NUR3225 Exam 2 MSK Questions With Complete Solutions
Greenstick
- incomplete break w/ 1 side bend (soft bones = children)
Segmental
- broken 2+ places (high-energy trauma)
avulsion
- bone pulled by tendon/ligament (sport injury)
Impacted
- broken ends driven into each other (falls)
Pathologic
- weakened bone break (minimal trauma, weak bone issue)
Stress/hairline
- tiny crack (repetitive/over use in athletes)
1. Hematoma form (1-3d)
- blood vessel rupture => clot form/inflam cells migrate =>
PAIN/SWELL/RED
2. Fibrocartilage callus form (3d-2wk)
fibroblast/chondroblast => soft callus (TEMPORARY
STABILZE fracture)
3. Bony callus/ossification form (2-6wk)
,- osteoblast deposit bone matrix => harden into immature
bone
4. Bone remodeling (6wk-several months)
- osteoclast remove excess bone => reshape to stress/load =>
final strength regained (1+y)
Closed reduction
- nonsurgical approach (simple) w/ manual realignment
under anesthesia
Open reduction/internal fixation (ORIF)
- surgical realignment w/ plate/screw/rod (complex/unstable)
External fixation
- metal pins/screws inserted externally (severe
trauma/infection)
Casts
- hard shell (MONITOR CIRCULATION)
Splint/brace
- minor fracture support
Traction
- pulling force to align (HIP/FEMUR)
External/internal fixation
- hold in place (external pin care)
Open fractures
, - surgical debridement/irrigation, TdAP vaccine + antibiotic
Nursing intv
- ABCDE (rib = resp distress, bleeding/pulses, neurovascular
assess = 6Ps, exposure = hypothermia/shock)
Do NOT attempt to reduce fracture (not in scope of practice)
Traction
- application of pulling force to injured/diseased body
part/extremity => DEC pain/muscle spasm/fracture,
IMMOBILIZE to prevent further damage, treat pathologic
condition, promote exercise, expand joint space
Traction care
neurovascular 6P (rpt alteration in sensation/circulation),
body alignment/position shift, skin integrity, exercise hourly,
DVT prevention (compression hose/anticoagulant),
cough/deep breathe, nutrition (fiber/protein/fluids)
Cast care
- ice 1st 24hr, elevate 1st 48hr, move joints above/below cast,
neurvasc check, rpt unrelieved pain/sensation/circulation
issues
External fixation care
- manage open fractures w/ spft tissue damage & provide
support complicated/comminuted fractures, elevate, monitor
infection, PIN CARE
Infection
Greenstick
- incomplete break w/ 1 side bend (soft bones = children)
Segmental
- broken 2+ places (high-energy trauma)
avulsion
- bone pulled by tendon/ligament (sport injury)
Impacted
- broken ends driven into each other (falls)
Pathologic
- weakened bone break (minimal trauma, weak bone issue)
Stress/hairline
- tiny crack (repetitive/over use in athletes)
1. Hematoma form (1-3d)
- blood vessel rupture => clot form/inflam cells migrate =>
PAIN/SWELL/RED
2. Fibrocartilage callus form (3d-2wk)
fibroblast/chondroblast => soft callus (TEMPORARY
STABILZE fracture)
3. Bony callus/ossification form (2-6wk)
,- osteoblast deposit bone matrix => harden into immature
bone
4. Bone remodeling (6wk-several months)
- osteoclast remove excess bone => reshape to stress/load =>
final strength regained (1+y)
Closed reduction
- nonsurgical approach (simple) w/ manual realignment
under anesthesia
Open reduction/internal fixation (ORIF)
- surgical realignment w/ plate/screw/rod (complex/unstable)
External fixation
- metal pins/screws inserted externally (severe
trauma/infection)
Casts
- hard shell (MONITOR CIRCULATION)
Splint/brace
- minor fracture support
Traction
- pulling force to align (HIP/FEMUR)
External/internal fixation
- hold in place (external pin care)
Open fractures
, - surgical debridement/irrigation, TdAP vaccine + antibiotic
Nursing intv
- ABCDE (rib = resp distress, bleeding/pulses, neurovascular
assess = 6Ps, exposure = hypothermia/shock)
Do NOT attempt to reduce fracture (not in scope of practice)
Traction
- application of pulling force to injured/diseased body
part/extremity => DEC pain/muscle spasm/fracture,
IMMOBILIZE to prevent further damage, treat pathologic
condition, promote exercise, expand joint space
Traction care
neurovascular 6P (rpt alteration in sensation/circulation),
body alignment/position shift, skin integrity, exercise hourly,
DVT prevention (compression hose/anticoagulant),
cough/deep breathe, nutrition (fiber/protein/fluids)
Cast care
- ice 1st 24hr, elevate 1st 48hr, move joints above/below cast,
neurvasc check, rpt unrelieved pain/sensation/circulation
issues
External fixation care
- manage open fractures w/ spft tissue damage & provide
support complicated/comminuted fractures, elevate, monitor
infection, PIN CARE
Infection
