Exam 3 Flashcards
OA VS Rheumatoid Arthritis
RA- bilateral , worse w/ resting, swollen synovial membrane
OA, unilateral, worse with movement , bone ends rub together
Autoimmune disorder that involves GI andmight need swallow study?
Systemic Sclerosis (SSC)
butterly rash with?
Lupus Erythematosus
-Systemic Lupus Erythematosus
1 reason people die of SLE?
kidney disease
SLE vs SSC
-SLE is chronic, progressive, inflammatory connective tissue disorder –> kidney failure
(systemic or discoid)
-SSC is -Chronic, inflammatory, autoimmune connective tissue disorder –joints/skin/GI/kidney
(limited or diffuse)
types of traction used to provide pain relief
skin traction, running traction
traction that attaches to bones
skeletal
what 2 types of traction determine if patient can move or not?
balanced and running
patient movement does not impact this kind of traction
balanced
balanced traction
Fractured extremity is suspended with two opposing forces Patient movement does not impact traction Used for alignment
running traction
Force exerted in one plane only (fractured limp is the opposing force) Patient movement will impact traction (the person’s limb is the opposing force) Used for rest, pain management and sometimes alignment
fatty emboli syndrome manifestations
Lungs (low O2, Dyspnea, tachypnea)
Brain (Confusion, headache, seizure, altered LOC)
Skin (Petechia on neck, chest and arms)
priority actions for fatty emboli syndrome?
oxygenation and albumin fluids
**prevention!
A patient is in the ED and has a new cast/ cast has just been
completed on the right forearm. What is your priority assessment?
Priority Education?
CMS
-teaching the patient to check for sensation, movement,
warmth, color
priority assessments and actions for forearm open fracture
Remove jewelry Perform NV assessment (CMS) Immobilize Elevate Ice and pain management (further medical interventions including reduction and immobilization)
Which discharge instruction will the emergency department nurse
include for a patient with a sprained ankle?
A) Keep the ankle loosely wrapped with gauze.
B) Apply a heating pad to reduce muscle spasms.
C) Use pillows to elevate the ankle above the heart.
D) Gently move the ankle through the range of motion
C) Use pillows to elevate the ankle above the heart.
Which statement by the patient indicates a good
understanding of the nurse’s teaching about a new short-
arm synthetic/ fiberglass cast?
A) “I can get the cast wet as long as I dry it right away with a hair dryer.”
B) “I should avoid moving my fingers and elbow until the cast is removed.”
C) “I will apply an ice pack to the cast over the fracture site off and on for
24 hours.”
D) “I can use a cotton-tipped applicator to rub lotion on any dry areas
under the cast.”
C) “I will apply an ice pack to the cast over the fracture site off and on for
24 hours.”
A patient who has had open reduction and internal fixation (ORIF) of left lower leg
fractures continues to complain of severe pain in the leg 15 minutes after
receiving the prescribed IV morphine. Pulses are faintly palpable and the foot is
cool to the touch. Which action should the nurse take next?
A) Notify the health care provider.
B) Assess the incision for redness.
C) Reposition the left leg on pillows.
D) Check the patient’s blood pressure.
A) Notify the health care provider.
Which action will the nurse take in order to evaluate the effectiveness of Buck’s traction for a patient who has an intracapsular fracture of the right femur? A) Assess for hip pain. B) Assess for contractures. C) Check peripheral pulses. D) Monitor for hip dislocation.
A) Assess for hip pain.
A patient with a right lower leg fracture will be discharged home with
an external fixation device in place. Which information will the nurse
teach?
A) “Check and clean the pin insertion sites daily.”
B) “Remove the external fixator for your shower.”
C) “Remain on bed rest until bone healing is complete.”
D) “Take prophylactic antibiotics until the fixator is removed.”
A) “Check and clean the pin insertion sites daily.”
A patient who has had open reduction and internal fixation (ORIF) of a hip fracture
tells the nurse he is ready to get out of bed for the first time. Which action should
the nurse take?
A) Check the patient’s prescribed weight-bearing status.
B) Use a mechanical lift to transfer the patient to the chair.
C) Delegate the transfer to nursing assistive personnel (NAP).
D) Decrease the pain medication before getting the patient up.
A) Check the patient’s prescribed weight-bearing status.
The nurse is caring for a patient who is to be discharged from the
hospital 4 days after insertion of a femoral head prosthesis using a
posterior approach. Which statement by the patient indicates a need
for additional instruction?
A) “I should not cross my legs while sitting.”
B) “I will use a toilet lift on the toilet seat.”
C) “I will have someone else put on my shoes and socks.”
D) “I can sleep in any position that is comfortable for me.”
D) “I can sleep in any position that is comfortable for me.”
When giving home care instructions to a patient who has comminuted left forearm
fractures and a long-arm cast, which information should the nurse include?
A) Make sure that only clean objects be used to scratch the skin underneath
the cast.
B) Avoid nonsteroidal anti-inflammatory drugs (NSAIDs).
C) Call the health care provider for loss of sensation of the hand.
D) Keep the hand immobile to prevent soft tissue swelling.
C) Call the health care provider for loss of sensation of the hand.
A patient is being discharged 4 days after hip arthroplasty using the
posterior approach. Which patient action requires intervention by
the nurse?
A) The patient uses crutches with a swing-to gait.
B) The patient leans over to pull on shoes and socks.
C) The patient sits straight up on the edge of the bed.
D) The patient bends over the sink while brushing teeth.
B) The patient leans over to pull on shoes and socks.
After being hospitalized for 3 days with a right femur fracture, a
patient suddenly develops shortness of breath and tachypnea. The
patient tells the nurse, “I feel like I am going to die!” Which action
should the nurse take first?
A) Stay with the patient and offer reassurance.
B) Administer prescribed PRN O2 at 4 L/min.
C) Check the patient’s legs for swelling or tenderness.
D) Notify the health care provider about the symptoms.
B) Administer prescribed PRN O2 at 4 L/min.
A patient arrived at the emergency department after tripping over a
rug and falling at home. Which finding is most important for the
nurse to communicate to the health care provider?
A) There is bruising at the shoulder area.
B) The patient reports arm and shoulder pain.
C) The right arm appears shorter than the left.
D) There is decreased shoulder range of motion.
C) The right arm appears shorter than the left.
A young adult arrives in the emergency department with ankle swelling and
severe pain after twisting an ankle playing basketball. Which of these prescribed
interprofessional interventions will the nurse implement first?
A) Send the patient for ankle x-rays.
B) Immobilize the ankle and apply an ice pack.
C) Administer naproxen (Naprosyn) 500 mg PO.
D) Give acetaminophen with codeine
B) Immobilize the ankle and apply an ice pack.
Which nursing action for a patient who has had right hip arthroplasty
can the nurse delegate to experienced unlicensed assistive
personnel (UAP)?
A) Reposition the patient every 1 to 2 hours.
B) Assess for skin irritation on the patient’s back.
C) Teach the patient quadriceps-setting exercises.
D) Determine the patient’s pain intensity and tolerance.
A) Reposition the patient every 1 to 2 hours.
The second day after admission with a fractured pelvis, a patient
suddenly develops confusion and is disoriented X 3 (Oriented only
to person). Which action should the nurse take first?
Take the blood pressure.
Assess patient orientation.
Check the O2 saturation.
Observe for facial asymmetry.
Check the O2 saturation.
After a motorcycle accident, a patient arrives in the emergency
department with severe swelling of the left lower leg. Which action
will the nurse take first?
A) Elevate the leg on 2 pillows.
B) Apply a compression bandage.
C) Assess leg pulses and sensation.
D) Place ice packs on the lower leg.
C) Assess leg pulses and sensation.
Which finding in a patient with a Colles’ fracture of the left wrist
is most important to communicate immediately to the health care
provider?
Swelling is noted around the wrist.
The patient is reporting severe pain.
The wrist has a deformed appearance.
Capillary refill to the fingers is prolonged.
Capillary refill to the fingers is prolonged.
OA nursing intervention
OA (Non-nursing: Analgesics (non opioid) & Surgery) Exercise and Rest balance Swimming, walking, cycling Hot or cold therapy (focus on heat) Home adjustments Weight control Supplements Glucosamine Chondroitin Position Shoes
RA nursing interventions
RA (Non-nursing pharmacology targets immune system) Pain Rest (Balance & Set priorities) Position Ice Heat/ Paraffin Hot Shower in the morning Mobility Occupational therapy Assistive devices Fatigue Pace activities/ rest and activity
