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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
Q

Symptoms of dislocation after hip arthroplasty

A

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

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26
Q

Major post-op priorities after a joint arthroplasty

A

bleeding
infection
positioning education

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27
Q

Interventions to make after a hip arthroplasty

A

Elevate toilet seat
Avoid low chairs and bending at the waist
Do not cross your ankles or legs

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28
Q

This is used short term following surgery to realign hip and femur fractures, and stop muscle spasms

A

Bucks traction

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29
Q

What should be monitored following a joint arthroplasty?

A

Bleeding
Surgical Site/Dressing
Pulses distal to the affected joint
Return of sensation
Symptoms of infection and VTE

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30
Q

Which cranial nerve controls tongue movement

A

Hypoglossal

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31
Q

What test is used to detect spinal cord or peripheral nerve conduction?

A

SERs test
(Somatosensory Evoked Responses)

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32
Q

Which side does the cane go on? WHY?

A

Uninvolved; so that weight may be distributed away from the affected limb

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33
Q

Which portion of the femur is commonly affected by avascular necrosis?

A

The neck of the femur

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34
Q

Which herbal medication most commonly taken interferes with clotting and anesthetic medications?

A

St. Johns Wort

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35
Q

Post-Op wound infection is most likely to occur within how many days following surgery?

A

30 days

36
Q

Syndrome associated with muscle atrophy and loss of strength

A

Disuse Syndrome

37
Q

Elderly patients are most at risk for which type of fracture?

A

Pelvic

38
Q

Why do we wrap an amputated limb in a figure 8 pattern?

A

to not impede blood flow

39
Q

Which position should a patient be in immediately following a BKA or AKA?

A

Supine with the limb elevated

40
Q

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?

A

Assess for complications

41
Q

Pulselessness, a very late sign of compartment syndrome, may signify

A

Lack of distal tissue perfusion

42
Q

Major complication of crushing fractures and long bone injuries

A

Fat embolism

43
Q

Symptoms of fat embolism

A

Mental status changes
Dyspnea and chest pain
Low SpO2
Tachypnea
Petechiae over the chest and neck

44
Q

Major intervention for fat embolism

A

Minimize movement of the fracture

45
Q

Fat embolisms can cause

A

CVA, MI, PE

46
Q

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.

A

Compartment Syndrome

47
Q

Interventions for compartment syndrome

A

Notify HCP
Keep extremity at heart level
Loosen and remove restrictive clothing
In severe cases - Fasciotomy

48
Q

The 6 P’s of Compartment syndrome

A

Pain
Paresthesia
Pallor of affected limb
Paralysis
Poikilothermia
Pulselessness

49
Q

When a patient has compartment syndrome, what does pulselessness mean?

A

Muscle ischemia

50
Q

A chronic, complex, and rare disorder characterized by regional pain in a limb that is disproportionate

A

CRPS
Complex Regional Pain Syndrome

51
Q

CRPS typically begins following…

A

Fracture, soft tissue injury, or surgery

52
Q

Symptoms of CRPS

A

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
Q

Treatment of CRPS

A

Analgesics
NSAIDs
Topical anesthetics
Corticosteroids
Opioids
Anticonvulsants
Antidepressants
Nerve blocks
Neural stimulation

54
Q

What should be assessed in a patient undergoing Buck’s Traction?

A

Skin Breakdown
PMSC:
P- Pulses
M- Motor function
S- Sensation in the limb
C- Cap refill

55
Q

What position is the patient in while in Buck’s Traction

A

Supine - do not elevate the head of the bed more than 25 degrees

56
Q

CAST care

A

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
Q

Some signs of infection with a cast

A

Hot spots, foul odors coming from the cast

58
Q

Fracture that breaks through the skin

A

Open or Compound

59
Q

Fracture that does not penetrate the skin

A

Closed or Simple

60
Q

Fracture that slants across the bone shaft

A

Oblique

61
Q

Fracture that twists around the bone shaft

A

Spiral

62
Q

Which fraction type would possibly indicate child abuse?

A

Spiral Fracture

63
Q

Fracture where bones are compressed after a fall or jump

A

Compression or Impact

64
Q

Fracture where bone is crushed from heavy object

A

Crush

65
Q

Which fractures are common in children

A

Greenstick, Buckle, and plastic fractures

66
Q

Signs of a Hip Fracture

A

Muscle spasms around the affected area
Ecchymosis on thigh and hip
Groin and hip pain with weight-bearing

67
Q

What is an osteophyte and what condition may cause them?

A

Bone spurs - Osteoarthritis

68
Q

Risk factors for Fractures

A

Bed rest
Osteoporosis
Steroids
Trauma – falls, accidents

69
Q

Symptoms of Fractures

A

Bruising w/ pain and swelling
Crepitus → crackling sound (bone fragment is rubbing together)
Muscle spasms
Odd appearance
Edema and erythema
Neurovascular impairment

70
Q

Signs of internal bleeding following a fracture

A

Hypotension
Tachycardia
Hematuria

71
Q

Why do fractures tend to heal faster in children?

A

periosteum is stronger, thicker, and more flexible

72
Q

What is the potential time frame for a fracture to heal in a child?

A

3-12 weeks depending on the extent of the fracture, presence of delaying factors, and compliance to treatment plan

73
Q

Risk factors for Developmental dysplasia of the hip (DDH)

A

Breech positioning
Oligohydramnios
Female sex → ligaments are more lax due to maternal hormones
Genetic factors
Native American or Eastern European descent

74
Q

Preferred treatment of DDH from birth to 6 months

A

Pavlik Harness

75
Q

How is DDH diagnosed?

A

In utero US
Barlow + Ortolani maneuvers @ birth until 6 months
X-Ray at or over 6 months

76
Q

What would you find during an infant assessment that might indicate they might have DDH?

A

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
Q

Nursing considerations for Pavlik harnesses

A

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
Q

Your infant patient is wearing a Pavlik harness. What would prompt you to call the MD IMMEDIATELY?

A

The infant cannot move their legs

79
Q

Osteomyelitis is most commonly caused by which microorganism?

A

Staphylococcus Aureus

80
Q

Symptoms of Osteomyelitis

A

Localized, extreme pain
Edema and erythema
Fever → may be low-grade and occur in the afternoon/evening
Drainage

81
Q

Treatments for Osteomyelitis

A

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
Q

Benefits of early ambulation following joint arthroplasty

A

Decreased VTE risk
Easier recovery
Increased mobility

83
Q

Patient p/s total hip replacement - positioning when turning

A

Abduction

84
Q

Patient p/s total hip replacement - positioning when transferring

A

Adduction

85
Q

Major patient education points for osteoporosis

A

Rubber mats in the showers
Well lit hallways
NO throw rugs
! Anything that decreases the risk of falls !

86
Q

Nursing consideration for Reclast (zoledronic acid)

A

Most potent bisphosphonate - extremely nephrotoxic and associated with acute kidney injury! Monitor kidney labs.

87
Q

To increase absorption, what should be taken alongside calcium supplements?

A

Magnesium and VitaminD

NSG210 (2 decks)

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