MSK Flashcards
With aging, bone calcium loss can result in:
Fractures
Joint stiffness and pain is the result of:
Articular cartilage wearing down
Falls can indicate:
Muscle strength declines
Other factors of the aging MSK are:
Decreased elasticity of ligaments/tendons/cartilage
Posture/gait changes
Poor nutrition/hormone loss
Occupational hazards (cartilage loss)
What should be included in nursing history?
Mobility/assistive devices
Psycho-social info
Adls
Joint pain assessment
Previous MSK injury/congenial defect
Nutrition/wt. assessment
Potential risk factors
During physical exams you should compare _______ to the _________
Affected extremity to unaffected extremity
Pain unrelieved by narcs should be:
Reported to RN/Dr.
Abnormal capillary refill is about how many seconds?
Anything over 3-5 seconds..report to Dr.
Peripheral pulses should be _____ to the injury
Distal
During an edema assessment, you assess:
Inflammation & fluid status I.e. WNL, +1 +2 +3 +4 & pitting
Tingling/paresthesia/numbness/absence of sensation are apart of:
Assessing sensory nerves
Limited or absent refers to
assessing motor nerves
Describe the pain assessment factors
Location, duration, interventions/effectiveness, quality/severity (0-10), precipitating factors, when pain started, radiation
This is a pain reliever
Analgesic
What are some diagnostic tests for MSK?
Calcium total (Paget’s disease)..count: 8.4-10.2 phosphorus, alkaline phosphate total (Paget’s disease), myoglobin, creatine kinase..high level=tissue damage, CK3 (MM) isoenzyme, uric acid…high level indicate gout, ESR…level should be less than 20, CBC
What are factors of complete blood count testing?
Red blood cell count, hemoglobin, hematocrit, white blood cell count (4.5-10.5 cells/L), platelet count (150,000-450,000/mcL
Coagulation profile consists of:
•activated partial thromboplastin time (aTTP): uses heparin therapy, antidote is protamine sulfate
•prothrombin time (PT): warfarin therapy, antidote is vitamin k
•international normalized ratio (INR): anticoagulant PTs, warfarin therapy, antidote is vitamin k
Heparin and warfarin are:
Blood thinners (anticoagulants)
Strain vs sprain
•Strain: tendon or muscle excessively stretched…tearing occurs…RICE used
•sprain: ligament excessively stretched from twisting…RICE used
A dislocation is:
Any joint in which ends of bones are forced from normal position
Median nerve swelling within carpel tunnel is:
Carpal tunnel syndrome
A hematoma may occur with a contusion due to:
Soft tissue injury by blunt force
A break in a bone is a:
Fracture
______ & ______ may cause a fracture
Stress and pathological issues
An ______ fracture could risk the result of shock, hypovolemia, & osteomyelitis
Open
A ____ doesn’t break skin but tachycardia and. Hypotension should be monitored
Closed
What are factors of fracture pathophysiology
•Body tries to repair fracture immediately
•adults > hematoma forms at fracture site 48-72 hours post injury
•callus -non bony union- forms after week
•healing depends on age/fracture location…avg. young healthy adult bones heal in ~6 weeks
•vitamin D&C, calcium, protein, hydration intake important during healing
What are some fracture symptoms
Pain, decreased ROM, limb rotation, deformity/shortening of limb, edema, ecchymosis, muscles spasms, crepitus
What are the fracture types?
•Displaced (unaligned)
•incomplete (unbroken in 2)
•complete (broken in 2)
•greenstick (bend/split; children)
•comminuted (splinters/shatters..fragments)
•impacted (bone goes into another)
•avulsion (bone torn from main bone…still attached to ligament/tendon)
•patho/neo (weakened bone»tumor/tumor pressure)
•compression (vertebrae collapse)
•spiral (from twisting motion)
•stress (overuse)
•longitudinal (on length of bone)
•oblique (diagonally)
•transverse (horizontally)
What’s the point of traction?
● Immobilize a fracture
● Maintain proper alignment of an extremity
● Relieve muscle spasm and relieve pain following injury, fracture or surgery
● Prevent soft tissue injury
Hemoglobin value less than 7 likely requires
Transfusion
What’s the 6 Ps of compartment syndrome & what is compartment syndrome ?
It’s compartments of fascia sheaths being pressured in reduced circulation
Pain, Paresthesia, Paralysis, Pallor, Pulselessness, Poikilothermia
______ & _____ should be accounted for before MRIs with contrast
Claustrophobia and metal
Contrast allergy and kidney function relate to
CT with contrast
High uric acid levels are associated with
Gout
Post op for hip fracture includes
Buck’s traction, pain control, N-V assessment, correct co-existing conditions
GFR, BUN, & creatinine levels should be tested before
CT scan
