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ATI Comprehensive > Med-Surg: Musculoskeletal/2 > Flashcards

Med-Surg: Musculoskeletal/2 Flashcards

1
Q

gouty arthritis GA

A

systemic inflammatory disease caused by problems with purine metabolism (primary gout) or hyperuricemia (secondary gout)

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2
Q

systemic inflammatory disease caused by problems with purine metabolism (primary gout) or hyperuricemia (secondary gout)

A

GA

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3
Q

GA CFs

5

A
  1. family hx
  2. excessive alcohol
  3. high purine intake - organ meats, yeast, sardines, spinach
  4. obesity
  5. comorbid conditions of DM and/or KD
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4
Q

high purine intake =

A

GA

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5
Q

GA manifs.

4

A
  1. excruciating pain and inflammation in one or more small joints - big toes most common
  2. tophi - deposits of sodium urate crystals, generally appear after years of GA
  3. progressive joint damage and deformity
  4. increased incident of uric acid renal stone
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6
Q

GA dx procedures

3

A
  1. serum uric acid > 7
  2. ESR
  3. synovial fluid analysis - will show uric acid crystals
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7
Q

GA NIs

4

A
  1. maintain best rest during attacks
  2. use bed cradle to keep linen off joint
  3. 3l fluid/day
  4. limit high purines
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8
Q

GA acute phase and chronic tx meds

A

acute - colchicine

chronic - allopurinol

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9
Q

colchine is to

A

GA acute attack med

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10
Q

allopurinol is to

A

GA chronic rx treatment

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11
Q

GA and weight loss

A

lose weight slowly; rapid weight loss can cause attack or increase the incidence of uric acid renal stones

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12
Q

comminuted fractures aka

A

fragmented

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13
Q

bone fracture 6 P’s

A 
pain
pressure
paralysis
pallor
pulselessness
paresthesia
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14
Q

fat emoblism s/s

7

A
  1. confusion
  2. anxiety
  3. tachycardia
  4. chest pain
  5. tachypnea
  6. hemoptysis
  7. petechiae over neck, upper arms, chest, abd (late sign)
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15
Q

compartment syndrome is irreversible if compromise persists beyond

A

4-6 hours

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16
Q

compartment syndrome s/s

A
  1. pain unrelieved by position or meds
  2. cyanosis
  3. tingling
  4. paralysis
17
Q

precursor of Osteoporosis

A

osteopenia

18
Q

osteoporosis CFs - primary

8

A
  1. women 65+
  2. men 75+
  3. asian, white
  4. family hx
  5. estrogen or androgen def
  6. protein def
  7. sedentary life
  8. smoking alcohol
19
Q

osteoporosis CFs - secondary

7

A
  1. bone cancer
  2. cushing’s
  3. DM
  4. meds
  5. paget’s disease
  6. prolonged immobilization
  7. RA
20
Q

osteoporosis manifs.

4

A
  1. shortened height
  2. hx of fractures
  3. thoracic kyphosis
  4. decreased bone mass
21
Q

PTH route

A

sq, daily, for osteoporosis tx

22
Q

osteomyelitis CFs

5

A
  1. DM
  2. hemodialysis
  3. injection drug use
  4. poor blood supply
  5. recent trauma
23
Q

osteomyelitis manifs. - main ones

4

A
  1. bone pain
  2. fever
  3. general discomfort
  4. local swelling, redness, warmth
24
Q

osteomyelitis dx proc. - not extensive list

2

A
  1. bone biopsy - which is then cultured

2. bone scan

25
Q

osteomyelitis NIs

3

A
  1. IV antibiotics
  2. if wound drainage - do contact precautions
  3. implement wound irrigation
26
Q

osteomyelitis therapeutic measures

2

A
  1. surgical excision of dead and infected bone may be needed

2. bone grafting may be performed in large impacted areas

27
Q

total joint arthroplasty post op for hip

3

A

keep abductor pillow in place while in bed, do not flex hip more than 90 degrees, do not position on operative side

28
Q

total joint arthroplasty post op for knee

A

maintain continuous passive motion CPM machine to promote joint mobility

29
Q

total joint arthroplasty opioid rxs

2

A

extended release epidural morphine or PCA

30
Q

amputation meds

5

A
  1. opioids for residual limp pain
  2. calcitonin to reduce phantom pain
  3. antispasmodics for muscle spams
  4. beta blockers for constant, dull, burning pain
  5. antiepileptic drugs for knife-like or sharp burning pain
31
Q

amputation - calcitonin

A

reduces phantom pain

32
Q

amputation - beta blockers

A

relieves constant, dull, burning pain

33
Q

amputation - antiepileptic meds

A

relieve knife-like or sharp burning pain

ATI Comprehensive (17 decks)

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