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Nursing I > M/S > Flashcards

M/S Flashcards

1
Q

The human skeleton has ____ bones.

A

206

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2
Q

What do bones provide?

A

structure, support for soft tissue, protect vital organs, movement

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3
Q

What minerals are stored in the bones?

A

calcium and phosphorus

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4
Q

What production happens in the bones?

A

blood production (hematopoiesis)

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5
Q

What are bones covered with that contain blood vessels and nerves?

A

periosteum (double layer of connective tissue)

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6
Q

What kind of bone is smooth, dense bone that forms shaft of long bones and outside layer of other bones?

A

compact bone

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7
Q

What kind of bone is contained within bone spaces that is light weight?

A

spongy bone

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8
Q

What does red bone marrow make?

A

blood cells and hemoglobin

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9
Q

Where is red bone marrow found?

A

flat bones of sternum, ribs, and ilium

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10
Q

What does yellow bone marrow consist of?

A

fat and connective tissue

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11
Q

Where is yellow bone marrow found?

A

shaft of long bones

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12
Q

What is needed for bones to be remodeled?

A

weight bearing

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13
Q

Area where two or more bones meet

A

articulations

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14
Q

What joint is 2 bones joined together, immovable?

A

synarthrosis

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15
Q

What joint is slightly movable?

A

amphiarthrosis

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16
Q

What joint is freely movable?

A

diarthrosis or synovial

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17
Q

What joint requires the most pain relief?

A

diarthrosis/synovial joints

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18
Q

Inflammation of synovial joint may indicate need for synovial fluid sample. The procedure is called _____

A

arthrocentesis

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19
Q

Synovial joints are found where?

A

at all limb articulations

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20
Q

The surface of synovial joints are covered with ____

A

cartilage

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21
Q

The joint cavity of synovial joints are covered with _____ filled with _____

A

synovial capsule and synovial fluid

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22
Q

Connect bone to bone

A

ligaments

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23
Q

Connect bone to muscles

A

tendons

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24
Q

___ muscles allow for voluntary movement

A

skeletal

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25
Q

___ and ___muscles allow for involuntary movement

A

smooth and cardiac

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26
Q

Musculoskeletal changes can be due to what 3 things, and can they be avoided?

A

aging process (unavoidable), decreased activity (avoidable), lifestyle factors (avoidable)

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27
Q

Loss of bone mass is called _____

A

osteoporosis

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28
Q

Who is at higher risk for osteoporosis?

A

older asian and caucasian women

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29
Q

Why does osteoporosis occur in women?

A

menopause and lack of estrogen

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30
Q

Keeping active prevents ____ and maintains ____

A

prevents bone loss and maintains muscle strength

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31
Q

Osteoporosis poses a higher risk for _____

A

fracture

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32
Q

Joint and disk cartilage dehydrates causing loss of flexibility and contributes to which degenerative joint disease?

A

osteoarthritis

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33
Q

Osteoarthritis causes what?

A

joints to stiffen and lose range of motion

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34
Q

When joint and disk cartilage dehydrate, this can cause a loss of height (1.5-2in), a stooped posture called _____

A

kyphosis

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35
Q

Kyphosis is a stooped posture which changes the center of gravity (hips and knees flex) creating a higher risk for ____

A

falling

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36
Q

What 5 things to include in the verbal assessment?

A
  1. health history
  2. chief complaint
  3. onset of problem
  4. effect on ADLs
  5. precipitating events
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37
Q

What 5 things to include in the physical examination?

A
  1. posture
  2. gait
  3. ability to ambulate with/without assistive devices
  4. ability to feed, toilet, and dress self
  5. muscle mass and symmetry
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38
Q

What 2 things are signs of a fractured hip?

A

shortened and internal rotation

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39
Q

Never attempt to move a joint past ______ or ______

A

normal ROM or past point where patient experiences pain

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40
Q

_____ test is performed when hip flexion contracture is suspected (usually done by physician)

A

Thomas

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41
Q

What forms bone?

A

osteoBlasts (Builders)

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42
Q

What reabsorbs bone?

A

osteoCLasts (CLeaners)

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43
Q

What cell is responsible for mineral deposit in bones?

A

osteocytes

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44
Q

What are 8 diagnostic tests?

A
  1. blood tests
  2. arthrocentesis
  3. x-ray
  4. bone density scan
  5. CT scan
  6. MRI
  7. ultrasound
  8. bone scan
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45
Q

____ occurs when tissues are subjected to more force than they are able to absorb

A

trauma

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46
Q

The severity of trauma depends on what two things?

A

the amount of force and the location of the impact

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47
Q

_____ bones cannot with stand force as well because they do not absorb as much energy

A

smaller

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48
Q

Musculoskeletal trauma ranges from ____ to ____

A

mild to severe

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49
Q

When soft tissue is damaged, it can lead to what?

A

bruise/contusion

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50
Q

Fractures can be severe enough to affect the function of ____, ____, and ____

A

muscles, tendons, and ligaments

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51
Q

True or False: musculoskeletal trauma can be so severe that is results in complete amputation

A

true

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52
Q

How can older adults maintain muscle strength?

A

by moving and exercising

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53
Q

In older clients what is the HIGHEST RISK for musculoskeletal trauma?

A

falls (which can lead to a deterioration of health)

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54
Q

What are 5 things that should be included in HOME SAFETY?

A
  1. lighting
  2. handrails
  3. throw rugs (bad)
  4. bath mats and grab bars
  5. shoes w/ good tread
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55
Q

What is the term used for significant bleeding into tissues causing build up/pooling of blood?

A

hematoma

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56
Q

What is the term used for the breakage of small vessels that leads to bleeding into soft tissues; causing swelling and discoloration?

A

contusion/bruise

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57
Q

What are the 6 neurovascular assessments?

A

pain, pulses, sensation, skin color, temperature, movement (and cap refill)

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58
Q

True or False: strains and sprains are NOT usually associated with soft tissue trauma

A

false. Strains and sprains are usually associated with soft tissue trauma

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59
Q

What is injured with a SPRAIN?

A

ligaments

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60
Q

What is injured with a STRAIN?

A

muscles and Tendons (sTrain)

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61
Q

True or False: Nurses usually grade sprains

A

false. Nurses do NOT usually grade sprains

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62
Q

Grade III (highest grade of sprain) means that what happened to the ligament?

A

complete tear of the ligament (leading to instability)
Grade I (overstretch)
Grade II (partial tear)

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63
Q

What is a microscopic tear in a muscle or tendon?

A

strain

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64
Q

Which field of work is at high risk for strains?

A

healthcare workers (usually due to unplanned movements)

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65
Q

How is soft tissue trauma diagnosed?

A

xray to rule out fracture (if pain continues an MRI is ordered because it is more in-depth than a CT)

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66
Q

What are the 5 assessments for soft tissue trauma?

A
  1. mechanism of injury
  2. protective devices
  3. pain assessment
  4. inspection for redness, swelling, and deformity
  5. ROM
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67
Q

Soft tissue trauma can be serious, what are the nursing teachings to provide the patient?

A
  1. promote comfort (RICE)
  2. prevent further injury
  3. allow healing (adequate resting time)
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68
Q

How to control pain with a soft tissue injury?

A

RICE, heat (after several days), NSAIDs

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69
Q

Impaired physical mobility can be a risk for what?

A

skin breakdown

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70
Q

True or False: fractures place the patient at risk for complications

A

true

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71
Q

Can severe muscle contractions lead to fractures?

A

yes

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72
Q

The nursing focus for a patient with a fracture should be what?

A

-assessing
-promoting comfort
-preventing complications
-re-enforce teaching

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73
Q

Closed/simple fractures…

A

skin remains intact

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74
Q

open/compound fractures…

A

bone protrudes through skin (would want to prevent infection)

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75
Q

Complete or incomplete fractures…

A

entire or partial

76
Q

Stable or unstable fractures…

A

non-displaced or displaced

77
Q

A spiral or greenstick fracture line can indicate what?

A

abuse (report to charge nurse)

78
Q

Fracture healing is affected by what two things?

A

age (elderly = longer recovery) and overall condition (malnutrition may lengthen recovery)

79
Q

A local inflammatory response to a fracture does what?

A

fights infection and starts healing process

80
Q

How long does it typically take for a bone to heal?

A

6-8 wks (12-16 wks for fractured hip)

81
Q

When does fracture healing begin?

A

within 48hrs

82
Q

Signs of hypovolemic (low blood volume) shock?

A

LOC (progressively worsens)
feeling cold (moves blood to vital organs)
pale
bp drops
hr increases

83
Q

Excess pressure that restricts blood vessels and nerves within a compartment

A

compartment syndrome (fascia does not stretch with swelling, which puts pressure on nerves and blood vessels) will have neurovascular changes

84
Q

What are the 6 P’s in compartment syndrome?

A

-pain
-pallor (pale)
-paresthesias (numbness/tingling)
-paresis (weakness)/paralysis
-pulselessness
-poikilothermia (low core body temp)

85
Q

Fracture complications that can delay healing

A

-delayed fracture reduction
-inadequate immobilization
-infection
-age

86
Q

Surgical reduction is called what?

A

open reduction (stabilized with hardware)

87
Q

Reduction without surgery is called what?

A

closed/manual reduction

88
Q

What is the goal when a patient has a fracture?

A

reduce (restore alignment) and immobilize

89
Q

The way to get a definitive fracture diagnosis is to do what?

90
Q

When a limb is immobilized/splinted ______ ____ should be ongoing

A

neurovascular checks (should be the same or improved, but never worse)

91
Q

Rigid device to immobilize bones and promote healing

92
Q

How long does it take for a plaster cast to dry?

93
Q

Hoe long does it take for a fiberglass cast to dry?

94
Q

What is the process called when splitting a cast to allow for expansion?

A

bivalving a cast

95
Q

When a cast is removed what is the patient at risk for?

A

skin break down

96
Q

What is used to maintain alignment by using weights?

97
Q

Surgery can be used to align and stabilize fractured bones. What is it called when pins are placed through the bone, but the stabilizers are outside the body?

A

external fixation

98
Q

Surgery can be used to align and stabilize fractured bones. What is it called when there is an open reduction and pins, plates, and screws are used PERMANENTLY?

A

internal fixation

99
Q

What does ORIF stand for?

A

open reduction, internal fixation

100
Q

It is important to become mobile when it is ordered because it helps do what?

A

-increase circulation
-decreases risk of complications

101
Q

Older adults suffer from what kind of fracture?

102
Q

Separation of contact between two bones of a joint

A

dislocation

103
Q

Partial separation of contact between two bones of a joint

A

subluxation

104
Q

True or False: Both dislocation and subluxation can lead to neurovascular problems

A

true (important to reduce and assess neurovascular)

105
Q

How are dislocations are usually reduced?

A

manual traction (closed reduction) could require surgery

106
Q

Once a dislocation is reduced, what will the patient need to comply with?

A

immobilization

107
Q

Partial or total removal of a body part

A

amputation

108
Q

Amputation can be caused by what two things?

A

-traumatic injury
-chronic illness (diabetes, peripheral vascular disease, and cancer) used to treat cancer

109
Q

Who is at a higher risk for a traumatic amputation?

110
Q

What is the most common amputation site?

A

lower extremity

111
Q

True or False: A limb CANNOT be reattached after a traumatic amputation

A

false. If there is not too much nerve/tissue damage and if acted quickly (4hr time limit) the limb could be reattached

112
Q

Death of body tissue due to lack of blood or an untreated infection

A

gangrene (can lead to amputation)

113
Q

True or False: Joints are preserved when possible in amputation for easier mobility after procedure

114
Q

Open wound at the end of stump (after amputation procedure) and why

A

guillotine (to let bacteria out (drain), when infection is present) wound is closed when infection is cleared

115
Q

Skin is formed to cover end of wound in an amputation procedure

A

closed (flap)

116
Q

What are the 4 amputation complications?

A
  1. infection
  2. delayed healing
  3. contractures
  4. phantom pain
117
Q

True or false: There can be significant physical and psychosocial effects to an amputee and their family

A

true. Adaptation takes time and effort

118
Q

What is the nurses role when caring for a new amputee?

A

relieve pain, promote healing, and prevent complications

119
Q

What is the main goal for an amputee?

A

to gain independence

120
Q

What is DDH?

A

developmental dysplasia of the hip (congenital defect)

121
Q

DDH reflects what 3 varieties of hip abnormalities?

A

-shallow acetabulum
-subluxation
-dislocations

122
Q

Mildest form of DDH; osseous hypoplasia of acetabular roof, femoral head remains in the acetabulum

A

acetabular dysplasia (preluxation)

123
Q

Partial dislocation

A

subluxation

124
Q

Most serious DDH when femoral head loses contact with acetabulum

A

dislocation

125
Q

True or false: It is important to be diagnosed with DDH at birth (early intervention) so that the hip can be reduced and immobilized

126
Q

When a newborn is diagnosed with DDH what immobilizer are they put in?

A

Pavlik harness

127
Q

How to tell if an infant has DDH?

A

-shortened limb on affected side
-restricted abduction of hip on affected side
-unequal gluteal folds (when prone)

128
Q

Test that moves hip up and out

A

Ortolani (reduce)

129
Q

Test that moves hip down and in

A

Barlow (dislocate)

130
Q

Are hips immobilized in adduction or abduction?

131
Q

Foot turns inward (letter J)

A

talipes varus

132
Q

Foot turns out (letter L)

A

talipes valgus

133
Q

Plantar flexion with toes lower than heel

A

talipes equinus

134
Q

Dorsiflexion with toes higher than the heel

A

talipes calcaneus

135
Q

What intervention usually works with congenital clubfoot?

A

serial casting (casts in infants need to be changed around every 2-4 wks)

136
Q

Head tilt caused by rotation of cervical spine

A

torticollis (stretching exercises and occasionally caused by visual impairment)

137
Q

Complex spinal deformity in three planes, may be congenital or develop during childhood

A

scoliosis (more common in girls)

138
Q

Treatment for scoliosis includes _____, _____, and/or _____

A

bracing, exercise (PT), surgery (stabilizing rods)

139
Q

What is a TLSO?

A

a brace for scoliosis to limit movement

140
Q

Progressive degeneration of muscle fibers, increasing disability and deformity with loss of strength

A

muscular dystrophies

141
Q

Must use upper extremities to stand up straight with MD

A

Gower’s sign

142
Q

The most severe form of MD, also called pseudohypertrophic muscular dystrophy

A

Duchenne Muscular Dystrophy (DMD)

143
Q

DMD affects mostly males or females?

A

almost affects males exclusively because it is x-linked

144
Q

Serum ___ and ____ levels are high in the first 2yrs of life, before onset of weakness; levels diminish as muscle deterioration continues

A

CPK and AST

145
Q

What 3 things to confirm DMD?

A

-EMG
-muscle biopsy
-serum enzyme measurement

146
Q

Curvature in the lumbar of the back

147
Q

“Hunchback”

148
Q

Waddling gait, frequent falls, and Gower’s sign

149
Q

There is no effective treatment of which congenital disorder?

150
Q

What is the primary goal with a patient that has DMD?

A

maintain function in unaffected muscles as long as possible

151
Q

What are some therapeutic treatments for DMD?

A

-ROM
-bracing
-performance of ADLs
-surgical release of contractures prn

152
Q

What are some nursing considerations of DMD?

A

-help patient and family cope
-teach child self help skills (be independent as long as possible)
-appropriate health care assistance as child’s needs intensify (home health, skilled facility, respite care for family)

153
Q

Severe form of clubfoot, present with other abnormalities, and is resistant to standard treatment

A

tetralogic/syndromic

154
Q

Clubfoot that may correct spontaneously or require passive exercise or serial casting

A

postural/mild

155
Q

Clubfoot when no other abnormalities are present and responds well to treatment

A

congenital/idiopathic

156
Q

pain in a joint

A

arthralgia

157
Q

Medical term for bunion

A

Hallux valgus

158
Q

Enlargement and lateral displacement of the great toe

A

bunion/hallux valgus

159
Q

Are bunions more prevalent in males or females?

A

females (shoes)

160
Q

How are bunions fixed?

161
Q

Flexion of the proximal interphalangeal joint with hyperextension of the MTP and distal interphalangeal joints (inability to straighten toe)

162
Q

caused by pressure/friction; thickened skin on top/side of toe (usually from shoe that does not fit properly)

163
Q

caused by pressure/friction; large thick patch of skin from overuse

164
Q

Sprain of the big toe joint (MTP joint)

165
Q

Inadequate mineralization of bone due to insufficient amounts of calcium or phosphate in ADULTS

A

osteomalacia

166
Q

Osteomalacia, but in children

167
Q

How is osteomalacia treated?

A

give Calcitriol

168
Q

Umbrella term that describes diseases that affect joints, tendons, ligaments, muscles, and bones

A

rheumatism

169
Q

inflammation of a join, can be local or systemic

170
Q

Degenerative joint disease with progressive loss of joint cartilage; most common form of arthritis

A

osteoarthritis

171
Q

Leading cause of disability in older adults and occurs in synovial joints

A

osteoarthritis

172
Q

What are the 6 risk factors for osteoarthritis?

A
  1. age
  2. repetitive joint use/trauma
  3. heredity
  4. obesity
  5. congenital and acquired defects
  6. immobility
173
Q

Is osteoarthritis localized or systemic?

174
Q

Reconstruction or replacement of the joint (total joint replacement)

A

arthroplasty

175
Q

Complications that come from arthroplastys

A

-infection
-impaired circulation
-thromboembolism (blood clot, DVT)

176
Q

Chronic systemic autoimmune disease that causes an inflammatory disorder of the joints (affects women more than men)

A

rheumatoid arthritis

177
Q

Patients may experience what 3 things with rheumatoid arthritis?

A
  1. joint swelling
  2. warmth of joint (does not occur with osteoarthritis)
  3. tenderness
178
Q

What is an ESR?

A

erythrocyte sedimentation rate: nonspecific test for inflammation 10-20 is normal

179
Q

Surgical immobilization of a joint by fusion of the adjacent bones

A

arthrodesis

180
Q

A metabolic disorder that leads to an accumulation of urate crystals in joints

181
Q

normal uric acid lvl scale

182
Q

what is the treatment for gout?

A

-reduce uric acid lvls
-diet and exercise
-stay away from foods with purines (organ meats, alcohol, some seafood and shellfish, drinks w/ high fructose corn syrup)

183
Q

Uric acid crystals can deposit where and cause what?

A

kidneys and cause kidney failure

184
Q

What med is avoided with gout?

A

aspirin because it can increase uric acid lvls

185
Q

What meds decrease uric acid lvls?

A

-colchicine
-allopurinol
-probenecid

Nursing I (10 decks)

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