MSK/ random Flashcards
Osteomyelitis
Infection of the bone leading to inflammation, increased vascularity, and edema –> ischemia and necrosis –> formation of abscess which contains dead bone that cannot drain (aka sequestrum) –> formation of new bone around the sequestrum (involucrum)
Medical management of osteomyelitis
- abx therapy for 6-12 weeks
- immobilize!!! affected area to decrease discomfort and risk of fracture of weakened bone
- surgical debridement
When is compartment syndrome seen and what is it?
- Seen after fracture or joint dislocation
- Swelling in muscle compartment, compresses nerves and bloody supple
- Sxs: < cap refill in that area, deep burning pain
- Tx: remove all external pressure
When does fat embolism syndrome occur and what is is?
- Seen after FEMUR and PELVIS
- ## Orthopedic emergency
Symptoms of fat embolism syndrome
classic triad of sxs: hypoxemia, AMS changes, petechial rash
- supportive treatment
Metastasis
Cancer cells break off from their cluster of growth and travel throughout the body via the bloodstream or lymphatic system, where they find new places to go
Cancer warning signs (CAUTIONUS)
C - change in bowel or bladder habits
A - a sore that does not heal
U - unusual bleeding/discharge
T - thickenings or lumps
I - indigestion or difficulty swallowing
O - Obvious change in a wart or mole
N - nagging or persistent cough or hoarseness
U - Unexplained anemia
S - sudden unexplained weight loss
major side effects of radiation for prostate cancer
proctitis, cystitis, and fatigue
The nurse working in an outpatient infusion center suspects what complication in a patient with breast cancer who has been receiving chemotherapy over the past 6 months and complains that it is getting difficult to button her shirt, hold her fork in the usual way, and that the bottom of her feet feel “prickly.”
Chemo brain
Peripheral neuropathy
Depression
Spinal cord compression
Peripheral neuropathy
A client with diabetes is attending a class on the prevention of associated diseases. What action should the nurse teach the client to reduce the risk of osteomyelitis?
Increase calcium and vitamin intake.
Monitor and control blood glucose levels.
Exercise 3 to 4 times weekly for at least 30 minutes.
Take corticosteroids as prescribed
A: monitor and control blood glucose levels
Rationale: Since poor glycemic control can exacerbate the spread of infection from other sources, the client with diabetes should maintain blood glucose levels within a desired range. Corticosteroids can exacerbate the risk of osteomyelitis. Increased intake of calcium and vitamins as well as regular exercise are beneficial health promotion exercises, but they do not directly reduce the risk of osteomyelitis.
Which nursing assessment finding would be indicative of compartment syndrome in the client with a cast applied to the left forearm 3 hours earlier?
Fingers pink, warm, and move freely
Capillary refill of left fingers greater than 3 seconds
Radial pulses 2+ bilaterally
Intact sensation
Compartment syndrome is characterized by neurovascular compromise. Capillary refill should be less than 3 seconds.
A nurse is caring for a client who just arrived from the OR after having foot surgery. Which nursing intervention is most important for the nurse to include in the nursing care plan this shift?
Examine the surgical dressing every four hours per orders
Administer pain medication per orders
Monitor vital signs every four hours per orders
Perform neurovascular assessment every hour per order
The priority nursing intervention is to perform a neurovascular assessment every hour. Early detection of neurological and perfusion problems is important to prevent complications from the surgery. Administering pain medication is important, but assessing the foot color and temperature are most important. Vital sign monitoring is important, but not a priority after foot surgery
The nurse is caring for a client with chronic gastritis. The nurse monitors the client knowing that this client is at risk for which vitamin deficiency?
Vitamin C
Vitamin A
Vitamin B12
Vitamin E
Clients with chronic gastritis from vitamin deficiency usually have evidence of malabsorption of vitamin B12 caused by the production of antibodies that interfere with the binding of vitamin B12 to intrinsic factor. However, some clients with chronic gastritis have no symptoms. Vitamins A, C, and E are not affected by gastritis.
The nurse is providing care to a client with gross ascites who is maintaining a position of comfort in the high semi-Fowler’s position. What is the nurse’s priority assessment of this client?
Respiratory assessment related to increased thoracic pressure
Urinary output related to increased sodium retention
Peripheral vascular assessment related to immobility
Skin assessment related to increase in bile salt
If a client with ascites from liver dysfunction is hospitalized, nursing measures include assessment and documentation of intake and output (I&O;), abdominal girth, and daily weight to assess fluid status. The nurse also closely monitors the respiratory status because large volumes of ascites can compress the thoracic cavity and inhibit adequate lung expansion. The nurse monitors serum ammonia, creatinine, and electrolyte levels to assess electrolyte balance, response to therapy, and indications of encephalopathy
