MSK Flashcards
What electrolytes, vitamins, and other building blocks are needed for the production of new bone?
calcium, P, vitamin D, and protein
How is bone healing affected by the aging process?
can be affected by nutrition, estrogen, and chronic diseases
What are the s/sx of a fat embolism?
petechial rash, tachypnea, hypoxemia, dyspnea, HA
What is a fat embolism?
Obstruction of the pulmonary (or other organ) vascular bed by fat globules
What is the tx for a fat embolism?
Bedrest Gentle handling Oxygen Hydration (IV fluids) Possibly steroid therapy Fracture immobilization
osteomyelitis is most likely to occur after what?
Open fractures in which tissue integrity is altered and after surgical repair of a fracture
What abnormal labs may be seen with fat embolism syndrome?
- Decreased PaO 2 level (often below 60 mm Hg)
- Increased erythrocyte sedimentation rate (ESR)
- Decreased serum calcium levels
- Decreased red blood cell and platelet counts
- Increased serum level of lipids
What is poikilothermia?
Limb that feels cooler than surrounding areas
What is avascular necrosis?
Chronic complication of a fracture where blood supply to the bone is disrupted causing a decreased perfusion and death of bone tissue
What is a nursing priority when the patient is in skeletal traction?
skin integrity because hardware is inserted directly into the bone
What is a nurse’s highest priority when taking care of fractures?
NVS compromise
What intervention will help prevent flexion contractures after an amputation?
lower extremity active ROM exercises in early post op period
Why are bisphosphonates used to prevent and treat osteoporosis?
they slow bone resorption (the process of osteoclasts breaking down bone)
Why should you not give bisphosphonates to patients who are sensitive to aspirin?
bronchoconstriction may occur
Who should not take bisphosphonates?
Patients with poor renal function, hypocalcemia, or gastroesophageal reflux disease (GERD)
What is a common complication of bisphosphonate therapy?
Esophagitis
Older age, smoking, and high alcohol intake are primary or secondary causes of osteoporosis?
Primary
What are examples of secondary osteoporosis?
DM, hyperthyroidism, corticosteroids, prolonged immobility, hyperparathyroidism
What are the symptoms of Sjogren syndrome associated with RA?
dry eyes, dry mouth, and dry vagina; eyes feel “gritty” as if sand was in the eye
What is the most important imaging test to diagnose osteoporosis?
DXA
What are early sx of RA?
inflammation, generalized weakness, fatigue, anorexia, weight loss, and persistent low grade fever.
What are late signs of RA?
Morning stiffness, msl atrophy, severe joint swelling and effusions, decreased ROM, TMJ is affected, joint deformities, severe weight loss, fever, and extreme fatigue, subcut nodules,
What is a Baker’s cyst?
cyst behind the knee that is usually seen in the late stages of RA
What is Felty syndrome?
A pulmonary complication associated with late RA
What happens to bone mineral density (BMD) levels in post menopausal women?
Rapidly decreases as serum estrogen levels diminish
How does protein deficiency cause osteoporosis?
50% of calcium is protein bound. Protein is needed to use calcium.
What is a side effect of Fosamax that requires an oral assessment before taking it?
Jaw osteonecrosis
How often should a person with osteoporosis get a DXA scan?
Every 2 years
What NVS checks should you always do s/p surgery?
mvt, sensation, pain, warmth, temp, distal pulses, cap refill
How can excessive caffeine intake contribute to osteoporosis?
calcium can be excreted in the urine
