AL SHIFA HOSPITAL - PERINTALMANNA CONTINUING NURSING EDUCATION - 2012 TOPIC: Prevention of complications of immobility in orthopedic patients Max marks:

20 Instructions: a. Write the correct alphabet (corresponding answer) in the box b. Fill the space with correct answer where necessary 1. What do you mean by fracture ? a) dislocation of the bone b) break in the continuity of the bone. c) reduction of total bone mass. d) infection of the bone. 2. What is meant by external fixation ? a) it is a metallic device composed of metal pins that are inserted into the bone and attached to external rods. b) it is a tight bandage enclosing the injured limb. c) it is a woden board placed to immobilize the injured limb. d) it is a rod inserted and hung by a weight. 3. What is the cause of muscle atrophy and contracture. a) prolonged immobility b) pin site infection. c) exercise d) calf tenderness 4. What are the signs of pressure ulcer ? a) redness , irritation and skin breakdown. b) pricking over the area. c) numbness and tingling sensation in the skin. d) fever. 5. What is the common skin changes over fixation area ? a) area becomes blue , purple or mottled. b) area becomes brown and hot to touch. c) area becomes brown and more sensitive. d) area becomes pale and more sensitive.

6. Which is the best exercise to prevent pressure ulcer in hip and lower extremity? a) deep breathing and coughing exercise. b) quadriceps and gluteal exercise. c) active exercise for injured extremities. d) passive exercise for uninjured extremity.

7. What type of joint problem can occur due to immobility? a) contracture b) joint pain c) sprain. d) osteophorosis. 8. What measures will prevent bladder problems such as kidney stones ? a) take calcium rich diet. b) take plenty of water. c) drinking fruit juice d) dont pass urine frequently. 9. What type of diet is needed for bone healing? a) diet rich in vitamin D , C and calcium. b) diet rich in vitamin K , E and iron. c) diet rich in vitamin A , E and potassium. d) diet rich in vitamin B and sodium. 10. Frequency of exercise for unaffected limbs? a) every hour b) once a day c) occasionally d) never. 11. What is the measure you are taking to prevent pressure sore? a) change position every 4th hourly. b) keep pressure areas wet and moisture. c) make your bed with wrinkles. d) dont move the pressure areas. 12. What measures you are taking to prevent foot drop? a) use sand bag. b) elevate foot end of cot. c) keep pillows. d) nothing. 13. Intake of water per day? a) 500 1000 ml. b) 1000 1500ml c) 1500ml 2000ml d) 2000 3000 ml 14. Frequency for pin site care? a) every hour. b) occasionally c) once a day. d) never

15. Period of hematoma formation? a) 14 days b) 7 days c) 60 days d) 3 weeks 16. Sequence of bone healing process? a) hematoma formation, callus ossification, callus formation, remodelling b) remodelling, hematoma formation, callus ossification, callus formation c) hematoma formation, callus formation, callus ossification, remodelling d) callus ossification, callus formation, hematoma formation, remodelling 17. Force responsible for proper bone alignment in a traction? a) Hydrostatic force b) Dynamic force c) Oncotic force d) Counteraction force 18. Five P,s of neuro vascular assessment in orthopedic patients: 1. 2. 3. 4. 5. 19. Principles of effective traction: [any 2] - {2 marks} 1.

2.

KEY 1. b 2. a 3. a 4. a 5. a 6. b 7. a 8. b 9. a 10. a 11. a 12. a 13. d 14. c 15. b 16. c 17. b 18. pain, pulse, parasthesia, paralysis, pallor 19. Principles of effective traction: (any two) Countertraction must be used to achieve effective traction Traction must be continuous to be effective in reducing and immobilizing fractures. Skeletal traction is never interrupted Weights are not removed unless intermittent traction is prescribed. Patient must be in good body alignment in the center of the bed when traction is applied. Ropes must be unobstructed. Weights must hang free and not rest on the bed or floor. Knots in the rope or the footplate must not touch the pulley or the foot of the bed