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Acute and Chronic > Joint Replacement/Assessment > Flashcards

Joint Replacement/Assessment Flashcards

Exam 1

1
Q

ROM
Pain
Joint deformity

A

assessment for joint replacement

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2
Q

When pt has pain in the jont what should you look?

A

effusion, redness, and warmth (active inflammation

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3
Q

During the _______ __________ the patient may have __________ on palpation or when putting the joint through ________ __ ________

A

joint examination
tenderness
range of motion

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4
Q

t/f should you force a joint during ROM

A

false

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5
Q

The buildup of excessive ____ ______ that restricts joint motion and _________ ability.

A

Arthrofibrosis

scar tissue
functional

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6
Q

Severe pain and __________ often interfere with ___________ and self-care

A

deformity
ambulation

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7
Q

The presence of excess joint fluid especially common in the _____.

A

joint effusion

knee

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8
Q

A grating sound caused by loosened bone and _______ in a synovial joint

A

crepitus

cartilage

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9
Q

joints should move ___________ no grating should be heard

A

smoothly

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10
Q

__________ typically a result of a known event or condition that directly __________ cartilage or causes joint __________

A

osteoarthritis

directly damages
instability

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11
Q

which is the most commmon form of arthritis?

A

osteoarthritis

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12
Q

why would you get a joint arthroplasty?

A

impaired mobility, persistent pain, and disability

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13
Q

occurs less often than primary disease and can result from joint injury and obesity

A

Secondary OA

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14
Q

Injury to the ______ from excessive use, trauma, or other joint disease (e.g., ___________ __________) predisposes a person to OA

A

joints
rheumatoid arthritis

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15
Q

Joint arthroplasties are often ________, knee, and some shoulders

A

hips

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16
Q

Replaced mostly with ______ __________ ________ and polyethylene, ________

A

high density metal
ceramic

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17
Q

t/f should pt be optimal health prior to surgery

A

TRUE

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18
Q

what may be prescribed prior to surgery to increase hemoglobin

A

Epoetin alfa

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19
Q

what would you do if a surgery is not emergent?

A

make efforts to get pt to optimal health

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20
Q

Hypertension and _________ and chf and will need to stabilizes before surgery

A

diabetes

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21
Q

t/f Epoetin alfa may be given instead of giving blood products

A

TRUE

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22
Q

________ ____ _____________ is a replacement of a severely ___________ hip with an artificial joint

A

total hip arthroplasty

damaged

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23
Q

what are some diseases that might cause you to get a total hip arthroplasty

A

osteoarthritis, rheumatoid arthritis, femoral neck fractures

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24
Q

Pt and family will need to ___________ for life at home

A

accommodate

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25
Q

t/f to have a toal hip arthroplasty the pt must have irreversibly damged hip joints and the potential benefits much outweight risks

A

TRUE

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26
Q

during a hip fracture a leg will…

A

shorten
exrernal rotation
adduction

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27
Q

older in age
female
history of osteroporsis
decrease estrogen related to metaphase
increase falls
history of chronic conditions
TIA’s anemia
medication
cardiovascular disease

A

risk factors that increase the likihood that a pt may have hip fracture

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28
Q

Interventions for hip fractures

A

bucks traction, immobility ( trochanter roll or sand bags)
surgery - internal fixation

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29
Q

surgically implanted devices applied directly to fractured bone segments to keep them temporarily or permanently in place.

A

surgery - internal fixation

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30
Q

t/f pt are at a high risk for venous thrmoembolism

A

true should take measures to prevent DVT

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31
Q

Stop meds that increase risk at least 1 wk before (unless emergent surgery) – will stop _________ _______ and ______ and OTC meds

A

blood thinners
herbals

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32
Q

what pulse should you assess before and after surgery?

A

Assess distal pulses for arterial flow and compare to prior

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33
Q

t/f Intermittent compression device (SCUDS)intraop/postop
don’t help to prevent dvt

A

false

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34
Q

what should you take to for the prophylaxis of deep vein thrombosis (DVT) after surgery

A

LMWH (Lovenox)

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35
Q

what increases the risk for venous thromboembolism?

A
  • Advanced age
  • obesity
  • preoperative leg edema
  • previous history of any VTE
  • varicose veins
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36
Q

may be applied before surgery to help decrease pain

A

skin (Buck) traction

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37
Q

t/f Most commonly done in hip replacements before surgery is when buck’s is used

A

TRUE

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38
Q

involves the use of a Velcro boot belt, or halter, which is usually secured around the affected leg

A

Buck traction

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39
Q

post op hip fracture what should you look for?

A
  • sever pain
  • inability to move leg
  • shortening & external rotation of the leg
40
Q
  • dvt
  • bleeding, swelling
  • pulmonary complication (atelectasis_
  • pressure ulcer
  • urinary retention
A

post op complications of hip fracyure surgery

41
Q

Some fractures _____ achieve union; that is, they never completely _______ (________)

A

never
heal
nonunion

42
Q
  • coughing and deep breathing
  • stocking and compression devices
  • turn q2h
  • maintain leg abduction
  • neuro status check
  • pain contril
  • mobilize ASAP
  • check under client for drainage
A

Nursing care intervention for post op hip fractures

43
Q

you will hear what when a joint comes out?

A

you will hear a pop

44
Q

Infection_________ before surgery will delay surgery

A

2-4 weeks

45
Q

what will you ask a patient to do before surgery to prevent infection?

A

Shower with antiseptic soap

46
Q

what may a patient take to prevent infection after surgery and before a dental procedure?

A

Prophylactic antibiotics prior

47
Q

what may a pt be given before surgery to decrease risk of infection?

A

prophylactic broad-spectrum antibiotics

48
Q

if a pt has to have a foley what may you be worried about

A

CAUTI and this is why you want the foley out ASAP

49
Q

a pt acuquires an infection in the no affected joint what my this cause the patient to do?

A

Persistent infection of a joint may require another replacement

50
Q

how long should a pt be on an anticoagulant post op?

A

6 weeks post op to prevent dvt

51
Q
  • Dislocations
  • Excess _______ drainage
  • Heel pressure ulcers
  • Avascular necrosis (_____ ______ _ ___)
  • _________ of prosthesis
A

other issues that arise from post op

wound
cell death of bone
Loosening

52
Q

On all post op- want early _______ to prevent ___________!

A

mobilization
complications

53
Q

what will an older pt absolutely need to get post op?

A

Older patient will definitely need pressure reducing mattress

54
Q

what may occur post op?

A

pt may be constipated

55
Q

__________ position with his or her head slightly elevated

A

supine

Preventing Dislocation of the Hip Prosthesis

56
Q

_______ splint, a wedge pillow placed between the legs __________ ________ beyond the midline of the body.

A

abduction
prevent adduction

Preventing Dislocation of the Hip Prosthesis

57
Q

hip is never flexed ____ _____ ___ degrees.

A

more than 90

Preventing Dislocation of the Hip Prosthesis

58
Q

When turning patient keep the ________ hip in abduction

A

operative

Preventing Dislocation of the Hip Prosthesis

59
Q

When using fracture bedpan nurse reminds patient to flex the __________ __and to use the ______ __ _____the pelvis onto the pan.

A

unaffected hip
trapeze to lift

Preventing Dislocation of the Hip Prosthesis

60
Q

On ______ times out of bed abduction pillow is _____ ___.

A

initial
left in

Preventing Dislocation of the Hip Prosthesis

61
Q

full flexion (_________) , adducted (legs together), and _______rotated.

A

risj for dislocation when

bending
internally

62
Q

t/f post op THA you want legs to be together when ambulating or moving

A

false you want something inbetween

63
Q

away from midline

A

abduction

64
Q

towards midline

A

adduction

65
Q

t/f you should bend affected him more than 90 degrees

A

FALSE

66
Q

t/f when lying on your back do NOT roll or turn your affect leg towards the other leg or turn your toes in ward?

A

TRUE

67
Q

t/f you should let the toes of your affect leg turn downward?

A

FALSE
you should not

68
Q

t/f when lying on your side, keep the affect leg outside the midline of the body?

A

TRUE

69
Q

t/f you can bend over to pick up objects post THA

A

FALSE

70
Q

t/d do not rotate your leg when standing. Keep leg straight.

A

TRUE

71
Q

t/f you can cross your legs when sitting?

A

FALSE

72
Q

t/f keep leg in extention when getting up?

A

TRUE

73
Q

t/f you should pivot on affected leg

A

FALSE

pivot on unaffected leg

74
Q

High-seat (orthopedic) chairs, __________ wheelchairs, and ________ toilet seats to prevent ________

A

semi-reclining
raised
flexion

75
Q

Nurse protects leg from _________, flexion, ________ or _________ rotation, or excessive weight ________

A

adduction
interal or external
bearing

76
Q

t/f a pt post op THA can put on shoes and socks

A

FALSE

77
Q

t/f a pt will be able to go back to normal ADL without assistance or modifications

A

FALSE

Will need someone to go to home to assess for need for modification- bath seat- elevated. Elevated toilet seat.

78
Q

what will a pt need post op to gain some indepence?

A

rehab/PT/OT

79
Q

__ __ __ _____is when the highest risks for the hip to come out

A

8 to 12 weeks

80
Q
  • Increased pain at the surgical site, ______, and immobilization
  • ________ ______ pain in the affected hip or increased discomfort
  • ___________ of the affected extremity
  • Abnormal external or internal rotation of the _____ extremity
  • Restricted ability or _________ to move the leg
  • Reported “________” sensation in the hip
A

S/S of dislocation

swelling
Acute groin
Shortening
affected
inability
popping

81
Q

t/f if pain is bad and leg is rotated odds are you should not be concerned?

A

FALSE

you SHOULD be concerned

82
Q

you get a pt up post op and they complain of lightheadness, they are experincing…

A

Orthostatic hypotension

83
Q

t/f a pt will have a weight bearing limit post op?

A

TRUE

84
Q

t/f a pt may begin to ambulate within 24 hours after surgery

A

TRUE

85
Q

t/f you should notify the surgeon of excessive or foul-smelling drainage?

A

TRUE

86
Q

driange of 200 to 500 in the first 48 hours is expected?

A

FALSE

it is normal the first 24 hours not 48

87
Q

t/f a drain is usully removed within the first 24 hours post op

A

TRUE

88
Q

t/f a there is no risk DVT after a TKA?

A

FALSE

there is a risk

89
Q

what can help decrease the risk for DVT?

A

Lovenoz (LMWH)

90
Q

t/f Prophylactic antibiotics are only given for THA

A

FALSE

Prophylactic antibiotics are also given for TKA

91
Q

t/f pt shoul flex foot frequently

A

TRUE

92
Q

t/f ice packs are used to control bleeding and swelling?

A

TRUE

93
Q

t/f Assess neurovascular status (pulse, color )frequently

A

TRUE

94
Q

when would a continuous passive motion machine be place post TKA

A

placed right after surgery

95
Q

The ______ is usually protected with a knee __________ and is elevated when the patient sits in a chair

A

knee
immobilizer

96
Q

t/f pain post op of TKA is worse than a THA

A

FALSE

hip pain is worse

Acute and Chronic (15 decks)

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