✓✓ Shock due to blood loss; Fat embolism syndrome; Venous
thromboembolism; Infection; Chronic complications: ischemic
necrosis, delayed union
Fat Embolism Syndrome
✓✓ serious complication of fracture; fat globules released from
yellow bone marrow into bloodstream; S/S: confusion,
tachypnea, resless; Intevention: administer O2 via nasal
cannula
Musculoskeletal Assessment
