[Exam 1] Chapter 41: Management of Patients with Musculoskeletal Disorders Flashcards
Benign Bone Tumors: What are these?
Slow growing, well circumscribed, and encapsulated. Present few symptoms.
Benign Bone Tumors: This includes which types?
Osteochondroma, enchondroma, bone cysts, osteoid osteoma, rhadbaomyoma and fibroma
Benign Bone Tumors: What is the most common type?
Osteochondroma, which shows as large projection of bone at end of long bones (knees or shoulders) during growth. Then becomes a static bony mass.
Benign Bone Tumors: Whatr are bone cysts?
Are expanding lesions within the bone.
Benign Bone Tumors: What is seen in young adults for bone cysts?
Aneurysmal (Widening), and present with a painful, palpable mass of long bones, vertebrae or flat bone
Benign Bone Tumors: When do unicameral bone cysts occur?
Most often within first two decades of life and cause mild discomfort and possible pathjologic fracture of humerus.
Benign Bone Tumors: What is a osteoid osteomam?
Painful tumor that occurs in children and young adults. Surrounded by reactive bone formation that can be seen on xray.
Benign Bone Tumors: Wat is a enchondroma?
Common tumor of the hyaline cartilage that develops in hand, femur, or humerus.
Malignant Bone Tumors: Usually arise from what?
Connective and supportive tissue cells (sarcomas) or bone marrow elements
Malignant Bone Tumors: Types of this include?
osteosarcoma, chondrosarcoma, ewing sarcoma and firosarcoma.
Malignant Bone Tumors: Osteosarcoma is the most common what
fatal primary malignant bone tumor. Diagnsosis depends if it has metastasized to the lungs.
Malignant Bone Tumors: Osteosarcoma presents msot often with who
children, adolescents, young adults and older adults with paget disease.
Malignant Bone Tumors: Osteosarcoma CMs?
localized bone pain, that can be accompanied by tender, palpable soft tissue mass.
Malignant Bone Tumors: Malignant tumors of the hyaline cartilage are called what
chondrosarcomas , where they grow and metastasize slowly or very fast depending on characteristics of tumor cells involved.
Metastatic Bone Disease: Is this more comon than primary bone tumors?
No
Metastatic Bone Disease: What is this?
Tumors that arise from tissues elsewhere in the body that may invade the bone and produce localized bone destruction or bone overgrowth.
Metastatic Bone Disease: Most primary sites of tumors that metastasize to boen include?
Kidney, prostate, lung, breast, ovary.
Bone Tumors. CMs: What signs may they show?
Symptom free, or may show weight loss, malaise, and fever.
Bone Tumors. CMs: What may occur with spinal metastasis?
Spinal cord compression.
Bone Tumors. CMs: What neurologic deficits may occur?
Progressive pain, weakness, gait abnormality, paresthesia, paraplegia, urinary retention , and los of bowel
Bone Tumors. Assess/Diagnostic: Diagnostic studies may include what
CT, bone scans, myelography, arteriography, MRI, biopsy, biochemical assays of blood and urine.
Bone Tumors. Assess/Diagnostic: Why are Chest X-Rays performed?
To determine the presence of lung metastasis.
Bone Tumors. Assess/Diagnostic: How are serum ALP levels here?
Frequently elevated with osteogenic sarcoma or bone metastasis.
Bone Tumors. Assess/Diagnostic: What electrolyte dysfunction may be present?
Hypercalcemia from breast, lung, or kidney cancer.
Bone Tumors. Assess/Diagnostic: Symptoms of hypercalcemia?
Muscle weakness, fatigue, anorexia, N/V, polyuria, cardiac dysrhythmias, seizures
Bone Tumors. Medical Mx of Primary Bone Tumors: Goal here?
Destroy or remove the tumor rapidly. May be accomplished by surgical excisioon, radiation therapy and chemotherapy.
Bone Tumors. Medical Mx of Primary Bone Tumors: Major gains are being made with what procedures?
Wide bloc excision with restorative frafting technique
Bone Tumors. Medical Mx of Primary Bone Tumors: If possible, what procedures are used?
Limb-sparing (salvage)
Bone Tumors. Medical Mx of Primary Bone Tumors: What can replace teh resected tissue?
Customized prosthesis, total joint arthroplasty, or bone tissue from patient (Autograft) or from donro (allograft)
Bone Tumors. Medical Mx of Primary Bone Tumors: Complications from grafting?
infection, lossening or dislocation of prosthesis, allograft nonunion, fracture, and devitalization of the skin
Bone Tumors. Medical Mx of Primary Bone Tumors: What is usually doen before and after surgery?
Chemotherapy due to danger of metastasis .
Bone Tumors. Medical Mx of Secondary Bone Tumors: Treatment of advanced metastic bone cancer?
Palliative. Goal is to relieve the patients pain and discomfort.
Bone Tumors. Medical Mx of Secondary Bone Tumors: What to do if bone weakened?
Structural support and stabilization are needed to prevent fracture.
Bone Tumors. Medical Mx of Secondary Bone Tumors: How are bones strengthened?
By prophylactic internal fixtion, arthroplasty or PMMA reconstruction.
Bone Tumors. Medical Mx of Secondary Bone Tumors: Are at higher risk than other patients for what problems postop
pulmonary congestion, hypoxemia, VTE and hemorrhage
Bone Tumors. Medical Mx of Secondary Bone Tumors: What is frequently disrupted by tumor invasion?
Hematopoiesis, but blood compoennt therapy can help resture this.
Bone Tumors. Nursing Mx: What does the nurse usually ask the patient?
About the onset and course of symtpoms.
Bone Tumors. Nursing Mx: During interview, what does te patient assess?
Nurse assesses the patietns understanding of disease, how patient has been coping, and how they’ve managed pain.
Bone Tumors. Delayed Wound Healing: Why may this occur?
Because of tissue trauma from surgery, previous radiation therapy, inadequate nutrition,, or infection.
Bone Tumors. Delayed Wound Healing: How does nurse help here?
Minimizes pressure on wound site ot promote circulation ot tissues. Aseptic wound dressing promtoes healing.
Bone Tumors. Delayed Wound Healing: How to reduce skin breakdown?
Respositioning the patient at frequent intervals
Bone Tumors. Inadequate Nutrition: What can be given to help with this?
Antiemetic agents and relaxation techniques reduce teh adverse GI effects of chemotherapy.
Bone Tumors. Inadequate Nutrition: How is stomatitis controlled?
With anesthetic or antifungal mouthwash.
Bone Tumors. Osteomyelitis and Wound Infections: What is done to diminsih this?
Prophylactic antibiotics and strict aseptic dressing techniques.
Bone Tumors. Osteomyelitis and Wound Infections: Why must other infections need to be prevented?
So that healing efforts are not divided between the cancer and the new acute process.
Bone Tumors. Hypercalcemia: Symptoms of this>
Muscular weakness, incoordination, anorexia, N/V, oconstipaion, ECG changes and AMS.
Bone Tumors. Hypercalcemia: Treatment includes?
Hydration with IV administration of normal saline, siuresis, mobilization, and meds like IV biphosphonates.
Bone Tumors. Hypercalcemia: What can the nurse help assist with?
Increasing the activity and ambulation to decrease calcium in blood.
Bone Tumors. Hypercalcemia: What is given if not responsive to IV biphosphonates?
DEnosumab
Bone Tumors. Educating About Self-Care: Patient education includes what?
Med, dressing changes, treatment regimens, and important of phusical and Ot programs
