Card Set Information
Adult MedSurg 2
What are some risk factors for developing osteoporosis?
– Age over 60 years
– Family history
– Caucasian or Asian race
– Thin, lean body build
– Low lifetime calcium intake
– Estrogen deficiency/androgen deficiency
– Smoking history/high alcohol intake
– Lack of physical exercise/prolonged immobility
What are some not so obvious SnSs of osteoporosis?
– Constipation/abdominal distention/reflux esophagitis
: Spine can compress so much-->compartment syndrome on GI.
– Respiratory compromise
Diagnostics for osteoporosis?
Bone density tests (usually through the hips).
Vitamin D levels usually wnl
Rx treatment for osteoporosis?
What is osteomyelitis?
pyogenic bone infection
Chronic or acute
Commonly results from a combination of local trauma (hematoma) and acute infection originating elsewhere in the body
Usually remains localized but can spread through bone to marrow, cortex, and periosteum
Characteristics of osteomyelitis?
Usually a blood-borne disease or trauma to the area.
Most often affects rapidly growing children (lower end of femur and upper end of tibia, humerus, and radius)
Most common sites in adults are pelvis and vertebrae (contamination assoc w/surgery or trauma)
Chronic osteomyelitis (rare) is characterized by multiple draining sinus tracts and metastatic lesions
Incidence of both chronic and acute osteomyelitis is declining, except in
Prognosis is good for acute osteomyelitis with prompt treatment
poor for chronic
osteomyelitis (more prevalent in adults).
What are the pathogens involved in osteomyelitis?
Staphylococcus aureus and...
What are the SnSs of osteomyelitis?
Rapid onset of sudden pain in affected bone
Tenderness, heat, swelling, and restricted movement over bone
May have tachycardia, sudden fever, N, malaise
Chronic infection can persist intermittently for years
Flare-up after minor trauma
Persistent draining of pus from old pocket in a sinus tract
Types of fxr
closed, open, comminuted, displaced,
oblique, spiral, impacted, greenstick
Read about cast care
How do you get a fat emboli?
Develops from fxr, travels through venous system-->lung vasculature = PE.
Tx is minimal. Just hoping healthy lung tissue compensates for eschemic tissue.
Often will have cardiac arrest as 1st symptom.
Where would you typically get a hip fxr?
Vascular bed of head of femur is poorly vascularized-->avascular necrosis.
When fxr is in proximal 1/3, there really isn't much medical intervention possible because of poor vascularization.
In other areas, screws n such can be helpful.
: Open Reduction Internal Fixation. Look it up.
The weight and pull fatigues the muscle and it will not spasm.
Skin care beneath traction is a nursing priority, but need MD order to remove it.
Nursing diagnosis for fxr
risk for peripheral neurovasc dysfunction
risk for infection
Impaired physical mobility
Peripheral neurovascualr dysfunction
Pain in affected extremity unrelieved by drugs
Pain on passive movement
Complications associated with fxr?
Acute compartment syndrome
Fat embolism syndrome (FES)
Complications from thromboembolism
Deep venous thrombosis (DVT)-->
Avascular necrosis (AVN)
Delayed union (take forever), nonunion (never heals), and
What is cast syndrome?
cast applied too tightly
Cast compresses the superior mesenteric artery against the duodenum
Patient complains of abdominal pain and pressure, N/V
– NG tube and suction
– May need to remove or split cast
Read about compartment syndrome
What are the 6 ps of compartment syndrome?
-- Paresthesia (numbness and tingling)
– Pain (distal to the injury)
– Pressure (rises)
– Pallor (coolness and loss of color)
– Paralysis (loss of function)
– Pulselessness (diminished or absent)
Nursing care for compartment syndrome?
Do not elevate extremity above heart level because...
...Raises venous pressure and slows arterial perfusion
– Do not use ice
– Notify MD
Nursing care for ORIF?
Early ROM via CPM-->faster healing and earlier ambulation-->v risk of DVT, PE, etc.