Adult Care 1 Exam 3 Flashcards
Renal and Musculoskeletal
1
Q
What are the 2 functions of the kidney?
A
Regulatory and Hormonal
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.
3
Q
What is glomerular filtration?
A
a process the kidneys use to filter excess fluid and waste products out of the blood
4
Q
What is a GFR?
A
glomerular filtration rate, indicates how well our kidneys are functioning (filtration), a decreased GFR indicates kidney disease
5
Q
What does a decreased GFR put the patient at risk for?
A
adverse reactions with medications, calls for lower doses
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
7
Q
What does tubular secretion mean?
A
Allows substances to move from blood to urine
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
9
Q
What does EPO do within the body?
A
triggers the RBC production in bone marrow
10
Q
What do prostoglandins do within the body?
A
dilate and constrict kidney vessels to keep glomerular filtration at a constant rate
11
Q
Activated Vitamin D regulates what?
A
Calcium
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
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”
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
15
Q
When do the kidneys not self regulate their blood pressure?
A
systolic blood pressure is less than 65 or 70
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
17
Q
What can NOT pass the glomerular wall?
A
RBC, large particles
18
Q
What is a urinalysis?
A
A test that looks at waste products from the kidneys, it can help detect some urologic disorders
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
20
Q
What does a urinalysis look at?
A
color, clarity, concentration, presence of different drugs, ketones bodies, glucose, protein
21
Q
What is NOT normally found in urine?
A
ketone bodies, leukocyte esterase, protein, glucose
–> can indicated diabetes, fat metabolism, infection, or cancer
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)
23
Q
What does turbidity look at in regards to urine?
A
if it is clear or cloudy
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)
25
What does an increase in nitrites indicate in a urine specimen?
a conversion of nitrates into nitrites, done when there is a bacteria like E.coli present
26
What are casts in the urine?
clumps of cells
27
What does a urine culture look at? How long does it take?
helps us identify what type of pathogen is presence in a urinary infection and what antibiotic will treat it, takes roughly 24 hours
28
What is BUN?
blood urea nitrogen, measures the effectiveness of kidney excretion of urea nitrogen which is a byproduct of protein breakdown in the liver
29
What external factors can effect BUN?
dehydration, infection, chemotherapy, steroid use
30
Normal BUN levels
10-20 mg/dL
31
What is creatinine?
produced when muscle or other proteins is broken down, great indicator of protein function
32
Normal creatine levels for a man
0.6-1.2 mg/dL
33
Normal creatinine levels for a female
0.5-1.1mg/dL
34
What does an increased creatinine indicate?
the ONLY reason creatinine would be increased is kidney impairement
35
What does a decreased creatinine indicate?
Decreased muscle mass
36
What does GFR stand for? What does it mean?
Glomerular filtration rate, creatinine clearance, how well the kidneys are filtering
37
What does a kidney ultrasonography (ultrasound) do, and what do we need to teach our patient to do prior to?
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
38
What does a bladder scan do?
looks at post void residual, how much urine is in the bladder prior to catheter insertion. no education needed, noninvasive
39
What information does a CT or MRI give?
shows masses/ obstructions within the urinary system (cysts, stones, tumors, etc.) generally uses IV contrast, requires the patient to be NPO.
40
What is a KUB?
X-ray of the kidneys, ureters, or bladder, no patient prep needed
41
What does a KUB look at?
kidney size, gross obstruction (stones)
42
What does a renal scan look at?
looks at renal perfusion, estimates GFR and gives us functional information about the kidney just by scanning the kidney
43
What is an IV Pyelogram?
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
44
What medication do you need to stop at least 24-48 hours before using IV contrast?
Metformin
45
What are some patient teaching points and nursing interventions for IV pyelogram?
patent IV is needed,NPO, monitor I&O 24hr post procedure
46
What is a cystoscopy?
A narrow tube inserted into urethra and advanced to bladder, looks for any abnormalities, occlusions, obstructions (and can remove kidney stones)
47
What are some nursing interventions and patient teaching points for a cystoscopy?
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
48
What is a voiding cystourethroscopy?
They watch you piss on an x-ray and see if theres a backward flow of urine path that is temporarily needed
49
What are some nursing interventions for a voiding cystourethroscopy?
increase fluid intake for 72 hours to minimize burning, monitor I&O, monitor for s/s of infection
50
What happens during kidney biopsy?
kidney tissue is removed and tested percutaneously (through the skin)
51
Does a kidney biopsy require informed consent?
Yes
52
What are some nursing considerations for a kidney biopsy?
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
53
Why should the nurse check the bedsheets after a kidney biopsy?
Client is at risk for bleeding
54
What is a composite urine ?
all urine within a designated time frame must be collected
55
Creatinine clearance is where...?
A 24 urine sample is used to to evaluate kidney function and is compared to creatinine level in the blood.
56
What are some patient teaching points for a 24 hour urine sample?
void first specimen of the 24 hours, keep collection on ice
57
What is a lithotripsy?
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
58
What are some nursing considerations of a lithotripsy?
Pre: apply numbing cream over site, monitor cardiac rhythm and rate, moderate sedation
Post: strain the urine, indwelling catheter
59
What is a common side effect of a lithotripsy?
bruising on the flank on the affected side
60
What is a Ureterolithotomy & nephrolithotomy?
An incision made to remove a stone, either in ureter or kidney
61
What are some nursing considerations for a ureterolithotomy & nephrolithotomy?
Pre: NPO, hold blood thinners, bowel prep, ensure informed consent as been signed
Post: monitor patient post anesthesia, monitor bleeding, strain urine
62
What are some patient teaching points for a ureterolithotomy & nephrolithotomy?
maintain adequate fluid intake, dietary changes
63
What is a nephrostomy tube?
Tube is placed into kidney to prevent stones to pass through the urinary tract any further , prevents further damage throughout the urinary system
64
what are the nursing interventions for a nephrostomy tube?
Monitor for bleeding, infection
Replace sterile dressing
Flush tube as ordered
65
How often should you empty a nephrostomy tube bag?
every 2-3 hours or when full
66
Cystitis
can be caused by infection, drugs, radiation
67
What is infectious cystitis?
inflammation of the bladder related to E.coli (UTI)
68
What is a UTI?
Infection anywhere with in the urinary system, also known as an overarching umbrella term
69
What is the difference between an acute UTI and a chronic UTI?
Acute = invasion of pathogen
Chronic = 2+ in 6 months
70
What are is one of the biggest causes of an acute care UTI?
catheters
71
What bacteria causes UTIs?
E.coli
72
S/S of a UTI include what?
pain, urgency, pain (dysuria), burning, odor, blood tinged urine
73
What are the risk factors for a UTI?
women (30x more likely)
catheter
antibiotics
age
obstruction
backflow
diabetes (d/t excessive amounts of glucose in urine)
BPH
Tumor
Mass
Intercourse
74
What are the diagnostics for a UTI?
urinalysis and it will be positive for leukocyte esterase, WBC, RBC, nitrates, and bacteria
75
What is pyelonephritis?
infection and inflammation of the kidney, pelvis, and medulla
76
What causes pyelonephritis?
complication of a UTI, infection typically occurs due to urine backflow from bladder to ureters to kidneys
77
What is the main cause of acute pyelonephritis?
active bacterial infection (E.coli)
78
What is the main cause of chronic pyelonephritis?
repeated/ continued infections due to genetic abnormality/ congenital defect
79
What can occur to the body if there are repeated pyelonephritis infections?
scarring which can inhibit blood flow and decrease GFR.
80
What are the s/s of pyelonephritis?
CVA tenderness, back flank pain, HTN
81
What imbalances will occur with pyelonephritis?
inability to conserve sodium and tendency to develop hyperkalemia
82
What are common risk factors for pyelonephritis?
chronic stones, spinal cord injury, bladder tumor, HTN, diabetes
83
What are the diagnostics for pyelonephritis?
same as a UTI and also increased BUN and creatinine
84
What is glomerulonephritis?
anything that can injure or inflame the glomerulus (which filters the blood)
85
What is glomerulonephritis associated with symptom wise?
increased BP, progressive kidney damage which ALWAYS leads to CKD, anemia, edema
86
When do the manifestations of glomerulonephritis occur for an acute case?
10 days after infection however there is a quick recovery
87
What is the causative agent for acute glomerulonephritis?
streptococcus
88
When do the manifestations of chronic glomerulonephritis occur for an chronic case?
20 years, there is mild protein in the urine
89
What are the symptoms associated with chronic glomerulonephritis?
Much milder than acute
SOB, Crackles, weight gain, fatigue, decreased GFR, increased RBC, HTN, fatigue, occasional edema
90
What medications do you use to treat UTI?
antibiotics, antifungals, analgesics, antispasmodics (decrease bladder spasms), fluids, sitz baths
91
What medications do you use to treat pyelonephritis?
antibiotics, analgesics, fluids
92
What medications do you use to treat glomerulonephritis?
antibiotics, corticosteroids (suppress immunity) and cytotoxic drugs, antihypertensive drugs, diuretics, SODIUM AND WATER RESTRICTION
93
What patients do you teach to avoid crowds?
patients with glomerulonephritis d/t corticosteroids
94
Common antibiotics to treat UTIs, pyelonephritis, and glomerulonephritis?
trimethorpin
trimethorpin/ sulfamethoxazole
nitrofuratoin
95
What is the urinary analgesic commonly used, and what patient teaching do you need to include?
phenazopyradine, can turn pee orange or red and that is a normal finding
96
What are renal calculi?
kidney stones, particles in the urine that can't stay dissolved and clump together
97
What is urolithiasis?
stones in the urinary tract
98
What is nephrolithiasis?
formation of stones in the kidney
99
What is uretolithiasis?
formation of stones in the ureter
100
What is the most common reason for kidney stones?
Dehydration
101
What are some other causes of kidney stone formation?
metabolic disorders causing excessive calcium
102
What are some signs and symptoms of renal calculi?
N/V, sudden (colicky) sharp severe pain near the lower back, scrotum, and testes, radiating pain to the testicles, hematuria, dysuria, frequency
103
What is the biggest risk factor for renal calculi?
dehydration
104
What treatment is used for renal calculi?
opioids, antibiotics, NSAIDS
105
What is hydronephrosis?
where the kidney itself enlarges because a stone is blocking, causing a urine backup and kidney pressure increases
106
What is a hydroureter?
enlargement of a ureter which creates dilation above the obstruction
107
What are common causes of hydronephrosis and a hydroureter?
tumor, stones, trauma, absesses
108
What treatment options are used for patients who have hydronephrosis or hydroureter?
treat early, pain management, antibiotics as needed, dietary changes r/t stone content
109
What diagnostics will you use for a patient with hydronephrosis or a hydroureter?
urinalysis, 24 hour urine (shows stone contents), CT of the abdomen or pelvis, KUB
110
What is polycystic kidney disease?
congenital disorder where healthy kidney tissue is replaced with cysts
111
What is the pathophysiology behind PKD?
tissue ischemia occurs, vessels constrict causing a reduction in blood flow to kidney, RAAS system is activated, HTN results.
112
What symptom is a priority in PKD?
HTN, can worsen kidney condition. headache can also occur
113
What are the diagnostics used for PKD?
ultrasound, MRI, CT, urinalysis, creatinine, BUN, GFR
114
What nursing interventions will need to be implemented in a patient with PKD?
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
What are some treatment options for a patient with PKD?
Control BP
Manage pain (avoid aspirin, use NSAIDS cautiously)
Treat constipation: increase fiber and fluids
Slow progression
116
What does red bone marrow do in the body?
produce RBC
117
What does yellow bone marrow do in the body?
contains fat, when a fracture occurs in the yellow bone marrow, patient is at risk for an embolism
118
Osteoclasts
are like cats, and they destroy anything on the counter
119
Osteoblasts
build
120
What do you do during a focused skeletal assessment?
mobility, previous issues, previous/current illness, lifestyle, allergies, pain, weakness
121
What is the calcitonin negative feedback loop?
calcitonin is released from the thyroid gland --> decreases calcium if above limits -->. inhibits bone reabsorption and renal excretion
122
What is the PTH negative feedback loop?
parathyroid hormone is released for the parathyroid gland --> increases calcium if below limits --> stimulates osteoclastic activity to release stored calcium
123
What is the relationship between estrogen bone density with age?
estrogens stimulate osteoblastic activity and inhibit PTH so when estrogen declines at menopause age, low calcium = increased bone loss (osteoporosis)
124
How do you prevent musculoskeletal problems associated with aging?
Maintain healthy amount of calcium and vitamin D within diet
Weight bearing exercises
Fall prevention
125
What are some patient teaching points to prevent musculoskeletal problems associated with aging?
Limit excess caffeine, alcohol, carbonated drinks
Consume protein, magnesium, Vitamin K
Avoid slippery surfaces
Exercise
Increase mobility
126
What is a complete fracture?
entire width of bone
127
What is an incomplete fracture?
bone does not divide
128
What is a closed fracture?
no visible wound
129
What is an open/ compound fracture?
break in the skin
130
What is a simple fracture?
one fracture line
131
What is a comminuted fracture?
multiple fracture lines, bone in multiple pieces
132
What is a displaces fracture?
bone fragments not in alignment
133
What is a non-displaced fracture?
bone fragments are in alignment
134
What is a pathological/ spontaneous fracture?
d/t underlying disease
135
What is a fatigue/ stress fracture?
d/t strain
136
What is a compression fracture?
older adults with osteoporosis, very painful
137
What are some indications for a pt who needs skin/ skeletal traction?
reduces pain while waiting for surgery, aids in realignment of the bone
138
What is skin traction (Bucks traction)?
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
What are some nursing interventions for a patient receiving skin/ skeletal traction?
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
What are the indications for a patient with an external fixator?
reduces and immobilizes fracture, encourages early mobility, used for soft tissue fracture
141
What are the nursing interventions for a patient with an external fixator?
thorough pin care, post op care including monitoring pain, encouraging ambulation
142
Emergency care for an extremity fracture includes what?
immobilize extremity, apply a splint to the area above and below, apply an icepack (but not directly on the skin)
143
What are some assessment finding of a fracture?
neuromuscular, capillary refill, 5 P's
144
What are diagnostics for a fracture?
X-ray, CT, MRI
145
What are some patient education points for a fracture patient?
Risk for falls, RICE, crutches
146
What are some lab values you need to monitor for a fracture patient?
Hgb, Hit, ESR, WBC
147
What treatment is used for fractures?
Pain management, nonsurgical, surgical
148
What are nonsurgical nursing interventions for fractures?
Closed reductions, splints, boots, casts, traction (skin, bucks, skeletal)
149
What are surgical interventions for a fracture patient?
Open reduction - internal versus external
150
What are some complications of fractures?
Venous thromboembolism (DVT, PE), Infection, Compartment syndrome, fat embolism
151
Assessment findings for patients with musculoskeletal trauma..?
Pain, tenderness, reduced movement, edema, ecchymosis (bruises )
152
What are diagnostics for musculoskeletal trauma?
CT, MRI, Bone scan
153
What are some good treatment options for musculoskeletal trauma?
Ice for 24-48 hrs, PT, steroid injections, massages, acupuncture
154
What are some nursing care points for a patient with musculoskeletal trauma?
Assess pain, manage pain, reduce swelling, RICE
155
What does RICE stand for?
rest ice compression elevation
156
What are the assessment findings for an amputation?
neurovascular status, skin color, pain, bleeding, infection, monitor surgical site, pulses, phantom pain
157
What is the treatment for an amputation in an emergent situation?
call 911, elevate limb, clean gauze, hold pressure
158
What is the treatment for an amputation in a post amputation surgery setting?
pain management, PT/OT, infection prevention, prosthesis
159
How do you treat phantom pain?
touching stump, massaging what’s left of the limb, pain medication, movement, distraction
160
What is the nursing care for an amputation patient?
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
What lab values do you need to monitor for in a patient with an amputation?
IV calcitonin, Beta-blockers, gabapentin, Tens unit
162
What medication would you give to an amputation patient to treat phantom limb pain?
IV calcitonin
163
What will you give to a patient who is experiencing the constant, dull, burning pain after an amputation?
Beta blockers
164
What medication will you give to a patient who is experiencing sharp, knife-like, burning, neuropathic pain associated with an amputation?
anti-epileptic drug
165
What medication will you give to a patient experiencing muscle spasms and cramping with an amputation?
antasphasmotics like baclophen
166
What are some complications of an amputation?
Bleeding/hemorrhaging, infection, flexion contractures, neuroma (sensitive tumor on damaged nerve)
167
What should a patient with an amputation do to prevent complications?
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
What is carpal tunnel?
compression of the median nerve at the wrist which causes numbness in the hand
169
What is the nursing assessment for carpal tunnel?
Phalen maneuver - Hold for 60 seconds and if tingling, numbness, and pain indicates carpal tunnel
Pain
Impaired mobility
170
What are the nonsurgical treatment options for carpal tunnel?
Brace
NSAIDs
171
What are the surgical treatment options for carpal tunnel?
Can release median nerve
Monitor neurovascular
172
What is the nursing care for carpal tunnel?
Pain medication
Wrist splinting
173
What education will you give to your patient who has recently been diagnosed with carpal tunnel?
avoid repetitive movements (pinching or grasping)
Avoid heavy grasping
Wear brace
174
What medications will you give to a patient with carpal tunnel?
NSAIDs, corticosteroid injections
175
What is a sprain?
excessive stretching of a ligament
176
How do you care for a sprain?
immobilization, RICE, possible surgery if severe
177
What is a strain?
excessive stretching of a muscle/ tendon
178
How do you treat a strain?
Heat/cold, activity limitations, NSAIDs, muscle relaxants, possible tendon repair
179
What is compartment syndrome?
acute, increased pressure in a compartment that decreases circulation
180
What assessment do you use for compartment syndrome?
5 p'S
181
What are the 5 P's?
Pain, paleness, pulselessness, paresthesia, paralysis
182
You can know the inflammation is in a compartment based on...?
If the pain medication doesn't work
183
How do you treat compartment syndrome?
fasciotomy
184
What are the nursing interventions for compartment syndrome?
monitor for the 5 P’s, do not elevate the extremity, wound care.
185
What assessment techniques do you use for a DVT/PE?
altered mental status is the earliest sign, increased respirations and increased heart rate, chest pain, dyspnea, crackles, decreased O2 stat.
186
Where does a DVT originate?
legs/ pelvis
187
What is the treatment for a DVT?
preventative measures, oxygen, anticoagulants, bedrest
188
How does a fat embolism occur?
fracture of the long bone in the yellow bone marrow 12-48 hours after procedure
189
How do you assess for a fat embolism?
altered mental status is the earliest sign, increased respirations and increased heart rate, chest pain, dyspnea, crackles, decreased O2 stat, *petechia*
190
What is the treatment for a fat embolism?
bedrest, oxygen, IV fluids, fracture immobilization
191
What are the complications of fractures?
compartment syndrome
DVT/PE
Fat embolism
infection (osteomyelitis)
192
What is osteomyelitis?
bacteria in the bony tissue leading to infection
193
What other pathogens can cause osteomyelitis?
parasites, viruses, fungal infections
194
What is the pathophysiology behind osteomyelitis?
inflammatory response --> increased vascular leak --> exudate leaks into the tissue --> ischemia --> necrotic bone --> sequestrium is formed (dead, separated bone)
195
What are acute symptoms of osteomyelitis?
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
What are s/s of chronic osteomyelitis?
-foot ulcers or bone surgery (most common cause)
-sinus tract formation
-localized pain
-drainage from the affected area
197
How do you treat osteomyelitis?
Surgical debridement
Topical, oral, and IV antimicrobial therapy
MRSA treatment (IV vancomycin, IV daptomycin, Linezolid [IV or PO])
Pain management
Hyperbaric Oxygen Therapy
198
What are the two types of casts?
fiberglass and plaster
199
What is a fiberglass cast?
Waterproof synthetic material
Used most often for immobilization
Becomes dry and rigid within a few minutes
Decreases risk for impaired skin integrity
200
What is a plaster cast?
Not as common anymore
Goes on hot and takes 24 hours to become dry
201
What are nursing interventions/ patient teaching points for casts?
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
What is included in a neuromuscular assessment?
Capillary refill
Pulses
Mental status
Skin color
Sensation
mobility
203
How do you prevent musculoskeletal problems associated with aging?
Maintain healthy amount of calcium and vitamin D within diet
Weight bearing exercises
Fall prevention
204
What do you teach your patient to do to promote a healthy lifestyle for aging?
Limit excess caffeine, alcohol, carbonated drinks
Consume protein, magnesium, Vitamin K
Avoid slippery surfaces
Exercise
Increase mobility
205
What does vitamin D and calcium do?
increase bone strength
206
What should you increase and limit?
magnesium and phosphorus
207
How to provide emergent care for an extremity fracture?
Immobilize extremity
Apply splint to the area above and below
Apply an icepack, but not directly on the skin
208
What is an arthroscopic procedure?
arthroscopic procedure is the diagnosing and treating of joint problems
209
Pt education for a CT scan, MRI
no jewelry
210
How do you prevent tissue damage during a digit amputation?
do not place digit directly on ice, put it in cold water with a little bit of ice
