Author Question: A patient is diagnosed with an oblique fracture of the left femur. In which order should the nurse ... (Read 121 times)

storky111 · **on:** Jun 25, 2018

A patient is diagnosed with an oblique fracture of the left femur. In which order should the nurse explain the steps of healing?

Choice 1. bony callus formation
Choice 2. fibrocartilaginous callus formation
Choice 3. hematoma formation
Choice 4. remodeling

Question 2

A patient diagnosed with bursitis asks the nurse, Why do you keep asking what my pain level is? Don't you believe me? How should the nurse respond?

1. It is important to know your pain level so that we can provide you with the best medication.
2. If you don't want the medication, you don't have to take it.
3. I can't give you the medication unless I know what your pain level is.
4. I don't understand why you are concerned about my questions. Would you clarify?

blakeserpa · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Correct Answer: 3, 2, 1, 4

When a bone fractures, bleeding and tissue damage at the site of the fracture initiate an inflammatory response. A hematoma forms between the fractured bone ends and around the bone surfaces. Within 48 hours, fibroblasts and new capillaries growing into the fracture form granulation tissue that gradually replaces the hematoma. Phagocytes remove cell debris. Osteoblasts migrate to the fracture site, where they build a web of collagen fibers from both sides of the fractured bone. Chondroblasts lay down patches of cartilage as a base for bone growth. This fibrocartilaginous callus connects bone fragments, splinting the fracture and maintaining bone alignment. The third stage of fracture healing, bony callus formation, begins 3 to 4 weeks after the injury and continues for 2 to 3 months. Osteoblasts continue to form collagen fibers and bone matrix, which are gradually mineralized with calcium and mineral salts. During the remodeling phase, excess callus is removed and new bone is laid down along the fracture line. The fracture site calcifies and the bone reunites.

Answer to Question 2

Correct Answer: 1

The nurse should explain the importance of assessing for pain so that appropriate medication can be provided. Asking the patient to rate the pain on a scale of 010 before and after any intervention is important to assess the effectiveness of the chosen pain relief strategy. The patient did not express concern or refuse medication. The nurse should address the patient's question.