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00NCLEX > Adult Musculoskeletal > Flashcards

Adult Musculoskeletal Flashcards

1
Q

Fat embolism

A
  • occurs within 48 hours following long bone fractures
  • HYPOTENSION
  • fever
  • petechiae = reddish-purple spots
    • not seen in pulmonary embolism
  • symptoms mimic pulmonary embolism
    • respiratory distress
    • tachypnea
    • low oxygen saturation
    • tachycardia
    • chest pain
  • IMMOBILIZATION LOWERS RISK
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2
Q

Huntington’s disease

A
  • muscle atrophy and contractures
  • give range of motion exercises
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3
Q

Rheumatoid arthritis (RA)

A
  • symmetrical joint involvement
  • bilateral joint pain and swelling
  • fatigue
  • low-grade fever
  • morning stiffness
  • weight loss
  • recommend handheld shower head
  • give NSAID
  • pain relieved by splint
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4
Q

Parkinson’s

A
  • blurred vision (not diplopia)
  • emotional lability
    • exaggerated changes in mood
  • fatigue
  • muscle incoordination
    • dyphageia
      • increase risk of aspiration and pneumonia
  • urinary urgency
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5
Q

Myasthenia gravis

A
  • muscle weakness
  • risk for impaired gas exchange
  • diplopia
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6
Q

Myasthenia gravis care

A
  • noninvasive mechanical ventilation
  • thymectomy can help
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7
Q

Multiple Sclerosis (MS)

A
  • vision changes
    • diplopia
  • mood changes (lability)
  • fatigue
  • diminshed response to pain!
  • muscle spasms and poor control
  • heat sensitivity!
  • urinary urgency

loss of myelin sheath on nerve

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8
Q

Thymectomy

A
  • removal of thymus
  • monitor respiratory status
  • ensure a bag-valve mask is available
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9
Q

Thyroidectomy care

A
  • calcium gluconate should be available because of the risk of severe hypocalcemia
    • numbness/tingling/twitching
  • tracheostomy kit because of the risk of airway edema
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10
Q

Traction care

A
  • avoid keeping the pulley system tight
  • no weight on bed/floor
  • weights 5-10 lbs
  • overhead trapeze
  • elevate feet to 10-20 degrees (prevent sliding)
  • DO NOT ELEVATE HOB
  • if pale, cold, unpalpable pulse
    • indicate circulatory impairment
    • NOTIFY PHCP
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11
Q

Fiberglass

A
  • waterproof synthetic casting material
  • can dry and become rigid within 30 minutes
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12
Q

Myopathy

A
  • elevated creatine levels
  • encourage active ROM exercises to prevent stiffness
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13
Q

Continuous passive motion (CPM)

A
  • use in total knee replacement
  • flex and extend knee
  • reduce scar tissue formation
  • maintain joint mobility*
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14
Q

Erythrocyte sedimentation rate (ESR)

A
  • marker for inflammation
  • elevated in osteomyelitis
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15
Q

Osteomyelitis

A
  • inflammation of the bone
  • caused by staphylococcal bacteria
  • follows respiratory or gastro infection
  • fever greater than 101F(38.3C)
  • antibiotics (6-12 weeks)
  • elevated ESR
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16
Q

Osteoarthritis

A
  • Heberden nodes
    • pea sized bony bumps on fingers close to nail
  • Brouchard node
    • bony bumps on middle joint of finger
  • morning stiffness
  • give NSAID
  • pain relived by splinting
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17
Q

Paget’s disease

A
  • bones become weaked and deformed
  • common areas are skull, pelvis, spine
18
Q

Asterixis

A
  • hand flopping tremor
    • nitrogenous waste buildup
  • End stage renal disease (ESRD)
  • hepatic encephalopathy
  • drug intoxication with phenytoin
19
Q

Lumbar puncture

A
  • used to obtain cerebrospinal fluid (CSF)
  • diagnose meningitis
  • encourage fluids
  • positioned lying flat for several hours
  • CONTRAINDICATED if increased ICP
20
Q

Halo fixator device

A
  • pins in skull, maintain spinal alignment
  • report infection or drainage
    • can be osteomyelitis (cranial bone infection)
  • wrench should be fixed to front of chest in case CPR
  • roll on side and push to get up from bed
  • cotton clothes worn under vest
    • no lotion/powder used
  • give straws for drinking
    • cut food into small pieces
21
Q

Avulsion fracture

A
  • fracture that pulls part of bone from tendon or ligament
22
Q

Complete fracture

A
  • whole cross section of bone
23
Q

Greenstick fracture

A
  • affects only one side of bone
24
Q

Polyarthritis

A
  • seen in rheumatic fever
  • give NSAID or steroid
    • naproxen
25
Q

Prolonged immobility can causes

A
  • decrease bone density
  • atelectasis
  • high calcium level
26
Q

Ganglion cyst

A
  • benign tumors
  • round and non-tender
  • usually on wrists
27
Q

Pilar cyst

A
  • fluid filled cyst found in hair follicle (scalp)
28
Q

Osteoporosis

A
  • decrease in bone mass = monitor for fractures
  • increased risk in
    • postmenopause
    • asian/white/women
    • men over 70 y/o = low testosterone
    • excessive smoking/drinking
  • encourage weight-bearing, calcium, vitamin D
29
Q

Laminectomy

A
  • spine surgery = applies for all spinal surgeries
  • LOCATION LOCATION LOCATION
  • Cervical = neck
  • Thoracic = upper back
  • Lumbar = lower back
30
Q

Cervical laminectomy

A
  • supplies the diaphragm and the arms
  • pre-op
  • first, assess for breathing
  • next, check functions of arms/hands
  • post-op
    • monitor for pneumonia
    • permantely cannot lift over your head
31
Q

Thoracic laminectomy

A
  • supplies gut/abdominal muscles
  • prpe-op
    • assess cough and bowels (cannot cough when you cannot contract abs)
  • post-op
    • pneumonia and paralytic ileus
32
Q

Lumbar laminectomy

A
  • lumbar supplies bladder and legs
  • pre-op
    • assess for urinary retention/last void/empty bladder
    • evaluate leg functions
  • post-op
    • urinary retention
    • leg problems
  • Lumbar = Legs, Urinary retention
33
Q

Postop Laminectomy

A
  • LOG ROLL for 6 weeks
  • do not dangle
  • supine to walking ASAP
  • sit for 10-15 min MAX to avoid orrthostatic hypotension
    • no more than 30 min
  • dont drive for 6 weeks
  • dont lift more than 5 pounds for 6 weeks
  • never again lift with waist
  • no jerking = no amusement park, horse riding, trail biking
34
Q

Cheiloplasty

A
  • cleft lip repair
  • causes excessive secretions = aspiration risk
    • ensure suction equipment available
  • never lay prone
35
Q

Cleft palate repair

A
  • place prone to promote drainage of secretions
36
Q

Micrognathia

A
  • undersized jaw
37
Q

Choanal atresia

A
  • nasal opening clogged by soft tissue or bone
38
Q

Osteomalacia

A
  • bone softening from low Vitamin D levels
  • monitor for fractures
  • most common cause is malnutrition
  • similar to osteoporosis
39
Q

Knee arthroplasty

A
  • require crutches
  • high risk for venous thromboembolism
    • resume anticoagulants for 14 days
40
Q

Carpal Tunnel Syndrome (CTS)

A
  • give NSAID
  • pain relieved with splinting
    • just like osteoarthritis, rheumatoid arthritis
41
Q

Rheumatoid arthritis (RA) vs Osteoarthritis (OA) vs Carpal tunnel syndrome (CTS)

A
42
Q

Contracture

A
  • permanent tightening of muscles, tendons, and skin
  • joints shorten and become stiff
    • joints can’t achieve full ROM
  • results from
    • disuse of muscle
    • atrophy
    • shortening muscle fibers

00NCLEX (30 decks)

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