EXAM 1 Flashcards
R.I.C.E.
Rest (2-3 days)
Ice (15-20 minutes, every 2-3 hours)
Compress (not during sleep)
Elevate (above heart level)
the 6 P’s for neurovascular assessment
pallor pain parasthesia pulselessness poikilothermia (polar/cold) Paralysis
what should be done immediately after a soft tissue injury
first 12-24 hours
what is a sprain
injury to a ligament
what is a strain
injury to tendons
what are s/s of a soft tissue injury
pain
edema
decreased function
contusion
what joints are commonly dislocated
hips
shoulders
elbow
thumb
what is the ROM with a dislocation
not able to move
no ROM
loss of ROM distal
whats important immediately after a dislocation
immobolize it
RICE
what is important to educate people on for future dislocations
at higher risk for future dislocations
what is bursitis
inflammation of bursa
what causes bursitis
repeat of excessive trauma/friction of joint
gout
RA
infection
s/s of bursitis
warmth pain stiffness swelling limited ROM
when does rotator cuff injury typically occur
age
injury
repetitive stress
how can you determine the difference between a rotator cuff injury and a dislocation
can still move it when it is a rotator cuff injury
what is carpal tunnel
the median nerve is compressed
what causes carpal tunnel
repeated hand movements
edema
trauma
arthritis
what is the Phalens Test
pushing of the hands together
what is the Tinels Test
tap over the nerve
what are the treatments for carpal tunnel
splint the wrist
promote rest 2-3 weeks
educate on prevention (short breaks)
what can prolonged immobilization cause
decreased metabolic rate bone demineralization (osteoporosis) tissue ischemia pressure ulcer decreased need for oxygen, loss of RR strength
what is different with fractures and children
they have more rapid healing
what is the weakest point of the bone with growing children
the growth plate
are of growing tissue at the end of long bones
what do osteoclasts do
clean up
what do osteoblasts do
building blocks
what do osteocytes do
cycle of it
how should you immobilize a fracture
in which it is found
where should you splint a fracture
above and below the limb/bone
why may a child still be able to move after a fracture
thick periosteum
labs can be evaluated for a fracture
H/H
Calcium
ESR
what is the main goal of treatment for a fracture
restore normal function
what is the most common reduction used for simple fractures
closed reduction
what does reduction do
realign ends of fractured bone
x-ray taken before and after
what are the types of immobilization
splinting casting traction external fixation internal fixation
what should you use when placing a wet cast
use palms and not fingers
what should you assess for when it comes to infections and casts
hot spots
how should you remove the nasty gunk after a cast
baby oil/soak it
what is a temporary form of traction
bucks traction
when is bucks traction used
for a femoral/hip fracture when they can’t have immediate surgery
what is the max weight for a bucks traction
10 pounds
should the weights be on the ground
no, call someone
what is skeletal traction
traction used to treat fractures of the femur
how many pounds can be used on skeletal traction
20-40 ibs
what is important care with skeletal traction
pin site care
what is an open reduction with an internal fixation device (ORIF)
bone ends reduced via surgical incision
bone ends held together by internal fixation devices
what is used for severe bone damage, crush injuries, splintered fractures, numerous breaks
external fixation
what kind of infection can occur with external fixation devices
Osteomyelitis
what is a common medication for fractures
tetanus
what is a common med for external fixation devices
bone penetrating antibiotics
what complications can occur with fractures
neurovascular (6 P/s) hemorrhage infection venous thrombosis compartment syndrome fat embolism syndrome
what type of fractures are most at risk for hemmorhage
open fractures
what are s/s of hemmorhage
increased HR
decreased BP
increased RR
what is compartment syndrome
swelling and increased pressure within a limited space
compromises function of blood vessels
impaired tissue perfusion
what is compartment syndrome caused by
restrictive dressings splints casts bleeding edema sweling IV
what is the earliest symptom of compartment syndrome
severe increasing pain that isn’t relieved by opiods
what can be done for compartment syndrome that is surgical
fasciotomy
what is a fasciotomy
surgical decompression to relieve pressure
can be left open for several days
what can occur if compartment syndrome is not treated
necrosis
infection
renal failure
Rhabdomyolysis (muscle breaks down, increased protein causes renal failure)
what two syndromes are an emergency
compartment syndrome
fat embolism syndrome
what is fat embolism syndrome
small fat particles that dislodge from broken bones (bone marrow fat) and distribute into tissues and organs
what is the triad of places that fat embolisms travel
lungs
brain
skin
what is one way to tell a fat embolism from a blood embolism
the skin
petechiae (rash) on chest, neck, axilla, conjunctiva
what is important not to do when someone has a suspected fat embolism
DO NOT MOVE
nursing care for fat embolism
continious immobilization of the long bone fracture
high fowlers
minimize movement
when can dysplasia of the hip occur
anytime during fetal life, infancy, childhoow
the pavlick harness is what form of brace
abduction brace (out)
when is juevenile scoliosis diagnosed
before age 10
what is the Ponseli method
frequent casting shortly after birth to correct a club foot
what are the s/s of osteomyelitis
fever diaphoresis malaise night sweats inflammation erythema restricted movement difficulty ambulating
what is osteoporosis
chronic progressive metabolic bone disease
loss of bone density and structure
weak fragile bones
what is osteopenia
bone loss, not yet osteoporosis
what is the key to helping osteoporosis
low impact exercise (walking)
what is Pagets disease
a skeletal bone disorder
excessive bone destruction followed by disorganized bone remodeling
what is the most common and most fatal form of bone cancer
Osteosarcoma
inside bone
who does osteosarcoma usually effect
young people 10-25
males
s/s of osteosarcoma
localized pain/tenderness
possible mass
what is Ewings Sarcoma difference from osteosarcoma
increased rate of being cured
outside the bone
what can be seen with ewings sarcoma
local pain/swelling
low grade fever
leukocytosis
anemia
what are the bone seeking cancers
prostate
breast
lung
thyroid
what will the patient report with cancer has metastasized
diffuse severe pain
what is primary gout caused by
purine metabolism
increased uric acid and kidneys cant excrete it all
what can secondary gout be caused by
renal unsufficiency
medications (diuretics, chemo)
what can increased uric acid cause in the kidneys
renal stone development
what should people increase their diet in when they have gout
seafood
red meat
organ meat
game meat
what is the most common form of joint disease
osteoarthritis
what is osteoarthritis
slow detirioration of articular cartilage and bone ends of joints
what are the nodes cause by arthritis called
heberdens
bouchards
what is the difference between OA and RA
OA is localized and has no systemic manifestations
where is heberdens nodes
distal
where is bouchards node
proximal
what is ice for
acute inflammation
what is heat for
stiffness
what age is arthroplasty/athroscopic surgery available to
under 55 years old
what is RA classified as
systemic autoimmune disease
