MSK

Question 1

S+S of compartment syndrome

Answer 1

7 Ps
Paresthesia
Pain
Pallor
Pressure
Pulselessness
Poikilothermia

Question 2

Tx of compartment syndrome

Answer 2

Limb at level of heart
Remove cast or tight dressing
Possible emergency fasciotomy
S+S at exposed site
Capillary refill and bilateral pulses
ROM exercises

Question 3

Gout risk factors

Answer 3

Metabolic syndrome (obesity, DM, hyperlipidemia)
High-protein, high-fat diet
Excessive alcohol intake
Diuretic therapy
Polycythemia vera

Question 4

Gout S+S

Answer 4

Severe pain
Joint warmth
Redness
Swelling
Possible fever

Question 5

Nursing interventions of gout (acute)

Answer 5

NSAIDs
Colchicine
Elevate involved limb
Immobilize joint
Apply ice
Avoid pressure or touching bed or clothing

Question 6

Nursing interventions of chronic gout

Answer 6

Allopurinol (avoid during acute exacerbations)
Avoid high purine foods (organ meats, wines, aged cheese)
Encourage weight reduction if obese
Avoid alcohol consumption

Question 7

Patho of guillain-barre syndrome

Answer 7

Acute, immune-related polyneuropathy -> segmental demyelination and axonal damage
Commonly follows respiratory/GI infx
Life-threatening risk for respiratory failure

Question 8

GB S+S

Answer 8

Symmetric, ascending muscle weakness
Diminished DTRs
Parethesias
Back pain
Urinary retention/ileus
Autonomic cardiovascular instability (tachycardia, dysrhythmias, BP changes)
Respiratory failure
Dysphagia

Question 9

Tx of GB

Answer 9

Supportive
Continuous cardiac monitoring
Resuscitative equipment available
Reposition every 2 hrs
SCDs to legs

Question 10

Myasthenia gravis patho

Answer 10

Antibodies attack acetylcholine receptors at neuromuscular junction
Impaired nerve impulse conduction -> progressive muscle weakness

Question 11

MG S+S

Answer 11

Fluctuating skeletal muscle weakness
Fatigue
Ptosis, diplopia
Weakness is worse w/ exertion and later in day

Question 12

Symptom exacerbation w/ MG

Answer 12

Stress
Infx
Temp changes
Meds (fluoroquinolones, aminoglycosides, magnesium sulfate)

Question 13

Nursing interventions for MG

Answer 13

Acetylcholinesterase inhibitors (pyridostigmine)
Diet recs to conserve energy: semi-solid foods, take med before meal
Relaxation and stress-reduction
Flu and pneumococcal vaxx
Plan ADL in morning

Question 14

Myasthenic crisis and tx

Answer 14

Severe oropharyngeal and respiratory muscle weakness - impaired swallowing, difficulty breathing
Intubation may be required
Semi-Fowler position
Administer corticosteroids
Prepare for plasmapheresis or IV immunoglobin

Question 15

Osteoporosis risk factors

Answer 15

Age
Postmenopausal status
Low body weight - thin, small stature
Smoking
Excessive alcohol intake
Sedentary lifestyle

Question 16

Complications of osteoporosis

Answer 16

Kyphosis (hunchback)

Question 17

Meds for osteoporosis

Answer 17

Meds: vitamin D, calcium carbonate, bisphosphonates
Diet: rich in calcium and vitamin D
Adequate sun
Smoking cessation
Limit alcohol
Frequent weight-bearing exercises
Fall prevention
Repeat bone density scans

Question 18

Patho of PK dz

Answer 18

Degeneration of dopamine, uncontrolled activity of acetylcholine

Question 19

Meds for PK dz

Answer 19

Carbidopa/Levodopa

Question 20

Nursing interventions for spinal cord injury

Answer 20

Maintain spinal alignment and immobilization: cervical collar, log-roll technique, avoid twisting torso
Respiratory: prepare for intubation
Cardiac: prepare to administer IV fluids for neurogenic shock
Turn every 2 hrs
Intermittent cath, bowel training
DVT ppx

Question 21

Sprain tx

Answer 21

RICE
Rest
Ice
Compression
Elevation

Question 22

GB vs. MG

Answer 22

GB: ascending and symmetrical, pain, respiratory, motor nerves, acute, tx is IVIG or plasmapheresis (for crisis)

MG: eyes and central nerves, neuromuscular junction, chronic, tx is Anticholinesterases (pyridostigmine)