EXAM 1 Flashcards by carleigh fraze

R.I.C.E.

Rest (2-3 days)
Ice (15-20 minutes, every 2-3 hours)
Compress (not during sleep)
Elevate (above heart level)

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the 6 P’s for neurovascular assessment

pallor
pain
parasthesia
pulselessness
poikilothermia (polar/cold)
Paralysis

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what should be done immediately after a soft tissue injury

first 12-24 hours

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what is a sprain

injury to a ligament

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what is a strain

injury to tendons

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what are s/s of a soft tissue injury

pain
edema
decreased function
contusion

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what joints are commonly dislocated

hips
shoulders
elbow
thumb

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what is the ROM with a dislocation

not able to move
no ROM
loss of ROM distal

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whats important immediately after a dislocation

immobolize it

RICE

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what is important to educate people on for future dislocations

at higher risk for future dislocations

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what is bursitis

inflammation of bursa

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what causes bursitis

repeat of excessive trauma/friction of joint
gout
RA
infection

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s/s of bursitis

warmth
pain
stiffness
swelling
limited ROM

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when does rotator cuff injury typically occur

age
injury
repetitive stress

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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

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what is carpal tunnel

the median nerve is compressed

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what causes carpal tunnel

repeated hand movements
edema
trauma
arthritis

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what is the Phalens Test

pushing of the hands together

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what is the Tinels Test

tap over the nerve

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what are the treatments for carpal tunnel

splint the wrist
promote rest 2-3 weeks
educate on prevention (short breaks)

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what can prolonged immobilization cause

decreased metabolic rate
bone demineralization (osteoporosis)
tissue ischemia
pressure ulcer
decreased need for oxygen, loss of RR strength

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what is different with fractures and children

they have more rapid healing

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what is the weakest point of the bone with growing children

the growth plate

are of growing tissue at the end of long bones

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what do osteoclasts do

clean up

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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