EXAM 3 Flashcards by Jenna Krausman

Define osteoarthritis

bones & joints deteriorating over time due to cartilage breakdown from overexertion.

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what do Narcotics put the pt at risk for?

constipation

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what do NSAIDs put the pt at risk for?

risk of bleeding

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Define TKR

Total Knee Replacement

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Define THR

Total Hip replacment

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What are the main complications for osteoarthritis?

fall risk
toxicity from medications
chronic pain

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What are the main complications for Joint replacement

Fall risk
DVT
Blood loss
Infection

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What are the 6 P’s to the Neurovascular test

Paresthensia (tingling)
Pain
Pokiothermia (temp) (cold)
Pallor
Perfusion
Pparalysis

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What are the 5 W’s to post op pt management

Wind (Airway)
Water (UTI or Drainage)
Walking (DVT prevention)
Wonder drugs (toxicity from meds)
Wound site (monitor for infections)

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What is the main difference between a fat embolism and a pulmonary embolism

Fat embolism includes a petechial rash

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Define closed fracture

Skin intact
all contents of breakage or damage is underneath
may present with bruising, swelling, or a indent

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Define open fracture

Bone pokes through skin, open wound

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Define complete fracture

full width of bone is broken

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Define incomplete fracture

not full width of bone (could even be a hairline fracture)

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Define Closed reduction procedure for a fracture

a non surgical procedure done by placing pt under general anesthesia to manually manipulate bone back in alignment to then start to heal with cast.

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Define Bucks traction method (post op)
what does this help with?

Strapping up pt affected limb, on the end of it attaching weights on a string.

helps pain reduction
pressure relief
decreases muscle spasms

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Define phantom limb pain
what are some non-pharmacological ways a nurse can manage a clients pain.

numbness, tingling or sharp neurological pains in a limb that is no longer there.

massage, mirror therapy, cognitive restructuring.

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Define neuromas

clumps of nerve axons in the distal end of the residual limb that have regenerated after surgery

makes it harder to wrap and apply prosthetic devices.

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How do you wrap an amputation

in a figure eight pattern.

Define compartment syndrome

treatment

if left untreated..?

severe complication of a fracture
involves excessive pressure in muscles that build up rapidly, causing severe pain, severe edema and is a medical emergency.

most immediate treatment is cutting an incision into the deep muscle to immediately release the pressure

if left un treated (quickly) pt could loose limb - tissues will die.

What two non-opioid analgesic medications are used for osteoarthritis

What two panel’s do you want to constantly assess while on these medications.

Acetaminophen (tylenol)
ibuprofen (Motrin)

Liver panels and Kidney panels.

What is the biggest modifiable risk factor to osteoarthritis

Loose weight

Define osteomyelitis

inflammation or swelling that occurs in the bone

Briefly describe the Wells score for DVT risk

a scoring range of -2-8 by answering 10 questions
DVT risk classification
High probability = >3 points
Moderate probability = 1-2 points
Low probability = 0 points

See page 688

What is Thrombectomy (talking about DVT)

Surgical procedure to remove DVT clot

Briefly explain the D-dimer test

a test to measure D-dimer, a protein in the body that breaks down clots. normal level = < 0.50 positive test (bad) = >0.50

Define Homans sign when talking about DVT

pain elected when dorsiflexion of foot.

What is an important nursing intervention relating to amputation patients in a emergency setting hint: has to do with blood

Cross and type blood in case of a transfusion being needed

Define a Fat emboli

when a bone breaks the inside fat of the bone marrow can be released into the body or blood vessels causing blockage.

List the Cardinal signs of inflammation

1. fever 2. malaise (general discomfort feeling) 3. chills 4. elevated WBC

List the 3 stages of the inflammatory response

1. warmth edema redness, pain, imobility 2. increased WBC, drainage, lead tissue (slough, eschar) 3. damaged tissue replaced w scar tissue (or scab)

What do B cells do in the inflammatory response

Mark infected cells with a flag. and therefore tell T cells where to work

What do T cells do in the inflammatory response

attack and destroy flagged cells (flagged by B cells)

antibodies are also known as what (list the major 5)

Immunoglobins IgA IgD IgE IgG IgM

What are the 6 steps to chain of infection

1. pathogen 2. revisor 3. portal of exit 4. mode of transportation 5. portal of entry 6. host

Define Naturally acquired ACTIVE immunity

body is naturally producing antibodies memory created

Define Naturally acquired Passive immunity

antibodies passed from mom to baby memory created

Define Artificially acquired ACTIVE immunity

Body produces antibodies naturally after the help of a vaccine memory created

Define Artificially acquired PASSIVE immunity

pt given immunoglobins (antibodies), no memory cells created.

What is a local hypersensitivity reaction

mild sneezing, itchy, watery eyes headache or sinus pressure

What is a systemic hypersensitivity reaction

severe Dyspnea, SOB, wheezing or crackles (broncho-constriction) Skin reactions or edema, rashes.

What are the key inflammatory cells seen in an allergic reaction Hint: Nurse would look at CBC with Diff**

Esonophils seen when DIFF is done because Diff breaks down WBC.

Define ICP

Intracranial pressure as a result of untreated Meningitis. can lead to herniations in the brain (VERY BAD) seizures, coma or death

What precautions is TB (what does this entail)

Airbone - negative pressure room - N95 mask - gloves - gown pt needs to have personal everything (vital machine, stethoscope) limit outside exposure and visitors - when needing to transfer pt outside room, pt to have normal surgical mask on (better then nothing)

TRUE or FALSE People with Hepatitis A should take Acetaminophen for occasional headaches

FLASE - acetaminophen can be liver toxic Hepatitis A is inflammation of liver cells limiting its normal function could lead to liver failure. + avoid all other liver toxic medications