Identify the postoperative nursing processes for a patient who has had an orthopedic surgical revision for a fracture that is casted. The nurse suspects that compartment syndrome is occurring.
Numbness in operative extremity
Pressure at the surgical
site
Passive pain at rest
Correct.
Passive pain at rest may cause the nurse to suspect the
development of compartment syndrome. Paresthesia may also indicate
compromised vascular perfusion to the affected limb. Pressure of the
affected limb indicates inflammation and is an early symptom of
compartment syndrome.
Identify the postoperative nursing processes for a patient who has
had an orthopedic surgical revision for a fracture that is casted.
The nurse suspects that compartment syndrome is occurring.
Most Common Symptoms
Pallor
Pulselessness
Pressure
Pain
Paresthesia
Paralysis
Correct.
The most common symptoms of compartment syndrome
are the "six Ps": passive pain at rest, along with pressure,
paresthesia, pallor, paralysis, and pulselessness. Pallor, paralysis,
and pulselessness are considered to be late findings.
Identify the postoperative nursing processes for a patient who has had an orthopedic surgical revision for a fracture that is casted. The nurse suspects that compartment syndrome is occurring.
Assist with cast removal
Begin preoperative
teaching
Prepare for compartment pressure
measurement
Prepare patient for fasciotomy
Correct.
As compartment syndrome is considered a medical
emergency, the nurse should be prepared to assist with removal of the
cast. Direct compartment pressure can be measured with a Stryker
device. A pressure within 30 mm Hg of the diastolic pressure or an
absolute pressure greater than 30 mm Hg is diagnostic for compartment
syndrome. Additionally, the nurse should anticipate that the patient
will undergo a fasciotomy to relieve pressure in the compartment and
begin preoperative teaching for this procedure.
Identify the postoperative nursing processes for a patient who has had an orthopedic surgical revision for a fracture that is casted. The nurse suspects that compartment syndrome is occurring.
Fat embolism syndrome
Hypovolemia
Venous thromboemboli
Rhabdomyolysis
Correct.
A patient who has had a fracture is at risk for
numerous complications, including but not limited to fat embolism
syndrome, rhabdomyolysis, hypovolemia, and venous thromboemboli.
Identify the postoperative nursing processes for a patient who has had an orthopedic surgical revision for a fracture that is casted. The nurse suspects that compartment syndrome is occurring.Fasciotomy
Treatment for compartment syndrome
Urgent procedure
Helps
to relieve pressure from internal edema
Correct.
When compartment syndrome is present, an immediate
fasciotomy is indicated to relieve internal pressure from edema. The
surgical procedure includes incisions on both the medial and lateral
aspects of the extremity down through the fascia, relieving the
compartment pressure.
The nurse is caring for a patient postsurgical fracture repair. Which complications should the nurse monitor for? Select all that apply.
Elevated serum potassium
Fat embolism syndrome
Hypovolemia
Rhabdomyolysis
Elevated blood urea nitrogen and creatinine