muscleskeletal Flashcards
hip fractures clinical manifestation
external rotation, abdution, muscle spasm, and shortiening of the extrem
interventions to prevent dislocation of hip prosthesis
supine with head of the bed elevated <60 degress, affected extremeity in neautral position, placing abductor pillow wedge when turning, and avoid crossing leg.
acute compartment syndrome
Severe pain unresponsive to analgesics
Immobility of digits
Changes in sensation—tingling or numbness (indicating early nerve ischemia) (Option 1)
Lack of pulses in distal extremity (not reliable for early ACS; absence of pulses indicates advanced/severe ACS)
Cool and pale distal extremity
pelvic and long bone injuries fat embolus
Sign and symptoms include altered mental status (eg, restlessness), chest pain, respiratory distress, and petechial hemorrhage.
clinical manifestationf of osteoarthritis
Pain exacerbated by weight-bearing activities: Results from synovial inflammation, muscle spasm, and nerve irritation (Option 4)
Crepitus, a grating noise or sensation with movement that can be heard or palpated: Results from the presence of bone and cartilage fragments that float in the joint space (Option 1)
Morning stiffness that subsides within 30 minutes of arising (Option 3)
Decreased joint mobility and range of motion
Atrophy of the muscles that support the joint (eg, quadriceps, hamstring) due to disuse
rheumatoid arthritis
a chronic autoimmune disorder, causes inflammation and remodeling of synovial joints, with progressive loss of functional capacity. Clients should be educated to protect the joints with range-of-motion exercises, allow for periods of rest during activities, use moist heat for stiffness and cold packs for pain, and sleep in a flat, neutral position.
gout
an inflammatory condition caused by ineffective metabolism of purines, which causes uric acid accumulation in the blood. Uric acid crystals typically form in the joints. Kidney stones can also develop, increasing the risk of kidney damage. Increasing fluid intake (2 L/day) to help eliminate excess uric acid (Option 3)
Implementing a low-purine diet, particularly avoiding organ meats (eg, liver, kidney, brain) and certain seafood (eg, sardines, shellfish)
Limiting alcohol intake, especially beer (Option 5)
Following a healthy, low-fat diet, as excess dietary fats impair urinary excretion of urates
Carpal tunnel syndrome
pain and paresthesia of the hand caused by median nerve compression within the carpal tunnel at the wrist.
hemoglobin level
Male: 13.8 to 17.2 grams per deciliter (g/dL) or 138 to 172 grams per liter (g/L) Female: 12.1 to 15.1 g/dL or 121 to 151 g/L.
external fixation care
the nurse should assess for signs of infection (eg, pin site drainage), perform pin care with a sterile cleaning solution, assess for loose pins, monitor for signs of neurovascular impairment (eg, decreased pulses, coolness), and promote early mobilization.
teaching points of cane
Hold the cane on the stronger side to provide maximum support and body alignment, keeping the elbow slightly flexed (20-30 degrees) (Option 1).
Place the cane 6”-10” (15-25 cm) in front of and to the side of the foot to keep the body weight on both legs to provide balance (Option 3).
For maximum stability, move the weaker leg forward to the level of the cane, so that body weight is divided between the cane and the stronger leg (Option 2). If minimal support is needed, the cane and weaker leg are advanced forward at the same time.
Move the stronger leg forward past the cane and the weaker leg, so the weight is divided between the cane and the weaker leg.
Always keep at least 2 points of support on the floor at all times.
cast care
instructions include reporting foul odors or hot areas in the cast; preventing the cast from getting wet; elevating the affected extremity above heart level for the first 48 hours; regularly exercising the affected extremity; and reporting symptoms of impaired circulation (eg, numbness, tingling, pallor, coolness). Clients should never insert objects inside the cast.
osteoporosis interventions
osteoporosis-related fall is the most common cause of hip fracture in the elderly. Interventions to reduce the risk of fall and hip fracture include bisphosphonate medication, calcium and vitamin D supplements, mobility and weight-bearing exercise, smoking cessation, and avoiding excessive use of alcohol.
oliguria
small amount of urine
Rhabdomyolysis
is a medical emergency caused by muscle injury that releases myoglobin into the bloodstream. The nurse’s priority when treating the client is to preserve kidney function by administering large volumes of IV fluid.
