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NRSG 200: Med Surg 3 > [Exam 1] Chapter 41: Management of Patients with Musculoskeletal Disorders > Flashcards

[Exam 1] Chapter 41: Management of Patients with Musculoskeletal Disorders Flashcards

1
Q

Benign Bone Tumors: What are these?

A

Slow growing, well circumscribed, and encapsulated. Present few symptoms.

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2
Q

Benign Bone Tumors: This includes which types?

A

Osteochondroma, enchondroma, bone cysts, osteoid osteoma, rhadbaomyoma and fibroma

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3
Q

Benign Bone Tumors: What is the most common type?

A

Osteochondroma, which shows as large projection of bone at end of long bones (knees or shoulders) during growth. Then becomes a static bony mass.

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4
Q

Benign Bone Tumors: Whatr are bone cysts?

A

Are expanding lesions within the bone.

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5
Q

Benign Bone Tumors: What is seen in young adults for bone cysts?

A

Aneurysmal (Widening), and present with a painful, palpable mass of long bones, vertebrae or flat bone

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6
Q

Benign Bone Tumors: When do unicameral bone cysts occur?

A

Most often within first two decades of life and cause mild discomfort and possible pathjologic fracture of humerus.

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7
Q

Benign Bone Tumors: What is a osteoid osteomam?

A

Painful tumor that occurs in children and young adults. Surrounded by reactive bone formation that can be seen on xray.

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8
Q

Benign Bone Tumors: Wat is a enchondroma?

A

Common tumor of the hyaline cartilage that develops in hand, femur, or humerus.

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9
Q

Malignant Bone Tumors: Usually arise from what?

A

Connective and supportive tissue cells (sarcomas) or bone marrow elements

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10
Q

Malignant Bone Tumors: Types of this include?

A

osteosarcoma, chondrosarcoma, ewing sarcoma and firosarcoma.

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11
Q

Malignant Bone Tumors: Osteosarcoma is the most common what

A

fatal primary malignant bone tumor. Diagnsosis depends if it has metastasized to the lungs.

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12
Q

Malignant Bone Tumors: Osteosarcoma presents msot often with who

A

children, adolescents, young adults and older adults with paget disease.

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13
Q

Malignant Bone Tumors: Osteosarcoma CMs?

A

localized bone pain, that can be accompanied by tender, palpable soft tissue mass.

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14
Q

Malignant Bone Tumors: Malignant tumors of the hyaline cartilage are called what

A

chondrosarcomas , where they grow and metastasize slowly or very fast depending on characteristics of tumor cells involved.

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15
Q

Metastatic Bone Disease: Is this more comon than primary bone tumors?

A

No

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16
Q

Metastatic Bone Disease: What is this?

A

Tumors that arise from tissues elsewhere in the body that may invade the bone and produce localized bone destruction or bone overgrowth.

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17
Q

Metastatic Bone Disease: Most primary sites of tumors that metastasize to boen include?

A

Kidney, prostate, lung, breast, ovary.

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18
Q

Bone Tumors. CMs: What signs may they show?

A

Symptom free, or may show weight loss, malaise, and fever.

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19
Q

Bone Tumors. CMs: What may occur with spinal metastasis?

A

Spinal cord compression.

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20
Q

Bone Tumors. CMs: What neurologic deficits may occur?

A

Progressive pain, weakness, gait abnormality, paresthesia, paraplegia, urinary retention , and los of bowel

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21
Q

Bone Tumors. Assess/Diagnostic: Diagnostic studies may include what

A

CT, bone scans, myelography, arteriography, MRI, biopsy, biochemical assays of blood and urine.

22
Q

Bone Tumors. Assess/Diagnostic: Why are Chest X-Rays performed?

A

To determine the presence of lung metastasis.

23
Q

Bone Tumors. Assess/Diagnostic: How are serum ALP levels here?

A

Frequently elevated with osteogenic sarcoma or bone metastasis.

24
Q

Bone Tumors. Assess/Diagnostic: What electrolyte dysfunction may be present?

A

Hypercalcemia from breast, lung, or kidney cancer.

25
Q

Bone Tumors. Assess/Diagnostic: Symptoms of hypercalcemia?

A

Muscle weakness, fatigue, anorexia, N/V, polyuria, cardiac dysrhythmias, seizures

26
Q

Bone Tumors. Medical Mx of Primary Bone Tumors: Goal here?

A

Destroy or remove the tumor rapidly. May be accomplished by surgical excisioon, radiation therapy and chemotherapy.

27
Q

Bone Tumors. Medical Mx of Primary Bone Tumors: Major gains are being made with what procedures?

A

Wide bloc excision with restorative frafting technique

28
Q

Bone Tumors. Medical Mx of Primary Bone Tumors: If possible, what procedures are used?

A

Limb-sparing (salvage)

29
Q

Bone Tumors. Medical Mx of Primary Bone Tumors: What can replace teh resected tissue?

A

Customized prosthesis, total joint arthroplasty, or bone tissue from patient (Autograft) or from donro (allograft)

30
Q

Bone Tumors. Medical Mx of Primary Bone Tumors: Complications from grafting?

A

infection, lossening or dislocation of prosthesis, allograft nonunion, fracture, and devitalization of the skin

31
Q

Bone Tumors. Medical Mx of Primary Bone Tumors: What is usually doen before and after surgery?

A

Chemotherapy due to danger of metastasis .

32
Q

Bone Tumors. Medical Mx of Secondary Bone Tumors: Treatment of advanced metastic bone cancer?

A

Palliative. Goal is to relieve the patients pain and discomfort.

33
Q

Bone Tumors. Medical Mx of Secondary Bone Tumors: What to do if bone weakened?

A

Structural support and stabilization are needed to prevent fracture.

34
Q

Bone Tumors. Medical Mx of Secondary Bone Tumors: How are bones strengthened?

A

By prophylactic internal fixtion, arthroplasty or PMMA reconstruction.

35
Q

Bone Tumors. Medical Mx of Secondary Bone Tumors: Are at higher risk than other patients for what problems postop

A

pulmonary congestion, hypoxemia, VTE and hemorrhage

36
Q

Bone Tumors. Medical Mx of Secondary Bone Tumors: What is frequently disrupted by tumor invasion?

A

Hematopoiesis, but blood compoennt therapy can help resture this.

37
Q

Bone Tumors. Nursing Mx: What does the nurse usually ask the patient?

A

About the onset and course of symtpoms.

38
Q

Bone Tumors. Nursing Mx: During interview, what does te patient assess?

A

Nurse assesses the patietns understanding of disease, how patient has been coping, and how they’ve managed pain.

39
Q

Bone Tumors. Delayed Wound Healing: Why may this occur?

A

Because of tissue trauma from surgery, previous radiation therapy, inadequate nutrition,, or infection.

40
Q

Bone Tumors. Delayed Wound Healing: How does nurse help here?

A

Minimizes pressure on wound site ot promote circulation ot tissues. Aseptic wound dressing promtoes healing.

41
Q

Bone Tumors. Delayed Wound Healing: How to reduce skin breakdown?

A

Respositioning the patient at frequent intervals

42
Q

Bone Tumors. Inadequate Nutrition: What can be given to help with this?

A

Antiemetic agents and relaxation techniques reduce teh adverse GI effects of chemotherapy.

43
Q

Bone Tumors. Inadequate Nutrition: How is stomatitis controlled?

A

With anesthetic or antifungal mouthwash.

44
Q

Bone Tumors. Osteomyelitis and Wound Infections: What is done to diminsih this?

A

Prophylactic antibiotics and strict aseptic dressing techniques.

45
Q

Bone Tumors. Osteomyelitis and Wound Infections: Why must other infections need to be prevented?

A

So that healing efforts are not divided between the cancer and the new acute process.

46
Q

Bone Tumors. Hypercalcemia: Symptoms of this>

A

Muscular weakness, incoordination, anorexia, N/V, oconstipaion, ECG changes and AMS.

47
Q

Bone Tumors. Hypercalcemia: Treatment includes?

A

Hydration with IV administration of normal saline, siuresis, mobilization, and meds like IV biphosphonates.

48
Q

Bone Tumors. Hypercalcemia: What can the nurse help assist with?

A

Increasing the activity and ambulation to decrease calcium in blood.

49
Q

Bone Tumors. Hypercalcemia: What is given if not responsive to IV biphosphonates?

A

DEnosumab

50
Q

Bone Tumors. Educating About Self-Care: Patient education includes what?

A

Med, dressing changes, treatment regimens, and important of phusical and Ot programs

NRSG 200: Med Surg 3 (46 decks)

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