Final Exam: Musculoskeletal Problems Flashcards
Sprain vs Strain?
Sprain: injury to a ligament
Strain: injury to a muscle or tendon
A patient is seen at the urgent care center after falling on the right arm and shoulder. It will be most important for the nurse to determine:
Whether the right arm is shorter than the left arm
What does an open comminuted fracture mean?
The bone is splintered into several many pieces
What assessment should be done if a fracture is suspected in emergency situations? What patient complaint should be reported to HCP immediately?
- Neurovascular status checks distal to the injury should be initiated immediately
- Notify HCP of persistent tingling and numbness with a cast
Following a motor vehicle accident, a patient arrives in the ED with a massive right lower-leg swelling. Which action will the nurse take first?
Check leg pulses and sensation as part of the neurovascular checks
Closed reduction is? (2)
- non-surgical manual realignment of bone fragments
- traction is applied to restore position, length, alignment
Open reduction is? (2)
- correction of bone alignment through a surgical incision
- includes nails and rods
What is Bucks’ traction?
Type of skin traction used preoperatively for patient with a hip fracture to reduce muscle spasms
What is important to assess for in Bucks’ traction? (2)
- S/S of infection, very high risk in traction because the patient is immobile
- Skin integrity every 2-4 hrs
Which assessment should be done frequently for casts?
Neurovascular assessment should be frequent to assess for possible s/s of compartment syndrome
What are the main two complications of fractures?
- compartment syndrome
- pulmonary embolism
What is compartment syndrome and what are the s/s (6 Ps)? When should the HCP be notified?
- swelling causes increased pressure within limited space
- s/s: pain, pressure, paresthesia, pallor, paralysis, pulselessness
- immediately report to HCP if s/s persist
Manifestations of pulmonary embolism? (6) what is the first sign?
- tachypnea
- hypoxia
- dyspnea
- chest petechia
- tachycardia
- changes in LOC (patient appearing confused will be an EARLY sign of PE)
What is the key prevention for reducing the risk of pulmonary embolism in fracture?
Early mobilization
Clinical manifestation of hip and femur fracture?
external rotation with a clear distinct shortening of the affected extremity with extreme pain
What is the normal urine output per hour?
30 CC
What assessments should be made after hip and femur fracture surgeries?
cardiac output by monitoring urine output and stable vital signs
At-home care for hip and femur fractures consists of avoiding? (3) The patient should ___.
- sitting at low positions (eg: toilet seats)
- 90-degree flexion
- putting on socks and shoes
- patient should keep a pillow between legs while in a supine position
When getting a patient from the bed into the chair for the first time since having an ORIF of a hip fracture, the nurse should:
Assist the patient to use a walker with partial weight-bearing to assist in transfer to the chair
Local S/S of osteomyelitis include? (3)
- tenderness
- swelling
- warmth at the site
Systemic S/S of osteomyelitis include? (3)
- night sweats
- chills
- malaise
Risk factors for osteoporosis? (9)
- white and Asian American
- low body weight
- advancing age
- female sex
- sedentary lifestyle
- decreased levels of estrogen
- family hx of osteoporosis
- alcohol intake
- extended use of corticosteroids
Nursing management for osteoporosis? (2)
- nutrition focuses on implementing more foods with calcium (eg: yogurts, dark green leafy vegetables)
- weight-bearing exercises (eg: walking, lifting weights) to build bone density and muscle mass
The nurse determine that teaching regarding diet for a patient with osteoporosis has been successful when the patient selects which of these meals as having the highest amount of calcium?
Sardine sandwich on whole wheat bread, one cup of fruit yogurt, and one cup of skim milk
What is an important assessment to monitor for patients who are from postoperative procedures for internal fixation or open reduction?
Urine output (indicates how well the organs are functioning)
How will a nurse expect the extremity with a fracture to look?
Shorter in length
Which fracture is the most deadly and at risk for infection?
Open fractures (bone protruding through skin)
What are the 6 Ps of the neurovascular assessment?
Pallor, paresthesia, pain, pulselessness, pressure, paralysis
