Med Surg Musculoskeletal Questions and
Answers () (Verified Answers)
What is a cast?
-Rigid external device molded to the contour of the body.
-Immobilized a reduced fracture or correct a deformity.
-Restrict body part movement.
What are nursing interventions related to cast care?
Wet Cast
a. hold cast with palms
b. turn cast to promote drying (do not cover)
Dry Cast
a. elevate effected limb
b. turn pt often
c. protect other body parts
d. provide hygiene care
e. check cast for rough edges
f. cover cast with plastic when bathing pt or if incontinent
g. no showers or swimming
What do you want to manage when patients have a cast?
-pt education
-pain management
-improve immobility
-promote healing of skin abrasion
-maintain adequate neurovascular function
-prevent complications
-discharge planning
What is compartment syndrome?
-Increased tissue pressure within a limited space (cast, muscle compartment)
-pt complains of deep pain; does not improve with opioids
-passive stretching of muscle causes pain
-nerve ischemia + swelling continues
-hypesthesia= a reduced sense of touch or sensation, or a partial loss of sensitivity to sensory stimuli
-paresthesia= an abnormal sensation, typically tingling or pricking
-paralysis
How do you manage compartment syndrome?
1. elevate extremity
2. cut cast
3. notify MD
4. fasciotomy
post op care:
1. sterile dressing, limb splinted, ROM, elevate limb, debridement/ grafting may be needed
What is a pressure ulcer?
-pressure on soft tissue
-susceptible areas: heel, malleoli (ankle), dorsum of toes, patella (knee), lateral epicondyle (elbow),
ulnar styloid process
, -s/s pt report pain and tightness, drainage, warmth
What is disuse syndrome?
-physical state caused by bed rest, immobility, and/or lack of physical activity
-significant atrophy (muscle loss)
-isometric contraction
What is a fracture?
-a break in the continuity of the bone
-stress:
a. direct blow
b. crushing forces
c. twisting motions
d. extreme muscle contractions
-soft tissue damage (muscle, joints, ligaments, tendons, nerves, blood vessels)
What is a complete fracture?
bone is broken all the way through
What is an incomplete or green stick fracture?
bone cracks and bends but does not completely break
What is a comminuted fracture?
a break or splinter of the bone into more than two fragments
What is a closed (simple) fracture?
a broken bone that does not penetrate the skin.
What is an open compound fracture?
a fracture in which there is an open wound or break in the skin near the site of the broken bone
What is an avulsion fracture?
an injury to the bone in a location where a tendon or ligament attaches to the bone
What are nursing managements related to fractures?
-decrease edema (inflammation)
-comfort measures/ pain management
-encourage activity within pt's ability
-physical therapy
-assistive devices
What are some early complications related to fractures?
a. shock
-hypovolemic
-traumatic
-blood loss
-decreased blood volume, decreased cardiac output, decreased tissue perfusion
Answers () (Verified Answers)
What is a cast?
-Rigid external device molded to the contour of the body.
-Immobilized a reduced fracture or correct a deformity.
-Restrict body part movement.
What are nursing interventions related to cast care?
Wet Cast
a. hold cast with palms
b. turn cast to promote drying (do not cover)
Dry Cast
a. elevate effected limb
b. turn pt often
c. protect other body parts
d. provide hygiene care
e. check cast for rough edges
f. cover cast with plastic when bathing pt or if incontinent
g. no showers or swimming
What do you want to manage when patients have a cast?
-pt education
-pain management
-improve immobility
-promote healing of skin abrasion
-maintain adequate neurovascular function
-prevent complications
-discharge planning
What is compartment syndrome?
-Increased tissue pressure within a limited space (cast, muscle compartment)
-pt complains of deep pain; does not improve with opioids
-passive stretching of muscle causes pain
-nerve ischemia + swelling continues
-hypesthesia= a reduced sense of touch or sensation, or a partial loss of sensitivity to sensory stimuli
-paresthesia= an abnormal sensation, typically tingling or pricking
-paralysis
How do you manage compartment syndrome?
1. elevate extremity
2. cut cast
3. notify MD
4. fasciotomy
post op care:
1. sterile dressing, limb splinted, ROM, elevate limb, debridement/ grafting may be needed
What is a pressure ulcer?
-pressure on soft tissue
-susceptible areas: heel, malleoli (ankle), dorsum of toes, patella (knee), lateral epicondyle (elbow),
ulnar styloid process
, -s/s pt report pain and tightness, drainage, warmth
What is disuse syndrome?
-physical state caused by bed rest, immobility, and/or lack of physical activity
-significant atrophy (muscle loss)
-isometric contraction
What is a fracture?
-a break in the continuity of the bone
-stress:
a. direct blow
b. crushing forces
c. twisting motions
d. extreme muscle contractions
-soft tissue damage (muscle, joints, ligaments, tendons, nerves, blood vessels)
What is a complete fracture?
bone is broken all the way through
What is an incomplete or green stick fracture?
bone cracks and bends but does not completely break
What is a comminuted fracture?
a break or splinter of the bone into more than two fragments
What is a closed (simple) fracture?
a broken bone that does not penetrate the skin.
What is an open compound fracture?
a fracture in which there is an open wound or break in the skin near the site of the broken bone
What is an avulsion fracture?
an injury to the bone in a location where a tendon or ligament attaches to the bone
What are nursing managements related to fractures?
-decrease edema (inflammation)
-comfort measures/ pain management
-encourage activity within pt's ability
-physical therapy
-assistive devices
What are some early complications related to fractures?
a. shock
-hypovolemic
-traumatic
-blood loss
-decreased blood volume, decreased cardiac output, decreased tissue perfusion
