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NURS241 Med Surg 2 > Med Surg 2- Musculoskeletal Exam > Flashcards

Med Surg 2- Musculoskeletal Exam Flashcards

1
Q

Ibandronate (Boniva)- Biophosphonates

A

For osteoporosis, osteoarthritis
Take on empty stomach 1st thing in morning, sit up 30 min after taking, take on same day weekly/monthly

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2
Q

Estrogen (hormone therapy)

A

Osteoporosis, osteoarthritis
At risk for blood clots

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3
Q

Ibuprofen
Naproxen

A

NSAIDs for RA pain

At risk for Gi distress, bleeding, strokes

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4
Q

Prednisone (corticosteroid)

A

Immunosuppresion- avoid large crowds and sick people

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5
Q

Methotrexate (DMARD)

A

Used for RA

Use contraception- can cause birth defects, abortion, death; avoid alcohol

Leukopenia, thrombocytopenia; will have increased creatinine and LFT

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6
Q

Hydroxychloroquine (DMARD)

A

retinal and corneal damage- must have regular eye exams every 6months

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7
Q

BRM’s (Biologic Response Modifiers)

A

Decreased immune response- avoid large crowds and sick people

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8
Q

Alloprurinol

A

CHRONIC antigout drug

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9
Q

Colchicine

A

ACUTE gout pain

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10
Q

Gabapentin

A

Used for phantom limb pain

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11
Q

Monoclonal Antibodies- Belimumab

A

Management of SLE (lupus)

Assess/check the CBC values (lower)

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12
Q

Heparin

A

Blood thinner used to prevent DVT and PE

Check PTT

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13
Q

Arthrogram

A

xray with contrast dye to visualize joint (knee)

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14
Q

Arthoscopy

A

diagnostic surgical procedure in which firbo-optic tube inserted for direct visualization

AFTER SURGERY- elevate extremity 12-24 hrs, apply ice

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15
Q

Osteoporosis

A

A condition in which the body’s bones become weak and break easily.

genetically linked

gentle in handling, give pt time

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16
Q

osteomalacia

A

softening of the bone due to vit. D deficiency

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17
Q

Ca and P relationship

A

when calcium rises, phosphorus drops

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18
Q

When collecting HH, ask about these drugs

A

Prednisone- fragile bones

Statins- achilles tendon rupture

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19
Q

What puts stress on joints

A

Weight

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20
Q

Gout has a genetic link with

A

osteoporosis

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21
Q

ALP level

A

30-120

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22
Q

Normal platelet count

A

150,000-400,000

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23
Q

Normal WBC

A

5,000-10,000

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24
Q

Normal ESR

A

anything above 20 means inflammation, 0-20

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25
Q

MRI

A

allergy to shellfish/iodine

remove metals and jewelry

Increases fluids to flush out contrast after procedure

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26
Q

CMS

A

circulation, motion, sensation

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27
Q

One cause of osteoporosis

A

Phosphorus in carbonated drinks

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28
Q

What to get on admission

A

Height, weight

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29
Q

What is best exercise?

A

Walking

30
Q

Osteomyelitis

A

infection of the bone

Increased WBC, ESR, positive blood cultures (B4 antibiotics)

31
Q

Bone tumors/cancer

A

usually metastasized from another area, leads to amputation and usually fatal

Most common type is osteosarcoa- focus on pain mainagement

32
Q

RICE

A

rest, ice, compression, elevate

33
Q

Gout

A

a type of arthritis characterized by deposits of uric acid crystals in the joints

elevated ESR and CRP (c-reactive protein)

can happen in other parts of body not only feet

34
Q

Gout treatment

A

Encourage fluids, decrease alc and purines in diet

tylenol, NSAIDs

35
Q

Post-Op Hip Replacement

A

Pillow between legs, prevents Adduction & dislocation

Encourage fluid intake, prevents DVT

prevent 90 degree flexion, legs always straight, HOB 30 degrees

prehab for exercises

check circulation every hour!

36
Q

Post-op, what to watch for

A

Delirium in elderly

37
Q

Assistive devices for hip surgery

A

Walker, cane goes on stronger/unaffected side

38
Q

RA factor testing

A

unusual antibodies in IGG- indicates connective tissue disease

no single test confirms

39
Q

What elevates blood sugar

A

steroids

40
Q

fatty embolism syndrome

A

life-threatening!

bone breaks and fat from inside bone can become a clot and travel through bloodstream

early s/s- hypoxemia, dyspnea, tachypnea

41
Q

Acute compartment syndrome

A

Swelling in a confined space that produces dangerous pressure; may cut off blood flow or damage sensitive tissue- serious edema!

S/S- 6 P’s

42
Q

Post- Op nursing interventions

A

ABCs

Assess patient CMS

Neuro checks q1hr

43
Q

Treating phantom limb pain

A

gabapentin

44
Q

What to do if pt has traction on post-op

A

if weights are messed up, call ortho tech or provider

45
Q

S/S Lupus

A

fever, fatigue, pain, butterfly rash, vasculitis, alopecia in women

46
Q

What to do with open bone fracture

A

cover with clean/sterile gauze

possibly splint, cover, ice, remove jewelry

47
Q

Emergent managing fracture

A

remove clothing (NOT SHOES), jewelry, CMS, control bleeding, cover

48
Q

Biphosphonates

A

slows bone resorption and may cause GI upset

49
Q

Fat embolism s/s

A

tachycardia, dyspnea

50
Q

Neurovascular assessment

A

CMS hourly

51
Q

Increased fracture healing diet

A

healthy diet (vit. B/C, iron, high protein/calories)

52
Q

BMRIs

A

decreased immunity- increased infections

53
Q

rheumatoid arthritis s/s

A

pain, limited ROM, swelling, fatigue, low grade fever (body attacks itself)

54
Q

Calcium foods

A

dark leafy green veggies, dairy

55
Q

RA determining labs

A

RA factor (IGG), ANA

56
Q

sign of osteoporosis

A

Kyphosis (change in height with humpback)

57
Q

Signs of fracture

A

serous drainage, weeping, edema

58
Q

What foods cause increased calcium excretion

A

high protein, caffeine, carbonation

59
Q

Dietary supplements for aid in treatment for osteoarthritis

A

Glucosamine and chrondoitin (bioflex) (OTC)

60
Q

Whats linked to Alkaline phosphate (ALD)

A

metabolic bone disease, bone cancer, problems with liver

61
Q

When is osteoporosis diagnosed

A

T-score is at or lower than -2.5

62
Q

S/S of osteomyelitis

A

Pain

Pallor

Puslelessness

Paresthesia

Paralysis

Poikilothermia

63
Q

Bone healing stages

A

Stage 1-Hematoma formation within 48 to 72 hr. after injury

Stage 2-Hematoma to granulation tissue (3 days to 2 weeks)

Stage 3- Callus formation (3-6 weeks)-the beginning of a non-bony union (bump on fracture)

Stage 4- Callus is resorbed and transformed into bone.

Stage 5- Consolidation & remodeling of bone.(4-6 weeks /1 year)

64
Q

Closed reduction

A

manipulation of the bone fragments without surgical exposure of the fragments

65
Q

Open reduction

A

surgical realignment of broken bone ends

66
Q

Bandages, splints, and boots/shoes

A

Assess CMS

Plaster cast- will feel burning sensation due to chemical hardening, normal reaction

67
Q

Traction

A

CMS checks

Buck’s traction- velcro boot being pulled

68
Q

Skeletal traction

A

Screws inserted into surgical site

Pin care q8hr to prevent infection

69
Q

carpal tunnel syndrome

A

caused by repetitive hand movements

can wear wrist brace

70
Q

Rotator cuff injury s/s

A

limited ROM, shoulder pain, weakness, loss of function, muscle atrophy

71
Q

Who is at increased risk for osteoporosis

A

Chinese american woman

*Older caucasian woman more at risk for injury (bone mass decreases)

72
Q

Dupuytren’s contracture

A

Thickening and shrinking of the fascia of the palm with fingers being drawn into a flexed position

NURS241 Med Surg 2 (3 decks)

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