finals 2125

Question 1

what is the signs and symptoms of osteomyelitis?

Answer 1

redness, warmth,pain
persistent fever
malaise, restlessness, nausea, night sweat
refusal to walk
abdominal pain+ constipation with vertebral osteomyelitis

Question 2

what are the risk factors of osteomyelitis?

Answer 2

trauma or open wounds .
weak immune system. bacterial infection,

Question 3

examples of complete fracture

Answer 3

transverse, spiral, oblique, comminuted

Question 4

examples of open fracture

Answer 4

buckle or greenstick

Question 5

what is transverse fracture

Answer 5

perpendicular to the long axis

Question 6

what is oblique fracture?

Answer 6

diagonal to the long axis

Question 7

what is spiral fracture?

Answer 7

caused by a twisting force

Question 8

what is a comminuted fracture?

Answer 8

produce more than 2 fragments

Question 9

what is the first phase of bone healing?

Answer 9

reactive phase

Question 10

what is reactive phase of a fracture?

Answer 10

early inflammatory phase: cellular debris be phagocytes hosts by immune cells , trigger inflammatory response, form blood hematoma between fractured bones.

Question 11

what is the 2nd phase of bone healing?

Answer 11

reparative phase

Question 12

what is reparative phase of a fracture?

Answer 12

formation of cartilaginous callus between the broken bones, replace cartilage with bone tissue, form bony callus.

Question 13

what is the third phase of a fracture?

Answer 13

bone remodeling phase

Question 14

what is bone remodeling phase?

Answer 14

bony callus is remodelled to the original shape

Question 15

what does extracapsular means?

Answer 15

outside of the capsule joint

Question 16

intracapsular

Answer 16

within the capsule

Question 17

sub trochanteric means?

Answer 17

below the trochanter

Question 18

what is linear skull fracture?

Answer 18

line, does not move the bone

Question 19

what is depressed skull fracture?

Answer 19

bone pressed into the dura, requires surgery

Question 20

what is diastatic skull fracture/.

Answer 20

common in older newborns and infants, occurs along the skull suture line and widens them

Question 21

what is basilar skull fracture?

Answer 21

break in the bone at the base of skull, deadly

Question 22

what is colles fracture?

Answer 22

fracture on the distal ulnar and radius bone on an outstretched hand

Question 23

what is reverse colles fracture?

Answer 23

fracture on the distal ulnar and radius bone on a flexed hand

Question 24

what is snuff box fracture

Answer 24

fall on outstretched hand, causing extreme dorsiflexion and force land on scaphoid. hard to detect early, usually mri

Question 25

pre op physical examination for OA, fractures

Answer 25

Physical Examination
✓ Musculoskeletal – shorter
Right limb, externally
rotated, unable to lift up
right leg, has pain,
(+) crepitus on movement
of Left knee
✓ Neurovascular – pedal
foot pulses & sensations
are intact (Neurovascular
Assessment Chart)
✓ Vital signs

Question 26

pre -op diagnostics test for OA and fractures

Answer 26

ECG
* Lab investigations e.g.
Renal Panel, FBC
* X-ray – Pelvis & Knees

Question 27

nursing roles and responsibilities for pre-op OA frctues

Answer 27

provide emotional support
(allay anxiety/ provide
comfort)
* Prepare for diagnostic
procedure/ surgery
* Maintain optimal
nutritional status
* Patient education (preoperation expectations &
care)

Question 28

Needs of Patients With Hip Replacement Surgery (I)

Answer 28

• Preventing Dislocation of Hip Prosthesis (Increased pain, shortening of leg, inability to move
  leg, abnormal rotation)
• Correct positioning using splint, wedge, pillows
• Keep hip in abduction when turning, adduction when transferring
• Limited flexing of the hip; <90 degrees
• Mobility and ambulation
• Patients usually begin ambulation within 1 day after surgery using walker or crutches
• Weight bearing as prescribed by the physician
• Drain use postoperatively
• Assess for bleeding and fluid accumulation
  Nursing Care of Patients with Musculoskeletal Conditions
  Needs of Patients With Hip Replacement Surgery (II)
• Prevention of infection (E.g. wound – pain, increased redness, swelling, purulent discharge, fever)
• Remove drain within 24 to 48 hours
• Strict hygiene practices
• At risk for up to 24 months
• Prophylactic antibiotic may be given
• Prevention of DVT (calf pain, swelling, redness)
• Appropriate prophylaxis,
• Instituting preventive measures, and
• Monitoring the patient closely for clinical signs of the development of DVT and PE
• Patient education and rehabilitation

Question 29

pain meds for OA

Answer 29

NSAIDS and opiods

Question 30

which population does COX-2 NSAIDs suit? ARGH

Answer 30

Asthmatic patient, impaired Renal function, Gastric irritation/gastric
ulcer, worsen Heart function (ARGH)

Question 31

what is Triamcinolone

Answer 31

Glococorticoids for OA

Question 32

how long does triamcinolone last?

Answer 32

Temporary effect à last for up to 6 weeks

Question 33

contraindication for intraarticular triamncinolone

Answer 33

Do not administer if patient has joint infection

Question 34

what prophylaxis to give patient pre op?

Answer 34

antibiotic

Question 35

what prophylaxis to give patient post op?

Answer 35

DVT

Question 36

why are woman more prone to oA?

Answer 36

Woman tend to have smaller, thinner bones
than men
* Estrogen, a hormone in women that protect
bones, decreases sharply when women hit
menopause

Question 37

pathophysiology of osteoporosis

Answer 37

osteoporosis, rate of formation is slower
* Osteoclastic bone resorption > osteoblastic bone
formation
* Bones gradually become brittle and more likely to
break.

Question 38

how does biphosphonates work for OA

Answer 38

• Inhibits resorption of osteoclast or its
  precursors, leading to increase in bone density