NU-155, Galen San Antonio, Final Exam, Harwell

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What are the s/s of a bone fracture?
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Terms in this set (71)
What are the s/s of a bone fracture?
Pain, edema, crepitus, deformity, feel crepitus (grinding of 2 bone fragments), shortened extremity, may see bone in an open fx, muscle spasms (seen or felt)
What are the treatments for a bone fracture?
-closed reduction- bone manipulated to alignment
-open reduction- surgical alignment
-stabilization- internal/external fixation, casts, splints
-traction
What are the complications of a bone fracture?
-healing impeded by improper alignment and inadequate mobilization
-infection with open reduction
What is external fixation for a fracture and why is it necessary?
-system of external pins or apparatus to hold the fractured area stable

-massive open fractures w/ extensive soft tissue damage
-infected fractures that don't heal properly
-multiple trauma (burns, chest or head injury)
What are the nursing assessments for skin/skeletal traction?
-assess to see that they are in correct position and that the weights are hanging freely
-assess pt's body position for proper alignment
What is the nursing care needed for strains/sprains?
-RICE
-NSAID's to manage swelling
-check for circulation/sensation below compression
What is a splint?
flexible or rigid device that is used to protect and maintain the position of an injured extremity
What patient teaching is needed for cast care?
-explain the procedure
-do NOT scratch under the cast
-cast must be protected from moisture
What is compartment syndrome?
External or internal pressure that restricts circulation in one or more muscle compartments of the extremities
What are the s/s of compartment syndrome?
Pallor, Pain, No Pulse, Paresthesia, Paresis (slight/partial paralysis)
What is the treatment for compartment syndrome?-immediate recognition -remove cast/dressings (if present) -surgical fasciotomyWhat is key to preventing compartment syndrome?elevation!!!What is carpal tunnel syndrome?compression of the median nerve, usually caused by repetitive movements of hands and wristsWhat are the s/s of carpal tunnel syndrome?-pain -numbness -tingling of the hand, particularly at night -repetitive movements of hands and wristsWhat is the treatment for carpal tunnel syndrome?-rest/splint -changing the angle of the wrist during repetitive motions -steroid injections -surgeryWhat is a TIA?Transient Ischemic Attack. Mini-stroke. Temporary loss of blood supply to the brainWhat are the risk factors for TIA/CVA?-smoking -hypertension -hyperlipidemiaWhat are the 2 types of CVA?-hemorrhagic- caused by a rupture of a cerebral artery -ischemic- caused by an occlusion of a cerebral artery (85% of strokes)What are the s/s of TIA/CVA?-motor function deficits -sensory deficits -language disorders -memory loss, emotional lability, impaired judgment -bladder/bowel incontinenceWhat are the interventions/assessments required prior to administering PO intake after a CVA?-gag reflex -swallow studyWhat are the complications of CVA (stroke)?-expansion of stroke -hemorrhage -seizures -herniation of brain if intracranial pressure cannot be controlledWhat are the nursing assessments needed during a seizure?-note the beginning and end time of seizure -note what pt was doing prior to seizure -note where the seizure began in the body -note the eye movement -note which side the head turns towards -note any noises that pt makes -note any evidence of repetitive movements -note incontinence of bladder/bowel -presence of apnea/cyanosis -changes in skin color or diaphoresisWhat is the patient care for lumbar puncture, before/after?Before- explain the procedure, obtain consent forms, promote comfort, establish baseline VS After- pt must lay flat for 4-6 hours, monitor VS, neuro status, I&O, puncture sight for CSF leakageWhat is decorticate posturing?Abnormal flexion: Hands pulled to chest and hyper-extended. Internal rotation and adduction of the arms with flexion of the elbows, wrists & fingers. "flexor - toward the cord"What is decerebrate posturing?Extensor response: Hands pushed to sides and body hyper-extended. Arms are stiffly extended, adducted & hyperpronated. Hyperextension of the legs with plantar flexion of the feet. (May indicate more serious damage.) "extensor = All E's"What are the s/s of viral meningitis?headache, fever, photophobia, stiff neckWhat are the s/s of bacterial meningitis?-sudden onset high fever -Severe headache -Vomiting -stiff neck -photophobia -brudzinski's sign -kernig's signWhat are the s/s of chlamydia?-most people have no symptoms -Males- penile discharge, painful/frequent urination -Females- vaginal discharge, painful urination, nausea, fever, painful intercourse, bleeding between menstrual periods, lower abdominal painWhat are the complications of chlamydia?-sterility -ectopic pregnancy -higher chance to be infected with HIV if exposedWhat is the treatment for chlamydia?-single dose of azithromycinWhat are the s/s of gonorrhea?-many people have no symptoms -males- whitish/greenish discharge from penis, burning with urination -females- vaginal discharge, redness/swelling of external genitalia, burning with urination, abdominal pain, abnormal menstruation -Rectal infection- discharge, itching, soreness, bleeding, painful bowel movementsWhat are the complications of gonorrhea?-sterility in both men and women -infections may lead to damage to heart tissue and joints -males may develop epididymitis or prostatitis -females may develop PIDWhat is the treatment for gonorrhea?-single dose IM ceftriaxone, oral cefixime, ciprofloxacin, ofloxacinWhat are the s/s of HPV?-pink/red, cauiflower-like growths on/around penis, urethra or scrotum in men and around vagina, cervix, urethra, perineum in women -oral, anal, pharyngeal/laryngeal lesions may also occur in both gendersWhat is the treatment of HPV?-no cure -application of topical medications for temp symptomatic relief -cryotherapy, surgical removal, injection of interferon into the lesionsWhat are the s/s of each stage of syphilis?Primary stage- reddish papule where organism entered the body, usually genitals/anus/mouth, lymph nodes are enlarged but not tender, symptoms disappear in 3-8 weeks and pt assumes they are cured but it has moved to the blood -Secondary stage- rash on extremities/chest/back/palms/soles, pustules containing highly contagious material, fever/sore throat/generalized aching, pt contagious during first and second stage -Latent stage- no s/s, not contagious -Tertiary stage- usually 1-20 years after contact-- arthritis, numbness of extremities, ulcers of skin and internal organs, pain due to damage to the heart/blood vessels, spinal cord or brainWhat are the complications of syphilis?blindness, mental illness, paralysis, heart disease, easier to contract HIVWhat is the medical treatment for syphilis?parenteral penicillin GWhat is candidiasis?fungal yeast infectionWhat are the s/s of candidiasis?thick, clumping yellow-white discharge, irritating/itchyWhat are the complications of candidiasis?if untreated it can lead to a metastatic foci infection in the eyes, vertebral column, liver, spleen, CNS, kidneysWhat is endometriosis?endometrial cells deposited in the pelvic cavity implant on structures within the cavityWhat are the complications of endometriosis?infertility (most common cause among menstruating women >30 yrs of age)What is the treatment for endometriosis?hormone therapy, surgeryWhat is Toxic Shock Syndrome (TSS)?caused by strains of Staphylococcus Aureus that produce toxins -> shock, tissue damage and coagulation issuesWhat are the symptoms of toxic shock syndrome?sudden onset- high fever, HTN, tachycardia, flu like symptoms, rash, peeling skin on palms/solesWhat is epididymitis?inflammation of the epididymisWhat are the s/s of epidiymitis?painful scrotal edema, nausea, vomiting, chills, feverWhat are the treatments of epidiymitis?treat with bed rest, ice packs, sits baths, analgesics, antibiotics, antiinflammatory drugs, and scrotal support/elevationWhat is testicular torsion?occurs unilaterally when testicle is mobile and the spermatic cord twists, cutting off blood supply to testicleWhat are the s/s of testicular torsion?intense pain, often accompanied by nausea and vomitingWhat is benign prostatic hyperplasia (BPH)?enlargement of the prostate glandWhat are the s/s of BPH?obstructive symptoms: decreasing size and force of the urinary stream, urine retention, and postpaid dribble.What is the medical treatment for BPH?Finasteride and dutasteride or tamsulosin, doxazosin and terazosinWhat are the invasive treatments for BPH?prostatectomy, microwave thermotherapy, transurethral needle ablation, stent, balloon dilationWhat are the complications of BPH?UTI, incontinence, hemorrhage, urinary leakage, inflammation of pubic bone, erectile dysfunctionWhat is the proper nursing care after TURP?compare VS to preop, monitor I&O, CBI, record urine color and any clots, IV Cath flow, monitor painWhat are cataracts?opacity or cloudiness of the lens; on visual inspection, the lens appears gray or milkyWhat is the treatment for cataracts?surgery is the only treatmentWhat is glaucoma?atrophy of the optic nerve, increased intraocular pressure and loss of peripheral vision (tunnel vision), caused by diabetic retinopathy, ocular trauma and corticosteroids useWhat are the s/s of glaucoma?severe pain in and around the eye, accompanied by halos around lights, blurred vision and loss of peripheral visionWhat is the treatment for glaucoma?eye drops and medications that decrease IOP and surgery to open aqueous humor drainage ductsWhat is retinal detachment?Separation of sensory and pigment layers of the retinaWhat are the complications of retinal detachment?complete vision loss and blindnessWhat are the s/s of retinal detachment?sudden appearance of flashing lights especially in peripheral vision, visual disturbances, blindness in the affected eye, described as a curtain or veil falling over a portion of the visual fieldWhat is wet macular degeneration and dry macular degeneration?dry- gradual blockage in the retinal capillaries leads to death of photoreceptors in the macula Wet- abnormal vessels develop in or near the macula into the sub-retinal space affecting central visionWhat are the s/s of macular degeneration?Early- colors are less vivid, blurred vision Progressive- sizes, shapes may seem distorted and straight lines may appear wavy, gradually central vision deteriorates and a dark spot appears in the center of visual fieldWhat is the treatment of macular degeneration?no curative treatment, trial medications are being researched, various laser treatments may help with wet macular degenerationWhat is the patient teaching for Meniere's disease?avoid nicotine, caffeine and to eat a low sodium diet to prevent vasoconstriction and can worsen symptomsWhat is the patient teaching for glaucoma treatment?therapeutic regimen MUST be followed to prevent blindness or other complicationsWhat is the post op care after cataract surgery?-semi fowlers to prevent pressure on the implant -avoid activities that increase IOP -slight discharge in the morning, some redness, scratchy feeling for a few days -pt is at increased risk of retinal detachment -notify PCP if new floaters in vision, sharp pain or increased redness occurs