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NSG210 > Mobility > Flashcards

Mobility Flashcards

1
Q

Blunt force injury to soft tissue

A

Contusion

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2
Q

Pulled muscle injury to the musculotendinous unit

A

Strain

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3
Q

Injury to the ligaments and supporting muscle fiber around a joint

A

Sprain

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4
Q

Articular surfaces of the joint are not in contact

A

Dislocation

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5
Q

Partial or incomplete dislocation

A

Subluxation

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6
Q

Autoimmune disease where the body attacks the myelin sheath

A

Multiple Sclerosis

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7
Q

Risk factors for MS:

A

Age
Female gender
Genetics
Temperate climate

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8
Q

Main risks to remember with patients with MS

A

Fall Risk
Aspiration Risk
Risk for malnutrition
Risk for Depression
Risk for ADL impairment

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9
Q

Triggers for people with MS

A

Stress, SIckness, Smoking, and Sun/Extreme Heat exposure

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10
Q

Noninflammatory degenerative disease of the protective cartilage cushion on the end of the bones, resulting in bone on bone rubbing

A

Osteoarthritis

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11
Q

The joints that are most affected in OA

A

Weight-bearing and finger joints

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12
Q

Risk factors for OA

A

Obesity
Smoking
Repetitive stress on the joints
Family history
Female

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13
Q

Clinical manifestations of OA

A

Crepitus
Pain - more with activity, relieved with rest
Morning Stiffness
Functional impairment
Large joints with decreased ROM

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14
Q

Bone disease in which the bones are fragile and porous. Loss in bone mass results in low bone density and brittle bones

A

Osteoporosis

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15
Q

This hormone inhibits bone resorption and promotes bone formation

A

Calcitonin

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16
Q

Risk factors for Osteoporosis

A

Postmenopausal Women
Excess Caffeine
Smoking
Elevated alcohol intake
Use of Anticonvulsants
Steroid use
Hyperparathyroidism
Cushing Syndrome
Diabetes Mellitus

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17
Q

Most prevalent bone disease in the world

A

Osteoporosis

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18
Q

Symptoms of Osteoporosis

A

Frequent Fractures + Compression Fractures
Loss of height from gradual collapse of vertebrae
Kyphosis

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19
Q

This symptom of Osteoporosis results in pulmonary insufficiency

A

Kyphosis

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20
Q

Treatments/Therapies for Osteoporosis

A

Vitamin D and Calcium Supps
Weight-bearing exercises and frequent ambulation
Smoking cessation
Decreasing caffeine intake
Bisphosphonates

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21
Q

Nursing considerations for Bisphosphonates (i.e. Alendronate, Risedronate, Reclast)

A

Give with a full glass of water on an empty stomach
Sit upright for 30 minutes after taking due to the risk for esophagitis

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22
Q

The S/S of Hypercalcemia

A

Slow bowels (Constipation)
Muscle weakness
Fatigue
Anorexia
N/V
Polyuria
Cardiac dysrhythmias
Seizures
Coma

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23
Q

The replacement of a diseased joint with a prosthetic joint

A

Joint Arthroplasty

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24
Q

Some reasons that someone would need a joint arthroplasty

A

OA
Severe joint pain
Loss of function
Jount degeneration due to RA
Trauma and fractures
Congenital deformities

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25
Symptoms of dislocation after hip arthroplasty
Swelling, extreme pain at surgical site Loss of mobility Acute groin pain in affected hip Popping noise Affected leg is longer/shorter than the unaffected leg Abnormal internal or external rotation
26
Major post-op priorities after a joint arthroplasty
bleeding infection positioning education
27
Interventions to make after a hip arthroplasty
Elevate toilet seat Avoid low chairs and bending at the waist Do not cross your ankles or legs
28
This is used short term following surgery to realign hip and femur fractures, and stop muscle spasms
Bucks traction
29
What should be monitored following a joint arthroplasty?
Bleeding Surgical Site/Dressing Pulses distal to the affected joint Return of sensation Symptoms of infection and VTE
30
Which cranial nerve controls tongue movement
Hypoglossal
31
What test is used to detect spinal cord or peripheral nerve conduction?
SERs test (Somatosensory Evoked Responses)
32
Which side does the cane go on? WHY?
Uninvolved; so that weight may be distributed away from the affected limb
33
Which portion of the femur is commonly affected by avascular necrosis?
The neck of the femur
34
Which herbal medication most commonly taken interferes with clotting and anesthetic medications?
St. Johns Wort
35
Post-Op wound infection is most likely to occur within how many days following surgery?
30 days
36
Syndrome associated with muscle atrophy and loss of strength
Disuse Syndrome
37
Elderly patients are most at risk for which type of fracture?
Pelvic
38
Why do we wrap an amputated limb in a figure 8 pattern?
to not impede blood flow
39
Which position should a patient be in immediately following a BKA or AKA?
Supine with the limb elevated
40
A client with a long arm cast continues to complain of unrelieved throbbing pain even after receiving opioid pain medication. Which is the priority action by the nurse?
Assess for complications
41
Pulselessness, a very late sign of compartment syndrome, may signify
Lack of distal tissue perfusion
42
Major complication of crushing fractures and long bone injuries
Fat embolism
43
Symptoms of fat embolism
Mental status changes Dyspnea and chest pain Low SpO2 Tachypnea Petechiae over the chest and neck
44
Major intervention for fat embolism
Minimize movement of the fracture
45
Fat embolisms can cause
CVA, MI, PE
46
What is it called when the pressure within the fascia/muscles builds to a dangerous level? Also the most serious complication associated with casting and splinting.
Compartment Syndrome
47
Interventions for compartment syndrome
Notify HCP Keep extremity at heart level Loosen and remove restrictive clothing In severe cases - Fasciotomy
48
The 6 P's of Compartment syndrome
Pain Paresthesia Pallor of affected limb Paralysis Poikilothermia Pulselessness
49
When a patient has compartment syndrome, what does pulselessness mean?
Muscle ischemia
50
A chronic, complex, and rare disorder characterized by regional pain in a limb that is disproportionate
CRPS Complex Regional Pain Syndrome
51
CRPS typically begins following...
Fracture, soft tissue injury, or surgery
52
Symptoms of CRPS
Severe burning pain Localized edema Hyperesthesia Stiffness Discoloration Vasomotor skin changes (fluctuating color and temp) Glossy, shiny skin Changes to hair and nail growth
53
Treatment of CRPS
Analgesics NSAIDs Topical anesthetics Corticosteroids Opioids Anticonvulsants Antidepressants Nerve blocks Neural stimulation
54
What should be assessed in a patient undergoing Buck's Traction?
Skin Breakdown PMSC: P- Pulses M- Motor function S- Sensation in the limb C- Cap refill
55
What position is the patient in while in Buck's Traction
Supine - do not elevate the head of the bed more than 25 degrees
56
CAST care
Clean and Dry (Never wet) Above the heart for the first 24 hours Scratch of itch? Hair dryer on cool setting or antihistamines Take it easy - no bearing weight, no finger indentations, no hard surfaces for the first 48 hours
57
Some signs of infection with a cast
Hot spots, foul odors coming from the cast
58
Fracture that breaks through the skin
Open or Compound
59
Fracture that does not penetrate the skin
Closed or Simple
60
Fracture that slants across the bone shaft
Oblique
61
Fracture that twists around the bone shaft
Spiral
62
Which fraction type would possibly indicate child abuse?
Spiral Fracture
63
Fracture where bones are compressed after a fall or jump
Compression or Impact
64
Fracture where bone is crushed from heavy object
Crush
65
Which fractures are common in children
Greenstick, Buckle, and plastic fractures
66
Signs of a Hip Fracture
Muscle spasms around the affected area Ecchymosis on thigh and hip Groin and hip pain with weight-bearing
67
What is an osteophyte and what condition may cause them?
Bone spurs - Osteoarthritis
68
Risk factors for Fractures
Bed rest Osteoporosis Steroids Trauma – falls, accidents
69
Symptoms of Fractures
Bruising w/ pain and swelling Crepitus → crackling sound (bone fragment is rubbing together) Muscle spasms Odd appearance Edema and erythema Neurovascular impairment
70
Signs of internal bleeding following a fracture
Hypotension Tachycardia Hematuria
71
Why do fractures tend to heal faster in children?
periosteum is stronger, thicker, and more flexible
72
What is the potential time frame for a fracture to heal in a child?
3-12 weeks depending on the extent of the fracture, presence of delaying factors, and compliance to treatment plan
73
Risk factors for Developmental dysplasia of the hip (DDH)
Breech positioning Oligohydramnios Female sex → ligaments are more lax due to maternal hormones Genetic factors Native American or Eastern European descent
74
Preferred treatment of DDH from birth to 6 months
Pavlik Harness
75
How is DDH diagnosed?
In utero US Barlow + Ortolani maneuvers @ birth until 6 months X-Ray at or over 6 months
76
What would you find during an infant assessment that might indicate they might have DDH?
Clunk sound during Barlow and Ortolani Maneuvers Stiff hip joint Legs that are different lengths An outward-turning leg on the affected side Uneven skin folds on the groin or thigh (front or back of the upper leg)
77
Nursing considerations for Pavlik harnesses
Do NOT take harness off to change diaper Do NOT adjust straps Place infant on their back to sleep Place long knee socks and undershirt on infant to prevent rubbing of the harness Needs to be worn at least 23 hours a day for at least 6 weeks Assess skin integrity (behind knees and diaper area)
78
Your infant patient is wearing a Pavlik harness. What would prompt you to call the MD IMMEDIATELY?
The infant cannot move their legs
79
Osteomyelitis is most commonly caused by which microorganism?
Staphylococcus Aureus
80
Symptoms of Osteomyelitis
Localized, extreme pain Edema and erythema Fever → may be low-grade and occur in the afternoon/evening Drainage
81
Treatments for Osteomyelitis
Long-term IV antibiotics for weeks or months (At least 4 weeks, patient will go home with a PICC line) Surgical debridement if it is severe Amputation if not responsive to therapy Adequate hydration, vitamins, protein
82
Benefits of early ambulation following joint arthroplasty
Decreased VTE risk Easier recovery Increased mobility
83
Patient p/s total hip replacement - positioning when turning
Abduction
84
Patient p/s total hip replacement - positioning when transferring
Adduction
85
Major patient education points for osteoporosis
Rubber mats in the showers Well lit hallways NO throw rugs ! Anything that decreases the risk of falls !
86
Nursing consideration for Reclast (zoledronic acid)
Most potent bisphosphonate - extremely nephrotoxic and associated with acute kidney injury! Monitor kidney labs.
87
To increase absorption, what should be taken alongside calcium supplements?
Magnesium and VitaminD

NSG210 (2 decks)

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