NCLEX RN Practice Question # 478

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Complications of Fractures ( NCLEX Review)   

Fat embolism

Description:

A fat embolism originates in the bone marrow and occurs after a fracture when a fat globule is released into the bloodstream. Compartment syndrome

Compartment syndrome

Description

1. Tough fascia surrounds muscle groups, forming compartments from which arteries, veins, and nerves enter and exit at opposite ends.
2. Compartment syndrome occurs when pressure increases within one or more compartments, leading to decreased blood flow, tissue ischemia, and neurovascular impairment.
3. Within 4 to 6 hours after the onset of compartment syndrome, neurovascular damage is irreversible if not treated.

Assessment

1. Unrelieved or increased pain in the limb
2. Tissue that is distal to the involved area becomes pale, dusky, or edematous.

Pain with passive movement

1. Loss of sensation (paresthesia)
2. Pulselessness (a late sign)

Interventions

1. Notify the physician immediately and prepare to assist physician.
2. If severe, assist the physician with fasciotomy to relieve pressure and restore tissue perfusion.
3. Loosen tight dressings or bivalve restrictive cast as prescribed.

Infection and osteomyelitis

Description:

 Infection and osteomyelitis (inflammatory response in bone tissue) can be caused by the introduction of organisms into bones leading to localized bone infection.

Assessment

1. Tachycardia and fever (usually above 101 F).
2. Erythema and pain in the area surrounding the infection
3. Leukocytosis and elevated erythrocyte sedimentation rate (ESR)
4. Interventions
5. Notify the physician.
6. Prepare to initiate aggressive, long-term intravenous antibiotic therapy.
7. Administer hyperbaric oxygen therapy to promote healing.
8. Surgery is performed for resistant osteomyelitis with sequestrectomy and/or bone grafts.
9. Avascular necrosis
10. Description: Avascular necrosis occurs when a fracture interrupts the blood supply to a section of bone, leading to bone death.
11. Assessment
12. Pain
13. Decreased sensation
14. Interventions
15. Notify the physician if pain or numbness occurs.
16. Prepare the client for removal of necrotic tissue because it serves as a focus for infection.