Exam 5 - Musculoskeletal Flashcards
What are the signs and symptoms of osteoarthritis?
Insidious onset
large weight-bearing joints (primarily)
joint stiffness-after immobility
chronic pain: deep aching
-aggravated by motion/exercise, weather changes
-relieved by joint rest
-night pain w/ paresthesia (w/ progression)
Crepitus: grating sounds &/or sensation w/ motion
decreased ROM
Joint spurs/deformity
-enlargement of large joints r/t bone overgrowth
-cool on palpation, hard
Why might a patient with osteoarthritis have limited activity?
Joint or muscle pain, weakness, fatigue, or joint swelling
This can lead to loss of joint motion, stiffness, and muscle weakness and tightness.
These problems can worsen fatigue and can cause joints to become unstable
What medications might be used to manage the pain with osteoarthritis?
Tylenol - preferred (less side effects, can be taken for chronic pain)
Topical medications - capsaicin, lidocaine patches, salicylates
What nursing interventions are performed while taking care of a post operative total hip arthroplasty?
Hip precautions- prevent flexion > 90°, or adduction
Use a hip abductor pillow between knees
VS q4 or more
CMST
Assess incision
Pain management
Working w/PT, OT, rehab
What are the treatments for a sprain?
RICE—Rest, Ice, Compression, and Elevation
What is osteoporosis?
Chronic metabolic loss of bone density
Decreased bone mineral density (BMD)
What are the risk factors for osteoporosis?
age
race
post-menopause
low calcium diet, poor nutrition
smoking, alcohol
inactivity
genetics
What is a T-score?
Standard deviation below or above average BMD for healthy young adults
Osteopenia: -1–2.5 (at risk)
Osteoporosis: -< -2.5 (greater than -2.5= osteoporosis)
What is compartment syndrome?
Occurs when excessive pressure r/t edema in a limited space. causes constriction of vessels; causing a decrease circulation to nerves & muscles
What is gout (gouty arthritis)?
systemic disorder in which urate crystals deposit in joints and cause inflammation
How does a nurse assess circulation to a leg?
pain
pallor
pulse
paresthesia
paralysis
Why are ace bandages used to wrap stumps after a knee amputation?
Wrapping with elastic bandages can also be effective in reducing edema, shrinking the limb, and holding the wound dressing in place.
What is Alendronate (Fosamax)? And what are the nursing interventions?
Bisphosphonates: Inhibits bone reabsorption, which minimizes the loss of bone density
It is typically given weekly but you may see dose variations based on patient. The medication should be taken in the morning on an empty stomach. It is important for the patient to not lie down for at least 30 minutes after taking the medication because it can cause esophageal bleeding.
What medications are used to treat gout?
Uric Acid Inhibitors: action & medication
inhibits the final steps of uric acid biosynthesis, which lowers uric acid levels to prevent attacks
Allopurinol (zyloprim) - these are taken ALL the time
What are the complications following surgery for a fractured femur?
Nerve damage
Blood clots (DVT can lead to a pulmonary embolism)
Fat embolism (fat emboli lodge in the pulmonary vascular or peripheral circulation,fat globules released about 12-48 hrs post injury)
Healing of the fractured bone in an abnormal alignment
