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CDM 2 > Exam 2: Self-Care > Flashcards

Exam 2: Self-Care Flashcards

1
Q

___ a fluid filled space that functions as a cushion between moving structures (bones, tendons, and muscles)

A

Bursa

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2
Q

Bursitis results from

A

acute injury to the joint or over-repetitive joint action (knee, shoulder, hip, big toe)

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3
Q

___ connect bone to muscle

A

Tendons

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4
Q

Tendonitis is usually tenderness and pain accompanied with __, edema and eryhtema

A

warmth

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5
Q

Which drugs have association with causing tendonitis or tendon rupture (rare)

A

Quinolone abx and statins

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6
Q

____ is an injury due to hyperextension but no pain at rest

A

Sprain

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7
Q

____ is an injury due to hyperextension with pain with movement and rest

A

Strain

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8
Q

Grading of Sprains (I-III)

A

Grade I - excessive stretching
Grade II - partial tear
Grade III - complete tear

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9
Q

Tearing a ___ is more common than tearing a ___

A

Ligament > tendon

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10
Q

___ connect bone to bone

A

Ligament

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11
Q

____ is joint pain that worsens with movement and very common

A

Osteoarthritis

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12
Q

Risk factors of OA

A 
Increasing age
F>M
Obesity
Repetitive joint use
Trauma
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13
Q

Non-drug for myalgia

A

Stretching, rest, heat

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14
Q

Drug for myalgia

A

Topical counter-irritant, topical, or oral analgesics

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15
Q

Non drug for tendonitis

A

Stretching, rest, Ice, heat, immobilization (splint or wrap)

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16
Q

Drug for tendonitis

A

Topical counter-irritants, topical or oral analgesics

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17
Q

Bursitis non drug

A

Joint rest, immobilization, ice

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18
Q

Bursitis drug

A

Topical or oral analgesics

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19
Q

Sprain/strain non-drug

A

RICE, stretching, protective wraps, cane/crutches if needed

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20
Q

Sprain/Strain drgu

A

Topical counter irritants, topical or oral analgesics

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21
Q

Topical agents are most useful in pain states that a predominately (peripheral/central) cause

A

Peripheral – works LOCALLY so not central

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22
Q

___ don’t actually block neurotransmission but distract

A

Counterirritants

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23
Q

Examples of counter irritants

A

Methyl salicylate
Camphor
Menthol

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24
Q

Counterirritant Potential adverse effects

A

Derm side effects
Avoid in children younger than 2
Use very cautiously under 18yo and least time possible (label say 12-18 yo)

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25
Counterirritant counseling
Apply only to intact skin (no open wounds) Light bandage is ok (can increase irritation) AVOID heating pads Methyl salicylate - caution with severe asthma sensitive to aspirin or nasal polyps
26
Capsaicin is helpful for what types of pain?
Nociceptive and neuropathic
27
Capsaicin MOA
Related to depletion of substance P in C fibers and defunctionalization of the nerves (peripherally and centrally)
28
Capsaicin dosing
MUST be applied 2-4x/day (duration is 4-6hrs) | DO NOT apply PRN
29
T/F: You can apply capsaicin prn whenever you need it
FALSE - 2-4x/day and NOT PRN
30
Lidocaine MOA
alters signal conduction in neurons by blocking the fast voltage-gated Na+ channels in the neuronal cell membrane responsible for action potential propagation. With sufficient blockage, the voltage-gated sodium channels will not open and an action potential will not be generated.
31
Dietary supp examples for OA and joint health
Glucosamine, Chondroitin and Methylsulfonylmethane (MSM or DMSO) Primarily studied in knee or hip OA
32
___ and ___ serve as building material fro cartilage production, inhibits leukocyte elastase (enzyme involved in cartilage degradation
Glucosamine and Chondroitin
33
___ is thought to provide biologically active sulfur and potentially has anti-inflammatory effects and can be taken as a supplement or added to topical creams.
MSM (Methylsulfonylmethane)
34
Better efficacy data between Glucosamine, Chondroitin, DMSO
Glucosamine > chondroitin, DMSO
35
Patients with ___ allergy should avoid glucosamine
shellfish
36
Glucosamine, Chondroitin and Methylsulfonylmethane (MSM or DMSO) ADEs
Side effects - Mild nausea, stomach upset, constipation, and diarrhea
37
Histamine Dihydrochloride Efficacy and MOA
Approved FDA ingredient for topical creams. Efficacy is not well known. It is thought to cause vasodilation, and relax muscles and tendons.
38
Emu oil efficacy
These are thought to reduce inflammation. There is no evidence proving effectiveness in pain. Benefit is probably due to a placebo effect or other ingredients it is combined with.
39
Patients should be referred to a health care provider if;
Visually deformed joint, abnormal movement, weakness in any limb, or suspected fracture Moderate-to-severe pain (pain score >6) Increased intensity of pain or other changes in the characteristic of pain Pain lasting > 2 weeks Pain that continues > 7days after treatment Pelvic or abdominal pain (other than dysmenorrhea) Accompanying N,V, F or other sx of infection < 2 year of age
40
Patient JP has joint pain that started 3 weeks ago, what do you recommend?
Refer to doctor
41
Patient LQ comes in asking for recommendations for pain for their 1 yo infant, what do you recommend?
Refer to doctor
42
What does RICE stand for
Rest Ice Compression Elevate
43
Cold therapy MOA
Blockage of pain impulse (Gate Control Theory), and vasoconstriction.
44
Cold packs work as an ___ reaction
Endothermic
45
When NOT to use cold therapy
Lacerations Greater than 20min at a time Pts with impaired circulation/sensation
46
What are buzzy for?
Cold and vibration for needle phobia
47
T/F: Cold is for vasodilation and you can use it even after 3 days
FALSE - vasoconstriction and need to use ASAP within 48-72hrs (decrease inflammation and potentially speed up healing process)
48
T/F: Heat therapy is for vasodilation, decrease muscle spasm and usually given 48-72 after injury
True
49
Dry or moist?: Electric heating pad
Dry (some have wet sponge to give moist)
50
Dry or moist?: Hot water bottle
Dry heat
51
Hot packs work as a ___ reaction
Exothermic
52
Dry or moist?: Hydrocollator
Moist
53
Hydrocollator storage instructions for short/long term
Short term - plastic bag and store in fridge | Long term - plastic bag and store in freezer
54
Dry or moist?: Thermophore
Moist
55
Dry or moist?: Paraffin Wax Bath
Dry
56
What is paraffin wax bath used for?
Arthritis
57
Counseling points for HEAT
Don't use on lacerations Don't use greater than 20min Don't use in pts with impaired circulation/sensation Place products on top -- don't lie or sit (burns)
58
Transcutaneous Electrical Nerve Stimulation (TENS) MOA
Stimulate the nerve and then does not send pain message to the brain because it is stimulated by something else You need to apply it to the right area for it to work Literature is mixed, most say may have some effectiveness initially but may wear off in months
59
Contraindications for TENS
Pacemaker Pregnancy (premature labor risk) Carotid sinuses (hypotension risk) Don't place over anterior neck (laryngospasm) Don't place over sensory impaired areas Use cautiously in pts with spinal cord stimulator or intrathecal pump (or any electrical device)
60
Passive Compression def
rigid. Compression is applied during muscle contraction
61
Active compression def
Constant pressure. More commonly used.
62
Compression therapy uses
injuries, laceration, and scar reduction
63
T/F: Arm and wrist support the forearm and elbow
False -- just forearm
64
___ are used for circulator problems int he feet and legs rather than injury
Compressio stockings
65
Which strength of compression stockings are too weak for someone who is ambulatory (walking around)?
8-15mmHg
66
___ are designed for NON-ambulatory patients to prevent thromboembolisms
TED stockings
67
If it says stockings are anti-embolisms and 15-18mmHg, are these for pts who are ambulatory?
No -- it is weak, meant for non-ambulatory pts
68
What to consider when picking compression stockings?
Length (knee/thigh high) | Strength (15-18mmHg kinda weak, usually for non-ambulatory pts)
69
Counseling for compression stockings
Put on your foot, work slowly upwards Make sure stocking is smooth, wrinkles might irritate your skin Don't pull -- avoid holes/runs Remove jewelry that may catch on the stockings Rubber kitchen gloves might help
70
Devices that help with putting on stockings
Donning gloves Foot slips Stocking Donner
71
Expected life of a compression stocking is ___ months
3-6 months
72
___ used for more severe circulatory issues. Usually on the lower body or extremities. A compressor is attached to the garment worn on the body. These devices provide transient pressure to augment the circulatory system
Lymphedema pump

CDM 2 (8 decks)

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