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Nursing Process > Exam 3, Part 2 > Flashcards

Exam 3, Part 2 Flashcards

1
Q

post-op assessments for prevention of complications

A 
respiratory status
CV status
temp
fluid status
wound site
GI status (N/V or decreased bowels)
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2
Q

management of shock

A
  • keep flat with legs elevated
  • O2
  • vitals, HCT, and blood gas
  • maintain temp
  • maintain volume
  • medication administration
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3
Q

when should you remove an oral airway

A

when gag reflex returns

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4
Q

prevention of dehiscence/ evisceration

A

teach the patient splinting

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5
Q

what to do in the case of evisceration

A

find sterile lap pad and cover it; do not push contents back in

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6
Q

important pre-op assessments

A
  • make sure they have actually fasted

- anticoagulants

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7
Q

risk factors for osteoporosis

A 
ACCESS
alcohol use
corticosteroids
calcium low
estrogen low
smoking
sedentary lifestyle
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8
Q

clinical manifestations of osteoporosis

A

lordosis or kyphosis, bone loss of 25-40% must occur efore it can be identified on an xray

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9
Q

diagnosis of osteoporosis

A

bone density scans starting at age 40

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10
Q

best exercise for osteoporosis

A

walking (it is weight bearing but not high impact)

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11
Q

medications for osteoporosis

A
  • Fosamax (Alendronate): sit upright for 30 mins and take on empty stomach, these drugs are very absorbant and will get stuck and cause erosion in the esophagus
  • Boniva: once a month
  • Calcitronin: s/e GI upset, inflammation at injection site; monitor serum calcium
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12
Q

complications of osteoporosis

A
  • hip fractures
  • T8 and below fractures
  • spinal compression and shortened stature
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13
Q

calcium and vitamin D sources

A
  • calcium: spinach, fish, orange juice, oatmeal, fortified cereals
  • vitamin D: milk, yogurt, eggs, cheese, fish
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14
Q

childhood diseases that could result in osteoporosis

A
  • juvenile idiopathis arthritis

- osteogenesis imperfecta

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15
Q

paget’s disease

A

excessive bone destruction occurs with replacement of bone by fibrous tissues and abnormal bone, most commonly affecting skull, femur, pelvis, and vertebrae

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16
Q

clinical manifestations of paget’s disease

A
  • bowing of the legs
  • waddling gait
  • pain, tenderness, and warmth over bones
17
Q

Tx of paget’s disease

A
  • *NSAIDS
  • Cacitonin
  • Fosamax
18
Q

complication with skeletal traction

A

more likely to get infections

-low grade fever, abscess around the pin with green, smelly drainage

19
Q

nursing diagnosis for a patient with musculoskeletal problems and/or an ambulation device

A
  • activity intolerance
  • impaired mobility
  • risk for falls
20
Q

when is a brace used for scoliosis

A

for 25-45 degree abnormalities, anything greater requires surgery

21
Q

clinical manifestations of DDH

A
  • one leg shorter than the other
  • restricted abduction of the hip
  • unequal gluteal folds when infant is prone
  • if bilateral dislocations: waddling gait and marked lordosis
22
Q

tests for DDH

A
  • ortolani test- move the leg out (abduct)
  • barlow test- move the leg in (adduct)
  • trendelenburg- greater trochanter is prominent and appears above the line from the anterosuperior iliac spine to the tuberosity of the ischium
23
Q

therapeutic management of DDH in infants newborn to 6 months

A

pavlik harness

24
Q

care of a child in a pavlik harness

A
  • provide skin care
  • check 2-3 times a day for redness
  • gently massage the skin once a day
  • avoid lotions and powders
  • diaper under straps
  • remove for bathing
25
Q

test for juvenile idiopathic arthritis

A

slit lamp eye exam: find iridocyclitis and uveitis (inflammation of the uvea- middle later of the eye that consists of the iris, ciliary body and choroid)
-this is unique to JIA

26
Q

pathophys of JIA

A
  • chronic inflammation of the synovium with joint effusion
  • destruction of cartilage
  • ankylosis (stiffening) of the joints as the disease progresses
27
Q

goals of therapy for JIA

A

preserve function, prevent deformities, and relieve symptoms

28
Q

main therapy for JIA

A

NSAIDS and pool exercises

29
Q

systemic lupus erythematosus

A
  • chronic, multi-system autoimmune disease of connective tissues and blood vessels
  • characterized by inflammation
  • symptoms are variable and unpredictable
  • most common in girls age 10-19
30
Q

therapies for osteosarcoma

A
  • radical resection or amputation of area
  • limb-salvage procedures with prosthetic replacement
  • chemo accompanying surgery
31
Q

therapes for ewings sarcoma

A
  • irradiation is first approach
  • chemo is adjunct to irradiation
  • sometimes surgical resection
32
Q

where do you find ewings sarcoma

A

in the marrow (femur, tibia, ulna, humerus, vertebrae, pelvis, scapula, ribs, skull

33
Q

treatment of osteomyelitis

A

antibiotics for 6-8 weeks

34
Q

Legg-calve-perthes disease

A
  • self-limiting, idiopathic in children age 3-12 years

- avascular necrosis of the femoral head

35
Q

clinical manifestations of legg-calve-perthes disease

A
  • insidious onset
  • may have limp
  • soreness or stiffness
  • limited ROM
  • vague history of trauma
36
Q

goal of treatment for legg-calve-perthes disease

A

keep the head of the femur in the acetabulum

Nursing Process (4 decks)

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