Fractures: NCLEX Priorities
Compartment syndrome (6 Ps), fat embolism, traction, weight-bearing status.
Fractures bring orthopedic complications. NCLEX tests compartment syndrome and fat embolism.
Compartment syndrome
6 Ps: Pain (out of proportion, on passive stretch), Pressure, Paresthesia, Pallor, Paralysis, Pulselessness (late). Emergency fasciotomy. Don't elevate affected limb (decreases perfusion).
Fat embolism
24-72h post-long-bone fracture. Dyspnea, petechial rash on chest/axilla, altered mental status. Supportive care, possible mechanical ventilation.
Traction
Skeletal vs skin. Weights hang freely. Pin care for skeletal. Frequent neurovascular checks.
Weight-bearing terms
NWB (none), TTWB (toe-touch), PWB (partial), WBAT (as tolerated), FWB (full).
Frequently asked
Cast and compartment syndrome?
Bivalve the cast or remove. Don't wait.
Hip fracture in elderly, high mortality?
Yes, ~25% 1-year mortality. Mobilize early to reduce.
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