Chapter 4 Exam Flashcards
Support protection movement mineral storage and hematopoiesis
Functions of the skeletal system
No movement
Synarthrosis
Slight movement
Amphiarthrosis
Free movement
Diarthrosis
Motion maintenance of posture and production of heat
Functions of the muscular system
Neurotransmitter for the skeletal muscle
ACH
Breaks down the ACH once it has transferred the message
Cholinesterase
A movement of an extremity away from the midline of the body
Abduction
A movement of the an extremity towards the midline of the body
Adduction
A movement allowed by certain joints of the skeleton that increases the angle between two adjoining bones
Extension
A movement allowed by certain joints of the skeleton that decreases the angle between two adjoining bones
Flexion
A movement of a bone around it’s longitudinal’s axis
Rotation
A movement of the hand and forearm that causes the Palm to face upward or forward
Supination
A movement of the hand and forearm that causes the Palm to face downward or backward
Pronation
A movement that causes the top of the foot to elevate or tilt upward
Dorsiflexion
A movement that causes the bottom of the foot to be directed downward
Plantar flexion
Is a myelographic examination that involves injection of radiopaque dye into the subarachnoid space at the lumbar spine to x-ray the spinal cord and vertebral column
Myelogram
This is used to detect structural disorders such as herniated disc, tumors, or the presence of infection
Myelogram
Lumbar puncture
Spinal tap
If this is used assess for allergy history to iodine or seafood, allergies of nature will cause reactions to this and always notify the health care provider if allergies exist
Contrast medium
This examination can be performed with or without the use of contrast medium
Myelogram
This examination may involve the entire spine or just the cervical or lumbar area
Myelogram
After this examination if the dye is used it is removed thru the spinal needle to prevent meningeal irritation
Myelogram
This is used most often and does not have to be removed because the body absorbs it and then the urine excretes it for a myelogram
Water soluble dye
Inform the patient that the test is performed with them on a what kind of table that is moved during the test to allow the contrast medium to flow upto the cervical area
Tilting
This is the most common discomfort after a myelogram
Headache
If water soluble dye is used the patient should lie in what position for approximately 8 hours after the myelogram to keep the dye in the lower spine and it reduces CSF leakage
Semi fowlers position
Headache, stiffness in the neck, leg weakness, or difficulty voiding and severely includes seizure, infection, drowsiness, headache, numbness, and paralysis and nuchal rigidity
Risk of myelogram
Nuclear scanning test are done in the nuclear medicine department which has scanners and camera detector that record images on radioactive film and are used with low radioactive isotopes
Pet scans
Nursing interventions for pet scans
Obtain written consent, inform that the radioactive isotopes won’t affect family, and follow the specific instructions for the specific test
Musculoskeletal magnetic resonance imaging assist in diagnosing abnormalities of bone and joint and surrounding soft tissue structures, includes cartilage, synovium, ligaments, and tendons this test uses magnetism and radio waves to make images of cross sections of the body
MRI
For this type of test preparation includes removal of any metal, titanium is safe but not if patient was involved in a explosion
MRI
This machine looks like a narrow tunnel which completely encloses the patient and they are required to lie still in the machine for 45 to 60 minutes, the patient enters head first and may feel some anxiety or claustrophobia
MRI Machine
After this test you must assess vital signs and allow patients to resume pre-test activities and they have no adverse effects
MRI
This involves body section examined from many different angles which uses a narrow x-ray beam and produces a three-dimensional picture of the structure being studied and iodine contrast dye is used sometimes and has radiation exposure occurs
CT
Get consent form from the patient, asking for allergies, keeping patient NPO, assess VS, voiding before test, removal of all metal, explain that patient must lie still completely during test and may feel warm and slightly nauseated when dye is injected
Patient preparation for CT scan
Observe for delayed allergic reactions and encourage fluids
Patient post preparation of a CT
This test is typically valuable in detecting metastic and inflammatory bone disease. This involves IV administration of nucleotides 2-3 hours before each test, no food or fluid restriction, and drink only water
Bone scans
This is a procedure done to obtain a specimen of body fluids
Aspiration
Obtaining consent, explain the procedure, encourage remaining still, voiding before procedure, maintain sterile technique, emotional support, upkeep of dressings, and specimen collection
Nursing interventions of aspiration
Is the puncture of a patient’s joint with a needle and the withdrawal of synovial fluid for diagnostic purposes
Arthrocentesis
Straw colored, clear, or slightly cloudy
Normal synovial fluid
With cloudy, milky, sangenius, yellow green or gray
Disease is present in synovial fluid
A lighted tube is used to visualize inside a body cavity
Endoscopy
Obtain consent, complete a checklist, initiate NPO status, administration of medicine, encourage voiding prior to, and maintain bed rest
Preparation for endoscopy
An endoscopic procedure that enables direct visualization of a joint
Arthroscopy
Explore the joint to determine the presence of a disease process, drain fluid from a joint cavity, and removes damaged tissue or foreign bodies
Factors for arthroscopy
Can perform spinal surgery with less damage to surrounding tissues by passing endoscopic equipment through small incisions
Endoscopic spinal microsurgery
This can be performed with the patient under local anesthesia and they treat spinal column disorders such as herniated disk spinal stenosis and spinal deformities such as scoliosis and kyphosis
Spinal microsurgery
This uses electrodes to measure electrical activity in specific areas of the body
Electrographic procedure
Involves insertion of needle electrodes into the skeletal muscles so that electrical activity can be heard seen on the oscilloscope and recorded on paper at the same time and this can be to detect chronic low back pain based on muscle fatigue patterns
Electromyogram
Weight bearing exercises helps maintain bone density, immobility causes the body to loose calcium, bed rest everyday leads to total bone density is loss, loss of activity will reduce bone resorption, and immobilized patient is at increased risk for pathologic fractures
Effects of bed rest on mineral content in bone
This is the most serious from of arthritis and can lead to severe joint deformity it’s a chronic systemic inflammatory autoimmune disease
Rheumatoid arthritis
Chronic inflammation of the synovial membrane
Synovitis
Joint pain and tenderness swelling or stiffness for 6 weeks or longer more than one joint is affected morning stiffness for more than 30 minutes or longer small joints are affected and same joints on both sides of the body are affected
Symptoms of RA
Morning stiffness joint pain muscle weakness and fatigue
4 classic symptoms of RA
Controlling the disease by administer disease modified and anti-inflammatory drugs provide pain relief reducing clinical symptoms in days to weeks prolonged joint functions and slowing the progression of joint damage
Medical management of RA
Administering prescribed salicylate or NSAIDs Assist with exercises program Physical therapy Encourage ret of inflamed joints Application of heat and cold therapy Assist and tech patient to extend joints Avoid use of pillow Encourage patient problem Remain active
Nursing interventions for RA
Is one of the types of arthritis that compromised the rheumatoid disorders and it’s a chronic progressive rheumatic disorder that affects the spine
Ankylosing spondylitis
The accompanying fixation of the joint
Ankylosis
Complaints of the lower backache stiffness and altering or bilateral sciatica pain that last for a few days and then subsides
Subjective data of RA
Assessment of tenderness over the spine and sacroiliac region peripheral joint edema and decreased ROM and assessment of VS that may indicate elevated temperature tachycardia and hyperpenia and respiratory difficulties
Objective data of RA
Providing a firm mattress bed boards and a back brace helps provide support encouraging the patient to lie on the abdomen for at least 15 to 30 minutes four times daily helps extend the spine turning and positioning every 2 hours postural and breathing exercise help compensate for the possibility of impaired gas exchange caused by the changes in posture and chest cavity size heat and cold applications will reduce inflammation and swelling and by encouraging the patient to use the firm mattress sleep without a pillow and do respiratory exercises
Nursing interventions for RA
Is referred to as a degenerative joint disease because it results from wear and tear on the joints it is a non-systemic non-inflammatory disorder that begins with the degeneration of the cartilage of joints thus causing damage to the bones
Osteoarthritis
Causes unknown
Primary osteoarthritis
Caused by trauma infections previous fractures rheumatoid arthritis stress on weight-bearing joints from obesity occupations placing abnormal stressors on the joints and occupation requiring excessive stooping and bending
Secondary osteoarthritis
This disorder most commonly affects the joints of the hand knee hip and cervical and lumbar vertebrae
Osteoarthritis
Bicycling and swimming are considered good exercises for people with this disease of the knee walking should be done on level ground as well
Osteoarthritis
Questioning the patient about pain and stiffness past illnesses surgical procedures or trauma may be relevant and information about excessive weight gain and occupation may be significant and complaints regarding reduced grip strength are common
Subjective data for OA
Assessment for joint edema tenderness instability and deformity
Objective data for OA
Appears on the sides of the distal joints of the fingers
Heberden’s node
Appear on the proximal joints of fingers these nodes are hard bony and cartilaginous enlargements
Bouchards node
Encourage the patient to maintain ADLs and adapt to limitations of the disease alternate sitting walking and standing with periods of rest can help reduce joint discomfort and deterioration assist the patient with a weight reduction plan if obesity is a problem if splints are used support of painful joint assessed for neurovascular impairment above and below the side of application check gate enhancers for safety considerations if the patient is on excessive aspirin over a long period of time GI bleeding may occur if necessary perform guaiac test on stool and emesis to determine the presence of occult blood
Nursing interventions for OA
Is a metabolic disease resulting from an accumulation of uric acid in the blood it is an acute inflammatory condition associated with ineffective metabolism of purines
Gout
Linked with hereditary factors
Primary gout
Resulting from use of certain medications are complications of another disease
Secondary gout
Is of unknown origin
Idiopathic gout
Women who experience gout traditionally are affected after this
Menopause
Crystals that form an accumulate in the joints
Purines
Calculi containing sodium you’re right deposits that develop in a particular fibrous tissue typically impatients with gout
Tophi
At night they have excruciating pain edema and inflammation in the affected joint only last a short period of time but return at intervals or it may be severe and continuous for 5 to 10 days they may have repeated attacks or only one attack in a lifetime
Signs and symptoms of gout
This includes noting a complaint of pain occurring at not involving the great tower other joints take a dietary history with specific questions on consumption of alcohol and foods high in purines
Subject of data of gout
Anchovies yeast Herring mackerel and scallops
Examples of foods high in purines like organ meats
Is aimed at getting medications prescribed by the healthcare provider for relief of pain and inflammation observed for side effects increase the patient’s fluid intake to at least 2000 ml daily carefully document and take an output advise the patient to avoid excessive use of alcohol and consumption of foods high in purines maintain bed rest enjoy and mobility while the patient is symptomatic bed cradles prevent pressure from bed linens and the affected joints
Nursing interventions for gout
Is a disorder that results in loss of bone density the reduction and sufficient to interfere with the mechanical support function of a bone
Osteoporosis
