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Third Semester > Adult Care 1 Exam 3 > Flashcards

Adult Care 1 Exam 3 Flashcards

Renal and Musculoskeletal

1
Q

What are the 2 functions of the kidney?

A

Regulatory and Hormonal

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2
Q

What is the regulatory function of the kidney?

A

Controls fluid and electrolyte balance by using glomerular filtration, tubular reabsorption, and tubular secretion.

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3
Q

What is glomerular filtration?

A

a process the kidneys use to filter excess fluid and waste products out of the blood

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4
Q

What is a GFR?

A

glomerular filtration rate, indicates how well our kidneys are functioning (filtration), a decreased GFR indicates kidney disease

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5
Q

What does a decreased GFR put the patient at risk for?

A

adverse reactions with medications, calls for lower doses

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6
Q

What does tubular reabsorption mean in regards to the kidneys?

A

water and electrolytes being reabsorbed and returned to the blood, keeps output between 1-3 L per day

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7
Q

What does tubular secretion mean?

A

Allows substances to move from blood to urine

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8
Q

What does renin do within the body?

A

Regulates BP by raising it through the RAAS, triggered by a decrease in BP (blood flow) in the arteries–> stimulates aldosterone –> sodium goes where water follows –> increase in BP and volume

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9
Q

What does EPO do within the body?

A

triggers the RBC production in bone marrow

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10
Q

What do prostoglandins do within the body?

A

dilate and constrict kidney vessels to keep glomerular filtration at a constant rate

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11
Q

Activated Vitamin D regulates what?

A

Calcium

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12
Q

What is the hormonal function of the kidney?

A

Controls RBC formation by erythropoietin
Maintains blood pressure by RAAS
Vitamin D Activation by regulating calcium balance

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13
Q

What does the nephron do in the kidneys, what is it nicknamed as?

A

helps form urine by filtering waste and products and water from the blood, “functional unit of the kidney”

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14
Q

What is a unique characteristic of the kidneys that no other organ does?

A

self regulate blood pressure by selectively constricting or dilating the afferent or efferent arterioles so GFR Is consistent even if there is systemic changes in BP

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15
Q

When do the kidneys not self regulate their blood pressure?

A

systolic blood pressure is less than 65 or 70

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16
Q

What is the renal threshold?

A

When the kidneys can not absorb the amount of glucose in the blood stream, so it is excreted in the urine to compensate

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17
Q

What can NOT pass the glomerular wall?

A

RBC, large particles

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18
Q

What is a urinalysis?

A

A test that looks at waste products from the kidneys, it can help detect some urologic disorders

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19
Q

What type of collection do you need to do for a urinalysis?

A

Early morning specimen, as it provides a more concentrated sample of waste products. Needs to be a midstream catch

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20
Q

What does a urinalysis look at?

A

color, clarity, concentration, presence of different drugs, ketones bodies, glucose, protein

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21
Q

What is NOT normally found in urine?

A

ketone bodies, leukocyte esterase, protein, glucose
–> can indicated diabetes, fat metabolism, infection, or cancer

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22
Q

What is a specific gravity in regards to a urine sample?

A

concentrate of particles, electrolytes, and waste
(high = dehydration or kidney disease, low= diluted urine, diuretics)

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23
Q

What does turbidity look at in regards to urine?

A

if it is clear or cloudy

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24
Q

What is leukocyte esterase?

A

enzyme found in WBC (neutrophils), indicates a UTI

leuko means white, cyte means cell, enzymes end in -ase. WBC are found in infections (UTIs)

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25
Q

What does an increase in nitrites indicate in a urine specimen?

A

a conversion of nitrates into nitrites, done when there is a bacteria like E.coli present

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26
Q

What are casts in the urine?

A

clumps of cells

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27
Q

What does a urine culture look at? How long does it take?

A

helps us identify what type of pathogen is presence in a urinary infection and what antibiotic will treat it, takes roughly 24 hours

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28
Q

What is BUN?

A

blood urea nitrogen, measures the effectiveness of kidney excretion of urea nitrogen which is a byproduct of protein breakdown in the liver

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29
Q

What external factors can effect BUN?

A

dehydration, infection, chemotherapy, steroid use

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30
Q

Normal BUN levels

A

10-20 mg/dL

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31
Q

What is creatinine?

A

produced when muscle or other proteins is broken down, great indicator of protein function

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32
Q

Normal creatine levels for a man

A

0.6-1.2 mg/dL

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33
Q

Normal creatinine levels for a female

A

0.5-1.1mg/dL

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34
Q

What does an increased creatinine indicate?

A

the ONLY reason creatinine would be increased is kidney impairement

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35
Q

What does a decreased creatinine indicate?

A

Decreased muscle mass

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36
Q

What does GFR stand for? What does it mean?

A

Glomerular filtration rate, creatinine clearance, how well the kidneys are filtering

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37
Q

What does a kidney ultrasonography (ultrasound) do, and what do we need to teach our patient to do prior to?

A

assesses blood flow to the kidney and looks for kidney stones and tumors, patient will need to drink 500- 1000mL of fluid 2-3 hours prior to procedure to ensure the bladder is full

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38
Q

What does a bladder scan do?

A

looks at post void residual, how much urine is in the bladder prior to catheter insertion. no education needed, noninvasive

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39
Q

What information does a CT or MRI give?

A

shows masses/ obstructions within the urinary system (cysts, stones, tumors, etc.) generally uses IV contrast, requires the patient to be NPO.

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40
Q

What is a KUB?

A

X-ray of the kidneys, ureters, or bladder, no patient prep needed

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41
Q

What does a KUB look at?

A

kidney size, gross obstruction (stones)

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42
Q

What does a renal scan look at?

A

looks at renal perfusion, estimates GFR and gives us functional information about the kidney just by scanning the kidney

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43
Q

What is an IV Pyelogram?

A

x-ray that uses IV contrast to evaluate KUB and diagnose blood in the urine/ pain in the back. used to determine UTI and kidney disease

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44
Q

What medication do you need to stop at least 24-48 hours before using IV contrast?

A

Metformin

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45
Q

What are some patient teaching points and nursing interventions for IV pyelogram?

A

patent IV is needed,NPO, monitor I&O 24hr post procedure

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46
Q

What is a cystoscopy?

A

A narrow tube inserted into urethra and advanced to bladder, looks for any abnormalities, occlusions, obstructions (and can remove kidney stones)

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47
Q

What are some nursing interventions and patient teaching points for a cystoscopy?

A

performed under general anesthesia or local anesthesia with some sedation
patient will be NPO after midnight prior to
pt will need a bowel prep with laxatives or enemas prior to
patient will be in the lithotomy position (on back, knees in the air)
urine may be pink tinged but not a gross amount of blood
patient needs to take oral fluids to increase output to reduce burning sensation

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48
Q

What is a voiding cystourethroscopy?

A

They watch you piss on an x-ray and see if theres a backward flow of urine path that is temporarily needed

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49
Q

What are some nursing interventions for a voiding cystourethroscopy?

A

increase fluid intake for 72 hours to minimize burning, monitor I&O, monitor for s/s of infection

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50
Q

What happens during kidney biopsy?

A

kidney tissue is removed and tested percutaneously (through the skin)

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51
Q

Does a kidney biopsy require informed consent?

A

Yes

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52
Q

What are some nursing considerations for a kidney biopsy?

A

Pt is NPO 4-6h prior to
R/F bleeding
monitor platelets and ptt and inr
Monitor vs (specifically bp {HTN causes increased bleeding})
Strict bedrest supine with back roll 2-6h after procedure
After bed rest is lifted and no bleeding is noted, client can walk to bathroom
Normal activity 24h after procedure if no bleeding has occurred
After 1-2 weeks client may resume strenuous activity

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53
Q

Why should the nurse check the bedsheets after a kidney biopsy?

A

Client is at risk for bleeding

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54
Q

What is a composite urine ?

A

all urine within a designated time frame must be collected

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55
Q

Creatinine clearance is where…?

A

A 24 urine sample is used to to evaluate kidney function and is compared to creatinine level in the blood.

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56
Q

What are some patient teaching points for a 24 hour urine sample?

A

void first specimen of the 24 hours, keep collection on ice

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57
Q

What is a lithotripsy?

A

a technique for treating stones in the kidney and ureter that does not require surgery. uses ultrasound shock waves to break up the stone in smaller fragments

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58
Q

What are some nursing considerations of a lithotripsy?

A

Pre: apply numbing cream over site, monitor cardiac rhythm and rate, moderate sedation
Post: strain the urine, indwelling catheter

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59
Q

What is a common side effect of a lithotripsy?

A

bruising on the flank on the affected side

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60
Q

What is a Ureterolithotomy & nephrolithotomy?

A

An incision made to remove a stone, either in ureter or kidney

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61
Q

What are some nursing considerations for a ureterolithotomy & nephrolithotomy?

A

Pre: NPO, hold blood thinners, bowel prep, ensure informed consent as been signed
Post: monitor patient post anesthesia, monitor bleeding, strain urine

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62
Q

What are some patient teaching points for a ureterolithotomy & nephrolithotomy?

A

maintain adequate fluid intake, dietary changes

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63
Q

What is a nephrostomy tube?

A

Tube is placed into kidney to prevent stones to pass through the urinary tract any further , prevents further damage throughout the urinary system

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64
Q

what are the nursing interventions for a nephrostomy tube?

A

Monitor for bleeding, infection
Replace sterile dressing
Flush tube as ordered

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65
Q

How often should you empty a nephrostomy tube bag?

A

every 2-3 hours or when full

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66
Q

Cystitis

A

can be caused by infection, drugs, radiation

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67
Q

What is infectious cystitis?

A

inflammation of the bladder related to E.coli (UTI)

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68
Q

What is a UTI?

A

Infection anywhere with in the urinary system, also known as an overarching umbrella term

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69
Q

What is the difference between an acute UTI and a chronic UTI?

A

Acute = invasion of pathogen
Chronic = 2+ in 6 months

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70
Q

What are is one of the biggest causes of an acute care UTI?

A

catheters

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71
Q

What bacteria causes UTIs?

A

E.coli

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72
Q

S/S of a UTI include what?

A

pain, urgency, pain (dysuria), burning, odor, blood tinged urine

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73
Q

What are the risk factors for a UTI?

A

women (30x more likely)
catheter
antibiotics
age
obstruction
backflow
diabetes (d/t excessive amounts of glucose in urine)
BPH
Tumor
Mass
Intercourse

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74
Q

What are the diagnostics for a UTI?

A

urinalysis and it will be positive for leukocyte esterase, WBC, RBC, nitrates, and bacteria

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75
Q

What is pyelonephritis?

A

infection and inflammation of the kidney, pelvis, and medulla

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76
Q

What causes pyelonephritis?

A

complication of a UTI, infection typically occurs due to urine backflow from bladder to ureters to kidneys

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77
Q

What is the main cause of acute pyelonephritis?

A

active bacterial infection (E.coli)

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78
Q

What is the main cause of chronic pyelonephritis?

A

repeated/ continued infections due to genetic abnormality/ congenital defect

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79
Q

What can occur to the body if there are repeated pyelonephritis infections?

A

scarring which can inhibit blood flow and decrease GFR.

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80
Q

What are the s/s of pyelonephritis?

A

CVA tenderness, back flank pain, HTN

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81
Q

What imbalances will occur with pyelonephritis?

A

inability to conserve sodium and tendency to develop hyperkalemia

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82
Q

What are common risk factors for pyelonephritis?

A

chronic stones, spinal cord injury, bladder tumor, HTN, diabetes

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83
Q

What are the diagnostics for pyelonephritis?

A

same as a UTI and also increased BUN and creatinine

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84
Q

What is glomerulonephritis?

A

anything that can injure or inflame the glomerulus (which filters the blood)

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85
Q

What is glomerulonephritis associated with symptom wise?

A

increased BP, progressive kidney damage which ALWAYS leads to CKD, anemia, edema

86
Q

When do the manifestations of glomerulonephritis occur for an acute case?

A

10 days after infection however there is a quick recovery

87
Q

What is the causative agent for acute glomerulonephritis?

A

streptococcus

88
Q

When do the manifestations of chronic glomerulonephritis occur for an chronic case?

A

20 years, there is mild protein in the urine

89
Q

What are the symptoms associated with chronic glomerulonephritis?

A

Much milder than acute
SOB, Crackles, weight gain, fatigue, decreased GFR, increased RBC, HTN, fatigue, occasional edema

90
Q

What medications do you use to treat UTI?

A

antibiotics, antifungals, analgesics, antispasmodics (decrease bladder spasms), fluids, sitz baths

91
Q

What medications do you use to treat pyelonephritis?

A

antibiotics, analgesics, fluids

92
Q

What medications do you use to treat glomerulonephritis?

A

antibiotics, corticosteroids (suppress immunity) and cytotoxic drugs, antihypertensive drugs, diuretics, SODIUM AND WATER RESTRICTION

93
Q

What patients do you teach to avoid crowds?

A

patients with glomerulonephritis d/t corticosteroids

94
Q

Common antibiotics to treat UTIs, pyelonephritis, and glomerulonephritis?

A

trimethorpin
trimethorpin/ sulfamethoxazole
nitrofuratoin

95
Q

What is the urinary analgesic commonly used, and what patient teaching do you need to include?

A

phenazopyradine, can turn pee orange or red and that is a normal finding

96
Q

What are renal calculi?

A

kidney stones, particles in the urine that can’t stay dissolved and clump together

97
Q

What is urolithiasis?

A

stones in the urinary tract

98
Q

What is nephrolithiasis?

A

formation of stones in the kidney

99
Q

What is uretolithiasis?

A

formation of stones in the ureter

100
Q

What is the most common reason for kidney stones?

A

Dehydration

101
Q

What are some other causes of kidney stone formation?

A

metabolic disorders causing excessive calcium

102
Q

What are some signs and symptoms of renal calculi?

A

N/V, sudden (colicky) sharp severe pain near the lower back, scrotum, and testes, radiating pain to the testicles, hematuria, dysuria, frequency

103
Q

What is the biggest risk factor for renal calculi?

A

dehydration

104
Q

What treatment is used for renal calculi?

A

opioids, antibiotics, NSAIDS

105
Q

What is hydronephrosis?

A

where the kidney itself enlarges because a stone is blocking, causing a urine backup and kidney pressure increases

106
Q

What is a hydroureter?

A

enlargement of a ureter which creates dilation above the obstruction

107
Q

What are common causes of hydronephrosis and a hydroureter?

A

tumor, stones, trauma, absesses

108
Q

What treatment options are used for patients who have hydronephrosis or hydroureter?

A

treat early, pain management, antibiotics as needed, dietary changes r/t stone content

109
Q

What diagnostics will you use for a patient with hydronephrosis or a hydroureter?

A

urinalysis, 24 hour urine (shows stone contents), CT of the abdomen or pelvis, KUB

110
Q

What is polycystic kidney disease?

A

congenital disorder where healthy kidney tissue is replaced with cysts

111
Q

What is the pathophysiology behind PKD?

A

tissue ischemia occurs, vessels constrict causing a reduction in blood flow to kidney, RAAS system is activated, HTN results.

112
Q

What symptom is a priority in PKD?

A

HTN, can worsen kidney condition. headache can also occur

113
Q

What are the diagnostics used for PKD?

A

ultrasound, MRI, CT, urinalysis, creatinine, BUN, GFR

114
Q

What nursing interventions will need to be implemented in a patient with PKD?

A

History assessment (family and personal)
HPI (s/s) (pain is the first sign, inspect abdomen, nocturia is also an early symptom)
Physical assessment (assess gently to decrease further pain, palpate lightly to not puncture cyst)

115
Q

What are some treatment options for a patient with PKD?

A

Control BP
Manage pain (avoid aspirin, use NSAIDS cautiously)
Treat constipation: increase fiber and fluids
Slow progression

116
Q

What does red bone marrow do in the body?

A

produce RBC

117
Q

What does yellow bone marrow do in the body?

A

contains fat, when a fracture occurs in the yellow bone marrow, patient is at risk for an embolism

118
Q

Osteoclasts

A

are like cats, and they destroy anything on the counter

119
Q

Osteoblasts

A

build

120
Q

What do you do during a focused skeletal assessment?

A

mobility, previous issues, previous/current illness, lifestyle, allergies, pain, weakness

121
Q

What is the calcitonin negative feedback loop?

A

calcitonin is released from the thyroid gland –> decreases calcium if above limits –>. inhibits bone reabsorption and renal excretion

122
Q

What is the PTH negative feedback loop?

A

parathyroid hormone is released for the parathyroid gland –> increases calcium if below limits –> stimulates osteoclastic activity to release stored calcium

123
Q

What is the relationship between estrogen bone density with age?

A

estrogens stimulate osteoblastic activity and inhibit PTH so when estrogen declines at menopause age, low calcium = increased bone loss (osteoporosis)

124
Q

How do you prevent musculoskeletal problems associated with aging?

A

Maintain healthy amount of calcium and vitamin D within diet
Weight bearing exercises
Fall prevention

125
Q

What are some patient teaching points to prevent musculoskeletal problems associated with aging?

A

Limit excess caffeine, alcohol, carbonated drinks
Consume protein, magnesium, Vitamin K
Avoid slippery surfaces
Exercise
Increase mobility

126
Q

What is a complete fracture?

A

entire width of bone

127
Q

What is an incomplete fracture?

A

bone does not divide

128
Q

What is a closed fracture?

A

no visible wound

129
Q

What is an open/ compound fracture?

A

break in the skin

130
Q

What is a simple fracture?

A

one fracture line

131
Q

What is a comminuted fracture?

A

multiple fracture lines, bone in multiple pieces

132
Q

What is a displaces fracture?

A

bone fragments not in alignment

133
Q

What is a non-displaced fracture?

A

bone fragments are in alignment

134
Q

What is a pathological/ spontaneous fracture?

A

d/t underlying disease

135
Q

What is a fatigue/ stress fracture?

A

d/t strain

136
Q

What is a compression fracture?

A

older adults with osteoporosis, very painful

137
Q

What are some indications for a pt who needs skin/ skeletal traction?

A

reduces pain while waiting for surgery, aids in realignment of the bone

138
Q

What is skin traction (Bucks traction)?

A

velcro boot attached to a pulley system and there is a weight that hangs down. decreases muscle spasms and keeps the bone in alignment while patient waits for surgery

139
Q

What are some nursing interventions for a patient receiving skin/ skeletal traction?

A

Pin care and maintaining clean site, monitor for skin breakdown q8hr
weights should never be moved onto the floor, should always be free hanging
neuro assessment

140
Q

What are the indications for a patient with an external fixator?

A

reduces and immobilizes fracture, encourages early mobility, used for soft tissue fracture

141
Q

What are the nursing interventions for a patient with an external fixator?

A

thorough pin care, post op care including monitoring pain, encouraging ambulation

142
Q

Emergency care for an extremity fracture includes what?

A

immobilize extremity, apply a splint to the area above and below, apply an icepack (but not directly on the skin)

143
Q

What are some assessment finding of a fracture?

A

neuromuscular, capillary refill, 5 P’s

144
Q

What are diagnostics for a fracture?

A

X-ray, CT, MRI

145
Q

What are some patient education points for a fracture patient?

A

Risk for falls, RICE, crutches

146
Q

What are some lab values you need to monitor for a fracture patient?

A

Hgb, Hit, ESR, WBC

147
Q

What treatment is used for fractures?

A

Pain management, nonsurgical, surgical

148
Q

What are nonsurgical nursing interventions for fractures?

A

Closed reductions, splints, boots, casts, traction (skin, bucks, skeletal)

149
Q

What are surgical interventions for a fracture patient?

A

Open reduction - internal versus external

150
Q

What are some complications of fractures?

A

Venous thromboembolism (DVT, PE), Infection, Compartment syndrome, fat embolism

151
Q

Assessment findings for patients with musculoskeletal trauma..?

A

Pain, tenderness, reduced movement, edema, ecchymosis (bruises )

152
Q

What are diagnostics for musculoskeletal trauma?

A

CT, MRI, Bone scan

153
Q

What are some good treatment options for musculoskeletal trauma?

A

Ice for 24-48 hrs, PT, steroid injections, massages, acupuncture

154
Q

What are some nursing care points for a patient with musculoskeletal trauma?

A

Assess pain, manage pain, reduce swelling, RICE

155
Q

What does RICE stand for?

A

rest ice compression elevation

156
Q

What are the assessment findings for an amputation?

A

neurovascular status, skin color, pain, bleeding, infection, monitor surgical site, pulses, phantom pain

157
Q

What is the treatment for an amputation in an emergent situation?

A

call 911, elevate limb, clean gauze, hold pressure

158
Q

What is the treatment for an amputation in a post amputation surgery setting?

A

pain management, PT/OT, infection prevention, prosthesis

159
Q

How do you treat phantom pain?

A

touching stump, massaging what’s left of the limb, pain medication, movement, distraction

160
Q

What is the nursing care for an amputation patient?

A

compression dressing, assess for bleeding, prevent further loss of circulation, promote comfort
promote mobility
assess for skin breakdown
Washed, rinse, dry daily
No alcohol or lotion
Wear prosthetic device
Teach pt limb care, keep wrapped in figure 8 method

161
Q

What lab values do you need to monitor for in a patient with an amputation?

A

IV calcitonin, Beta-blockers, gabapentin, Tens unit

162
Q

What medication would you give to an amputation patient to treat phantom limb pain?

A

IV calcitonin

163
Q

What will you give to a patient who is experiencing the constant, dull, burning pain after an amputation?

A

Beta blockers

164
Q

What medication will you give to a patient who is experiencing sharp, knife-like, burning, neuropathic pain associated with an amputation?

A

anti-epileptic drug

165
Q

What medication will you give to a patient experiencing muscle spasms and cramping with an amputation?

A

antasphasmotics like baclophen

166
Q

What are some complications of an amputation?

A

Bleeding/hemorrhaging, infection, flexion contractures, neuroma (sensitive tumor on damaged nerve)

167
Q

What should a patient with an amputation do to prevent complications?

A

push limb down into the bed to straighten muscle, ROM exercises, trapeze bar for strengthening, turn q2hr, firm mattress, prone position every 3-4hr for 20-30 min if not contraindicated, support on a pillow only for the first 24 hours

168
Q

What is carpal tunnel?

A

compression of the median nerve at the wrist which causes numbness in the hand

169
Q

What is the nursing assessment for carpal tunnel?

A

Phalen maneuver - Hold for 60 seconds and if tingling, numbness, and pain indicates carpal tunnel
Pain
Impaired mobility

170
Q

What are the nonsurgical treatment options for carpal tunnel?

A

Brace
NSAIDs

171
Q

What are the surgical treatment options for carpal tunnel?

A

Can release median nerve
Monitor neurovascular

172
Q

What is the nursing care for carpal tunnel?

A

Pain medication
Wrist splinting

173
Q

What education will you give to your patient who has recently been diagnosed with carpal tunnel?

A

avoid repetitive movements (pinching or grasping)
Avoid heavy grasping
Wear brace

174
Q

What medications will you give to a patient with carpal tunnel?

A

NSAIDs, corticosteroid injections

175
Q

What is a sprain?

A

excessive stretching of a ligament

176
Q

How do you care for a sprain?

A

immobilization, RICE, possible surgery if severe

177
Q

What is a strain?

A

excessive stretching of a muscle/ tendon

178
Q

How do you treat a strain?

A

Heat/cold, activity limitations, NSAIDs, muscle relaxants, possible tendon repair

179
Q

What is compartment syndrome?

A

acute, increased pressure in a compartment that decreases circulation

180
Q

What assessment do you use for compartment syndrome?

A

5 p’S

181
Q

What are the 5 P’s?

A

Pain, paleness, pulselessness, paresthesia, paralysis

182
Q

You can know the inflammation is in a compartment based on…?

A

If the pain medication doesn’t work

183
Q

How do you treat compartment syndrome?

A

fasciotomy

184
Q

What are the nursing interventions for compartment syndrome?

A

monitor for the 5 P’s, do not elevate the extremity, wound care.

185
Q

What assessment techniques do you use for a DVT/PE?

A

altered mental status is the earliest sign, increased respirations and increased heart rate, chest pain, dyspnea, crackles, decreased O2 stat.

186
Q

Where does a DVT originate?

A

legs/ pelvis

187
Q

What is the treatment for a DVT?

A

preventative measures, oxygen, anticoagulants, bedrest

188
Q

How does a fat embolism occur?

A

fracture of the long bone in the yellow bone marrow 12-48 hours after procedure

189
Q

How do you assess for a fat embolism?

A

altered mental status is the earliest sign, increased respirations and increased heart rate, chest pain, dyspnea, crackles, decreased O2 stat, petechia

190
Q

What is the treatment for a fat embolism?

A

bedrest, oxygen, IV fluids, fracture immobilization

191
Q

What are the complications of fractures?

A

compartment syndrome
DVT/PE
Fat embolism
infection (osteomyelitis)

192
Q

What is osteomyelitis?

A

bacteria in the bony tissue leading to infection

193
Q

What other pathogens can cause osteomyelitis?

A

parasites, viruses, fungal infections

194
Q

What is the pathophysiology behind osteomyelitis?

A

inflammatory response –> increased vascular leak –> exudate leaks into the tissue –> ischemia –> necrotic bone –> sequestrium is formed (dead, separated bone)

195
Q

What are acute symptoms of osteomyelitis?

A

Fever (above 101), swelling around affected area
possible erythema/ hyperpigmentation and heat in the affected area
tenders of affected area
bone pain that is constant, localized, and pulsating; worsens with movement

196
Q

What are s/s of chronic osteomyelitis?

A

-foot ulcers or bone surgery (most common cause)
-sinus tract formation
-localized pain
-drainage from the affected area

197
Q

How do you treat osteomyelitis?

A

Surgical debridement
Topical, oral, and IV antimicrobial therapy
MRSA treatment (IV vancomycin, IV daptomycin, Linezolid [IV or PO])
Pain management
Hyperbaric Oxygen Therapy

198
Q

What are the two types of casts?

A

fiberglass and plaster

199
Q

What is a fiberglass cast?

A

Waterproof synthetic material
Used most often for immobilization
Becomes dry and rigid within a few minutes
Decreases risk for impaired skin integrity

200
Q

What is a plaster cast?

A

Not as common anymore
Goes on hot and takes 24 hours to become dry

201
Q

What are nursing interventions/ patient teaching points for casts?

A

Monitor cases every 8 hours for fluid, swelling, smells, fit
Monitor for infection: do not insert anything within the cast
Assess for circulation
Cast cutter/saw doesn’t cut through skin, but client may feel warmth

202
Q

What is included in a neuromuscular assessment?

A

Capillary refill
Pulses
Mental status
Skin color
Sensation
mobility

203
Q

How do you prevent musculoskeletal problems associated with aging?

A

Maintain healthy amount of calcium and vitamin D within diet
Weight bearing exercises
Fall prevention

204
Q

What do you teach your patient to do to promote a healthy lifestyle for aging?

A

Limit excess caffeine, alcohol, carbonated drinks
Consume protein, magnesium, Vitamin K
Avoid slippery surfaces
Exercise
Increase mobility

205
Q

What does vitamin D and calcium do?

A

increase bone strength

206
Q

What should you increase and limit?

A

magnesium and phosphorus

207
Q

How to provide emergent care for an extremity fracture?

A

Immobilize extremity
Apply splint to the area above and below
Apply an icepack, but not directly on the skin

208
Q

What is an arthroscopic procedure?

A

arthroscopic procedure is the diagnosing and treating of joint problems

209
Q

Pt education for a CT scan, MRI

A

no jewelry

210
Q

How do you prevent tissue damage during a digit amputation?

A

do not place digit directly on ice, put it in cold water with a little bit of ice

Third Semester (5 decks)

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