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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
Q

Counterirritant counseling

A

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

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26
Q

Capsaicin is helpful for what types of pain?

A

Nociceptive and neuropathic

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27
Q

Capsaicin MOA

A

Related to depletion of substance P in C fibers and defunctionalization of the nerves (peripherally and centrally)

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28
Q

Capsaicin dosing

A

MUST be applied 2-4x/day (duration is 4-6hrs)

DO NOT apply PRN

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29
Q

T/F: You can apply capsaicin prn whenever you need it

A

FALSE - 2-4x/day and NOT PRN

30
Q

Lidocaine MOA

A

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
Q

Dietary supp examples for OA and joint health

A

Glucosamine, Chondroitin and Methylsulfonylmethane (MSM or DMSO)

Primarily studied in knee or hip OA

32
Q

___ and ___ serve as building material fro cartilage production, inhibits leukocyte elastase (enzyme involved in cartilage degradation

A

Glucosamine and Chondroitin

33
Q

___ 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.

A

MSM (Methylsulfonylmethane)

34
Q

Better efficacy data between Glucosamine, Chondroitin, DMSO

A

Glucosamine > chondroitin, DMSO

35
Q

Patients with ___ allergy should avoid glucosamine

A

shellfish

36
Q

Glucosamine, Chondroitin and Methylsulfonylmethane (MSM or DMSO) ADEs

A

Side effects - Mild nausea, stomach upset, constipation, and diarrhea

37
Q

Histamine Dihydrochloride Efficacy and MOA

A

Approved FDA ingredient for topical creams. Efficacy is not well known. It is thought to cause vasodilation, and relax muscles and tendons.

38
Q

Emu oil efficacy

A

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
Q

Patients should be referred to a health care provider if;

A

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
Q

Patient JP has joint pain that started 3 weeks ago, what do you recommend?

A

Refer to doctor

41
Q

Patient LQ comes in asking for recommendations for pain for their 1 yo infant, what do you recommend?

A

Refer to doctor

42
Q

What does RICE stand for

A

Rest
Ice
Compression
Elevate

43
Q

Cold therapy MOA

A

Blockage of pain impulse (Gate Control Theory), and vasoconstriction.

44
Q

Cold packs work as an ___ reaction

A

Endothermic

45
Q

When NOT to use cold therapy

A

Lacerations
Greater than 20min at a time
Pts with impaired circulation/sensation

46
Q

What are buzzy for?

A

Cold and vibration for needle phobia

47
Q

T/F: Cold is for vasodilation and you can use it even after 3 days

A

FALSE - vasoconstriction and need to use ASAP within 48-72hrs (decrease inflammation and potentially speed up healing process)

48
Q

T/F: Heat therapy is for vasodilation, decrease muscle spasm and usually given 48-72 after injury

A

True

49
Q

Dry or moist?: Electric heating pad

A

Dry (some have wet sponge to give moist)

50
Q

Dry or moist?: Hot water bottle

A

Dry heat

51
Q

Hot packs work as a ___ reaction

A

Exothermic

52
Q

Dry or moist?: Hydrocollator

A

Moist

53
Q

Hydrocollator storage instructions for short/long term

A

Short term - plastic bag and store in fridge

Long term - plastic bag and store in freezer

54
Q

Dry or moist?: Thermophore

A

Moist

55
Q

Dry or moist?: Paraffin Wax Bath

A

Dry

56
Q

What is paraffin wax bath used for?

A

Arthritis

57
Q

Counseling points for HEAT

A

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
Q

Transcutaneous Electrical Nerve Stimulation (TENS) MOA

A

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
Q

Contraindications for TENS

A

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
Q

Passive Compression def

A

rigid. Compression is applied during muscle contraction

61
Q

Active compression def

A

Constant pressure. More commonly used.

62
Q

Compression therapy uses

A

injuries, laceration, and scar reduction

63
Q

T/F: Arm and wrist support the forearm and elbow

A

False – just forearm

64
Q

___ are used for circulator problems int he feet and legs rather than injury

A

Compressio stockings

65
Q

Which strength of compression stockings are too weak for someone who is ambulatory (walking around)?

A

8-15mmHg

66
Q

___ are designed for NON-ambulatory patients to prevent thromboembolisms

A

TED stockings

67
Q

If it says stockings are anti-embolisms and 15-18mmHg, are these for pts who are ambulatory?

A

No – it is weak, meant for non-ambulatory pts

68
Q

What to consider when picking compression stockings?

A

Length (knee/thigh high)

Strength (15-18mmHg kinda weak, usually for non-ambulatory pts)

69
Q

Counseling for compression stockings

A

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
Q

Devices that help with putting on stockings

A

Donning gloves
Foot slips
Stocking Donner

71
Q

Expected life of a compression stocking is ___ months

A

3-6 months

72
Q

___ 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

A

Lymphedema pump

CDM 2 (8 decks)

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