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Level 3 > Families exam 4 - musculoskeletal > Flashcards

Families exam 4 - musculoskeletal Flashcards

1
Q

What are manifestations of a fracture?

A
  • pain
  • crepitus
  • deformity
  • edema
  • ecchymosis
  • warmth
  • redness
  • not using the affected area
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2
Q

What does a neurovascular assessment include?

A
  • sensation
  • skin temp
  • skin color
  • cap refill
  • pulses
  • movement
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3
Q

What type of fractures needs a supine position?

A
  • distal arm
  • pelvis
  • lower extremities
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4
Q

What type of fractures needs a sitting position?

A
  • shoulder
  • upper arm
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5
Q

What should be assessed when a pelvic fracture is present?

A

blood in the urine

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6
Q

What should be done to relieve pain with a fracture?

A
  • elevate
  • apply ice packs (no > 30 mins)
  • analgesics
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7
Q

How long should an extremity be elevated with a cast?

A

for the first 24-48 hours

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8
Q

How long should ice be used with a cast?

A

for the first 24 hours

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9
Q

What should you watch for with a cast?

A
  • increased warmth
  • hot spots on the cast
  • drainage
  • skin breakdown
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10
Q

How can itching be relieved with a cast?

A

hair dryer

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11
Q

How is force applied with skin traction?

A
  • weights are attached by a rope to the extremity
  • tape and straps are applied to the skin along with boots/cuffs
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12
Q

How is force applied with skeletal traction?

A
  • directly to the skeletal structure and/or specific bone
  • insertion of pin/rod
  • use of weights attached by a rope
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13
Q

Can nurses remove weights for traction?

A

NO

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14
Q

What should pin sites be assessed for?

A
  • pain
  • redness
  • swelling
  • drainage
  • odor
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15
Q

What type of fracture most commonly causes osteomyelitis?

A

open fracture

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16
Q

What does osteomyelitis look like?

A
  • swollen
  • red
  • constant pain that increases with movement
  • tender
  • warm
  • tachycardia
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17
Q

What type of cultures should be done for osteomyelitis?

A
  • skin
  • blood
  • bone
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18
Q

What type of biopsy should be done for osteomyelitis?

A
  • joint
  • bone
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19
Q

What medications are given for osteomyelitis?

A

antibiotics (IV or oral)

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20
Q

Should you elevate the extremity with osteomyelitis?

A

YES

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21
Q

Should you elevate the extremity with compartment syndrome?

A

NO, keep at heart level

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22
Q

Do pain meds help with compartment syndrome?

A

NO

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23
Q

What are the 5 P’s for compartment syndrome?

A
  • pain
  • paresthesias
  • pallor
  • paralysis
  • pulselessness
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24
Q

What are characteristics of the skin with compartment syndrome?

A
  • pale
  • cold
  • cyanotic nail beds
25
Q

How much space should there be between skin and cast?

A

1 finger

26
Q

What can the nurse do for compartment syndrome?

A
  • loosen dressing
  • open cast
27
Q

What procedure can be done for compartment syndrome?

A

fasciotomy

28
Q

Where does asymmetry occur with scoliosis?

A
  • scapula
  • ribs
  • flanks
  • shoulders
  • hips
  • legs (one is shorter than the other)
29
Q

When should a scoliosis screening be done?

A

adolescence

30
Q

What slows the progression of scoliosis?

A

bracing

31
Q

When is a spinal fusion with rod placement done with scoliosis?

A

for curvatures > 45 degrees

32
Q

What should be monitored after spinal fusion surgery?

A
  • neurovascular status
  • skin
  • drain sites for infection
  • decreased H&H
  • bleeding
33
Q

What is subluxation?

A

incomplete dislocation of the hip

34
Q

What is dislocation?

A

when the femoral head does not have contact with the acetabulum

35
Q

Is DDH painful at birth?

A

no

36
Q

What is a positive trendelenburg sign, and when does it occur?

A
  • when the pelvis tilts down while bearing weight on the affected side
  • child DDH
37
Q

What is a positive ortolan test, and when does it occur?

A
  • the hip is reduced by abduction
  • infant DDH
38
Q

What is a positive barlow test, and when does it occur?

A
  • the hip is dislocated by adduction
  • infant DDH
39
Q

What are characteristics of walking in a child with DDH?

A
  • walking on toes on the shorter leg
  • walking with a limp
40
Q

What bone is shortened in an infant with DDH?

A

femur

41
Q

What happens to gluteal and thigh folds in an infant with DDH?

A

they are asymmetric

42
Q

How long is the pavlik harness worn?

A

12 weeks

43
Q

How often are the straps on the pavlik harness checked/adjusted?

A

q 1-2 weeks

44
Q

What should be worn with the pavlik harness?

A

an undershirt and knee socks

45
Q

Can lotions/powders be used with the pavlik harness?

A

NO

46
Q

How should a diaper be worn with the pavlik harness?

A

under the straps

47
Q

What type of traction should be used when adduction contracture is present?

A

bryant traction

48
Q

What is bryant traction?

A

skin traction where the hips are flexed at a 90 degree angle with the butt raised off the bed

49
Q

How should a hip spica cast be handled until it dries?

A
  • elevated
  • with palm of hand
50
Q

Can you get a hip spica cast get wet?

A

NO

51
Q

What should be assessed with a hip spica cast?

A
  • neurovascular status
  • skin in the diaper area
  • pain
  • hydration status
  • color and temp of toes
52
Q

What can prednisone cause?

A
  • adrenal suppression
  • bone loss
  • hyperglycemia, glycosuria
  • myopathy
  • PUD
  • infection
  • F&E imbalances
53
Q

What should be done for adrenal suppression caused by prednisone?

A
  • altered day dosing schedule
  • taper dose
54
Q

What should be done for bone loss caused by prednisone?

A
  • weight-bearing activities
  • calcium and vitamin D
  • low dose
55
Q

What should be done for hyperglycemia and glycosuria caused by prednisone?

A

increase insulin dose

56
Q

What should be done for myopathy caused by prednisone?

A

decrease the dose

57
Q

What should be done for PUD caused by prednisone?

A
  • avoid NSAIDS
  • report s/sx of bleeding
  • admin with food
58
Q

What should be done for infection caused by prednisone?

A

avoid large crowds and sick people

Level 3 (29 decks)

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