Can someone please help me

Tweety, BSN, RN · Oct 9, 2006

The patho question is one for you to look up. It's too detailed for me to answer. Sorry. :)

Chest X-rays are done on pre-op patients just as a screening tool to see if there is any underlying problems that would interfere with them being intubated by nurse anesthesist or MD. The hyperinflation may be caused by COPD/emphysema and is important to note in how they oxygenate him during surgery and after. But is probably a secondary diagnosis not related to the femur fracture.)

Normal sinus rhythm is means the heart is beating (conducting it's electrical activity) in a normal manner from the sinus node, and is not significant. It's rhythm is regular and the rate is WNL (60 to 100).

Low PTT's expose the patient to a high risk for bleeding and might need to be corrected prior to surgery.

rn/writer, RN · Oct 9, 2006

i am hoping a nurse experienced in med-surg can help me with explaining a few things.
1. describing the pathophysiology of displaced periprosthetic supracondylar femur fracture.
2. why the patient had a chest x ray before surgery. (and results were mild hyperinflation-not sure how this relates to diagnosis)
3. what does normal sinus rythm mean on ekg result.
4. how does diagnosis relate to low calcium in blood, and low ptt in coagulation studies.

when people post questions that are part of an assignment, we sometimes get complaints that members are being asked to do the poster's homework. assignment questions usually get a better response when the poster lists her own thoughts on what the answer might be and/or mentions the research she has already done.

no one minds helping students who have hit a stumbling block or who are confused about what they have read. we just don't want to rob you of the opportunity to learn as much as you can the old-fashioned way first. that way, you'll have a better chance of retaining the knowledge down the road.

mbgirl81 · Oct 9, 2006

i'm not trying to get anyone to do this for me, i have been reading about it but cannot understand what exactly pathophysiologic definition of a fracture is. it's a break in the bone, and the supracondylar is above the knee (on femur). do i need to explain more? if i do explain more, do i explain how this effects the body or body systems. about the chest x-ray, i thought it was a pre-op test but i wanted to make sure. the lab values are confusing b/c i have to tell how they are connected with diagnosis, for example her h & h was low, as well as rbc's, so i figure this is from loosing blood during surgery. but why would calcium be low. sorry for bothering anyone..and thanks tweety! i really appreciate the help.

rn/writer, RN · Oct 9, 2006

i'm not trying to get anyone to do this for me, i have been reading about it but cannot understand what exactly pathophysiologic definition of a fracture is. it's a break in the bone, and the supracondylar is above the knee (on femur). do i need to explain more? if i do explain more, do i explain how this effects the body or body systems. about the chest x-ray, i thought it was a pre-op test but i wanted to make sure. the lab values are confusing b/c i have to tell how they are connected with diagnosis, for example her h & h was low, as well as rbc's, so i figure this is from loosing blood during surgery. but why would calcium be low. sorry for bothering anyone..and thanks tweety! i really appreciate the help.

you weren't bothering anyone. didn't mean to imply that at all.

some of the questions you listed above should probably be directed toward your instructor. only they know how much detail they expect you to provide.

i suggested that you let us know what you're thinking about the questions you ask so we'll know where you're getting hung up. it helps you to be taken more seriously, and it helps us to share information with a clear conscience.

re: low calcium. consider the pathophysiology of bone repair and regeneration.

meownsmile, BSN, RN · Oct 11, 2006

H&H could be low from the fracture itself, not necissarily the surgery. Fracture in a long bone causes bleeding and you have to remember where the red blood cells are made. Anything that disrupts the marrow of a long bone may interfere with H&H and RBC's.

Periprothsetic- Maybe a fracture above a previously implanted knee prosthesis. I dont know, ive worked ortho for 14 years and ive never had to know details of a fracture that far. I know you are in school and its different, but ive never even heard a physician use those terms in dictation.

augigi, CNS · Oct 11, 2006

low ptt's expose the patient to a high risk for bleeding and might need to be corrected prior to surgery.

just a correction - high ptts predispose to bleeding, not low.

i am hoping a nurse experienced in med-surg can help me with explaining a few things.
1. describing the pathophysiology of displaced periprosthetic supracondylar femur fracture.
2. why the patient had a chest x ray before surgery. (and results were mild hyperinflation-not sure how this relates to diagnosis)
3. what does normal sinus rythm mean on ekg result.
4. how does diagnosis relate to low calcium in blood, and low ptt in coagulation studies.

i would say:

1. periprosthetic supracondylar femur fracture: patient has a previous prosthesis/joint replacement, and when the leg was injured, this could not break so the bone broke around it ("periprosthetic").

2. preop cxr as mentioned as a screening for anesthesia complications/baseline to compare with postop complications such as chest infection.

3. as discussed.

4. a) hypocalcaemic patients are at higher risk of bone fractures.

b) low ptt is a risk factor for thrombus (clots) in patients with fractures who are immobile. you'd give s/c heparin until the patient is ambulant.

chenoaspirit, ASN, RN · Dec 11, 2006

I thought a HIGH ptt was a risk for bleeding. A higher number means longer time it took for blood to clot. Right?

augigi, CNS · Dec 11, 2006

Isn't that what I said?

chenoaspirit, ASN, RN · Dec 11, 2006

I was responding to the original poster. Didnt read your post.