FINAL EXAM NR574 - WEEK 8 TRAUMATIC ORTHO QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED)

FINAL EXAM NR574 - WEEK 8 TRAUMATIC ORTHO QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED) 1. __________ serves as a border for the intrapelvic organs and plays a critical role in trunk stabilization and mobility of the hip joints Correct Answer The pelvic ring 2. The pelvic ring is divided into anterior and posterior sections. The posterior ring consists of _________ &____________ Correct Answer the two sacroiliac joints (SI) joints and the sacral bone. 3. The pelvic ring is divided into anterior and posterior sections. The ______________ reaches from the anterior columns of the acetabula along the pubic rami to the symphysis Correct Answer the anterior ring 4. Shareena is a 32-year-old female who was involved in a high speed motor vehicle crash (MVC). She was the restrained driver in a head-on collision. She is minimally responsive, pale, cool to touch, and diaphoretic. Vital signs: blood pressure (BP) 88/46; heart rate (HR) 128; respiratory rate (RR) 24; oxygen saturation (SpO2) 94%. It is noted that Shareena has significant pelvis and lower extremity deformities. What of the following is the priority for Shareena? a. Order a CT of the abdomen and pelvis b. Check a CBC c. Bind her pelvis (Correct answer) d. Order a fluid bolus of 1 liter (L) normal saline Correct Answer c. Bind her pelvis Rationale: Shareena has obvious pelvic trauma and symptoms of hemorrhagic shock. She is cool, pale, tachycardic, hypotensive, & minimally responsive. Binding her pelvis is a quick intervention that may prevent hemorrhage. -Ordering a CT of the abdomen and pelvis is incorrect. It takes time to order and obtain the test before performing an intervention for an unstable client. -Checking CBC is incorrect. The time it would take to draw and obtain the results is too long before initiating treatment for an unstable client. -Ordering a fluid bolus of 1L normal saline is incorrect. A bleeding client should not be given crystalloid fluid. Giving large amounts of fluids will cause dilution and can worsen cellular hypoxia and hypoperfusion, especially in a trauma client. 5. what are the 3 common mechanisms of action for pelvic fractures Correct Answer anteroposterior lateral compression vertical sheer force 6. Mechanism of Action Correct Answer Anteroposterior - example: pedestrian versus motor vehicle 7. Mechanism of Action Correct Answer lateral compression - example: motor vehicle collision, motorcycle, and direct crush injuries 8. Mechanism of Action Correct Answer vertical sheer force - example: fall or jump landing on a straight leg 9. what is the difference between stable vs unstable pelvic fx Correct Answer pelvic ring displacement stable: do NOT involve the pelvic ring. minimally displaced fx. unstable: In unstable fractures involving the pelvic ring, there is wide displacement with the increased potential of damaging the underlying vessels and nerves. 10. what is the most common reversible cause of death in clients with pelvic fractures Correct Answer Hemorrhage -Mortality in the first 24 hours of pelvic fracture is almost always related to uncontrolled bleeding and hemorrhage. 11. 6 main treatment modalities with pelvic fx Correct Answer 1. stabilize the pelvis - bind the pelvis! 2. mass transfusions - initial rescusitation 3. interventional radiology -embolize sm areas of bleeding 4. ExLap - lg bleeding stabilization 5. orthopedic surgery - vertical shear fractures and open pelvic fractures will require intervention 6. supportive care - DVT prophylaxis, pain management, rehab, PT/OT 12. unstable pelvic fracture - pelvic stabilization Correct Answer -controls bleeding -Binding of the pelvis using a pelvis binder or even a sheet can prevent hemorrhaging until the client can be taken to the operating room or interventional radiology. ATLS (Primary Surgery order) -Compress (push in) iliac wings only once ‐ Perineal and genital exam during "Exposure" component of primary survey ‐ Place Temporary Pelvic binder at level of greater trochanters during logroll ‐ Stat Pelvic X ray 13. ExLap (exploratory laparoscopy) for unstable pelvic fractures Correct Answer Significant free fluid in the abdomen/pelvis or shock from suspected intraperitoneal bleeding warrants exploratory laparotomy to locate and control the bleeding. -may need vascular surgery depending. 14. Patient presents to the ER with suspected unstable pelvic fx. Which diagnostic tool will you use first Correct Answer FAST EXAM! The Focused Assessment with Sonography for Trauma (FAST) assessing for free fluid in the abdomen and pelvis. A large amount of fluid in the abdomen/pelvis is an indication for emergent exploratory laparotomy to evaluate and control bleeding before the client undergoes extensive imaging. 15. diagnosis recommendation for a stable pelvic fx Correct Answer basic Xray (yes its broken, no its not) no concerns for vasculature compromise 16. the preferred imaging modality for clients with injuries due to high-energy trauma, as multiple body systems are likely to be injured Correct Answer CT Scan 17. When injury to the vascular system is suspected, what diagnostic imaging is best Correct Answer CT angiography can be performed to better localize the bleed. 18. how to assess for pelvic stability Correct Answer -placing the hands on the iliac crests -push firmly down and then rocking from side to side. -If the pelvis is mobile, an unstable fracture should be assumed, and the pelvis must be stabilized to prevent further damage. 19. When should the stability of the pelvis be assessed Correct Answer In clients WITHOUT obvious pelvic trauma, the stability of the pelvis should be assessed. if tis obvious, bind that shit 20. objective findings of pelvic fx Correct Answer -swelling