Fractures

Question 1

Plastic Deformation (bend)

Answer 1

Bone is bent no more than 45 degrees w/out breakage

Question 2

Buckle (torus)

Answer 2

Compression of bone resulting in a bulge or raised area at fracture site

Question 3

Greenstick

Answer 3

Incomplete fracture of bone

Question 4

Transverse

Answer 4

Break is straight across bone

Question 5

Oblique

Answer 5

Break is diagonal across bone

Question 6

Spiral

Answer 6

Break spirals around bone
abuse

Question 7

Epiphyseal (growth plate)

Answer 7

Injury to the end of the long bone on growth plate

Question 8

Stress

Answer 8

Small fractures/cracks in bone due to repeated muscle contractions

Question 9

Complete

Answer 9

Bone fragments are separated

Question 10

Incomplete

Answer 10

Bone fragments are still attached

Question 11

Closed or Simple

Answer 11

The fracture occurs w/out a break in skin

Question 12

Open or Compound

Answer 12

Fracture occurs w/ an open wound & bone protruding

Question 13

Complicated Fracture

Answer 13

Fracture results in injury to other organs & tissues

Question 14

Comminuted

Answer 14

Fracture includes small fragments of bone tht lie in surrounding tissue

Question 15

Bone Healing & Remodeling

Answer 15

• Typically rapid healing in children
  > from neonatal to early childhood to later childhood to adolescence
• School-age: most broken bones
• Infants: uncommon to have broken bones, but heal quickly
  > collar bone most common from birth
• Most common in peds:
  > collar bone
  > forearm

Question 16

Fractures - Diagnostics

Answer 16

• Radiographs
  > x-ray
• Hx taking
• Suspicion of fracture in a young child who refuses to walk or bear weight

Question 17

Goals of Fracture Management

Answer 17

• Reduction & immobilization
• Restoring function
• Preventing deformity
  > at risk: malnutrition

Question 18

Fractures - Neurovascular Assessment

6

Answer 18

• Pain & point of tenderness
• Pallor
• Pulselessness
• Paresthesia: sensation distal to fracture site
• Paralysis: movement distal to fracture site
• Pressure

Question 19

Osteomyelitis

Answer 19

At risk for infection after broken bone
caused by staph

Question 20

Osteomyelitis - Manifestations

Answer 20

• Irritability
• Fever
• Tachycardia
• Edema
• Pain is constant but incrs w/ movement
• Not wanting to use affected extremity
• Site of infection tender, swollen, & warm

Question 21

Osteomyelitis - Nursing Actions

Answer 21

• Assist in diagnostic procedures
  > obtaining skin, blood, & bone cultures
• Assist w/ joint or bone biopsy
• Admin IV & oral antibiotics
• Monitor hepatic, hemtologic, & renal function
• Monitor for development of superinfection
  > candidiasis, c diff
• Immobilize & elevate
• Admin pain meds
• Consult w/ parents & provider regarding home care

Question 22

Osteomyelitis - Education

Answer 22

• Length of treatment tht can be needed & long-term antibiotics
• Monitor hearing due to ototoxicity of some antibiotics
• Limit movement of affected limb & avoid bearing any weight until cleared
• Provide diversional activities consistent w/ pt’s lvl of development
• Ensure proper nutrition

Question 23

Caring for Fractures

Answer 23

• Cast appliation techniques
  > plaster vs fiberglass
• Care management
• Cast care at home
  > red flags: Ps
  > itchy
• Cast removal
  > scary
• Skin care