muscoskeletal

Question 1

dorsiflexion vs plantar flexion

Answer 1

in dorsiflexion, we point the toes toward our nose or toward the ceiling. dorsiflexion can help prevent foot drops.
in plantar flexion, we point the toes down, ex: toward the plant (on the floor)

Question 2

abduction

Answer 2

abduction is the movement of a limb away from the body’s midline

Question 3

abdominal aortic aneurysm

Answer 3

caused by uncontrolled hypertension and atherosclerosis. but when it is happening, I does drop BP, and causes lots of abdominal pain

Question 4

bolutism

Answer 4

caused by cdiff, it inhibits the release of acetylcholine causing muscle weakness, paralysis, and other symptoms.

Question 5

foods high in magnesium

Answer 5

BSS
bananas, fish, spinach, kale, beans

low in magnesium: onions, mushrooms,

Question 6

types of stroke

Answer 6

ischemic: thrombolytic and embolic
thrombolytic: a clot or thrombus blocks an artery in the brain, thrombi can formed in arteries (atherosclerosis)
embolic occurs comes from the heart or a diff body part and goes to the brain.
afib inc. risk

hemorrhagic: due to brain leaks or ruptures, bleedings. high BP put pressure on brain cells and cause leaks

Question 7

older adults skin

Answer 7

dec. dermal flow
degeneration of elastic fibers
devpt of actinic lentigo (dark spots)
loss of subcutaneous fat
thinning of subcatenous layer
dry itchy skin

Question 8

decrease platelets causes

Answer 8

bruising, common in neutropenia

and fatigue is common w/ low RBC in anemia
both symptoms are common in a leukemia pt receiving chemo

Question 9

burn measurement for face, arm, legs

Answer 9

face: 4.5%
each arm is 9%
each leg is 18%

Question 10

when rn put straight Cath, client drain nonstop and is at 800ml of urine, what to do?

Answer 10

stop the drainage b/c it can cause harm (ex: bladder spasm, etc..)

Question 11

contralateral stimulation

Answer 11

right side hurt, so I rub left side
might also do scratching, applying heat/cold

Question 12

client w/ cystic fibrosis has a 101.2F temp, what to do

Answer 12

real each question fully and think what is that question asking?
I answered pancrealipase, thing is that is administered within 30mn before meals or snacks. but in that case the client isn’t about to eat, and he has a fever, which indicates an infection.
CF clients are susceptible to infections, so azithromycin (antibiotic) will help

they’re also at high risk for diabetes due to this, having to take pancrealipase and all. diabetes is a routine check in CF

Question 13

when someone just fell, what do the 1st

Answer 13

stabilize the cervical spine, try to make sure that the client does not move.
after this then you can check for lacerations

Question 14

isometric exercise involve

Answer 14

applying pressure against a stable object like pressing hands together or pushing an extremity against a wall

Question 15

acupressure

Answer 15

using pins and needle to provide pressure

helps w/ pain, nausea, anxiety, stress, sleep
PANSS

Question 16

what might cause urinary incontinence? vs urinary retention?

Answer 16

bed rest (immobility), dementia, difficulty walking, cholinergics

urinary retention: enlarged prostate, vaginal prolapse, anticholinergics, antihistamine

Question 17

anticholinergic side effects, ex 2 meds

Answer 17

they are dry: dry eyes, no tears, blurred vision, dilated pupils, decrease sweating. they relax the ciliary muscle

urinary retention
constipation
tachycardia

atropine, benztropine, ipratropium bromide, oxybutynin

ipratropium bromide: long term asthma management

Question 18

types of pain
visceral
neuropathic
phantom
radiating
cutaneous or superficial somatic
nocireceptors

no need to know all by head, explaining 3 is fine

Answer 18

visceral: internal pain, internal organs, hard to identify

phantom: the leg is no longer there but you still feel the pain
neuropathic: neuroreceptors
radiating: you feel the pain elsewhere

cutaneous or superficial somatic: skin or underlying tissues, easily recognized. sharp, localized.

nocireceptors: most common pain. due to exposure to toxins, chemical or mechanical stimuli

somatic: pain originating from skin, muscles, bones, connective tissue

Question 19

what to do if a pt only wants to shower once a week

Answer 19

try to understand and accept their decision. don’t force dignity.

Question 20

what helps prevent contractures

Answer 20

splinting (temporarily immbolize a joint to help it heal or to prevent displacement, contractures, etc..). splint most injuries, post op, fractures, soft tissue injuries

range of motion exercises

it occurs when muscles are stiff, so moving muscles helps prevent contractures

Question 21

crutches: basic tripod (crutch) stance that’s taught to the client is to place the crutches — cm or — inches in front of and — cm or — inch to the side of each foot.
remember this, but 1 inch = 2.54 cm

Answer 21

1 inch = 2.54cm
6 inches x 2.54 = 15cm

Question 22

pain relief w/ hemmorhoids during pregnancy

Answer 22

cold compresses: may help reduce inflammation
left side lying position
inc. fiber and water intake

what won’t help is mineral oils: they may interfere w/ fat absorption

Question 23

clear liquid diet

Answer 23

transparent, light. is clear when melted

no pulp, no dairy
ex: it’s clear that Grandma Has Candy
grandma; gelatin
has candy: hard candy (its clear when melted
coffee without milk is clear
apple juice (since its clear, unlike orange/tomato/prune juice which are full liquids

more: salt and sugar added are permitted.

Question 24

full liquid

Answer 24

milk is full of nutrients
full: milk, diary, pulp, tomato juicee, sherbert, milkship, frozen yogurt, pudding

Question 25

what happen to a patient’s calcium when they’re bedridden

Answer 25

it can cause calcium bone loss, but in some ind. hypercalcemia may occur w/ prolonged immobility (in critically ill patients)

Question 26

lumbar spine

Answer 26

easiest place to get back injury

Question 27

compartment syndrome

s/s

do they have pulse in extremity?

Answer 27

pallor, numbness, tingling(immediate follow up), COOL (compartment is COOL) extremities, Dec. sensation (parathesia), motor weakness, diminished pulses
interventions:
contraindications: heat, warm compresses (may burn client)

pulse is weakened or lost

interventions depend if its acute or chonic: fasciotomy (surgical procedure), nsaids, stabilizing/resting the affected muscle.

Question 28

diabetic ketoacisodis main s/s and interventions

Answer 28

s/s: fruity breath, lethargic.

dka is a life threatening condition causing severe dehydration, severe insulin resistance, fluid loss.
give saline .9% immediately first (fluid ressusitation, then give insulin to reduce the blood glucose

-no need to give sodium polystyrene (even if k+ is high, b/c insulin will reduce that k+ so it will go back in place. if sodium polystyrene is given + insulin, that would deplete sodium too much

check ABG levels (remember diabetic ketoacidosis): acidity, so check abg to see if that clears up

dextrose 5% saline is contraindicated b/c dextrose will inc. blood sugar, and its already past 250.

strict urine intake and output to monitor how well fluid ressussitation is working.
urinalysis is not a priority intervention in dka, yes u can check for infection but its not priority here. remember the client has already been diagnosed w/ dka

Question 29

at what angle should pt sits when self administering peritoneal dialysis

Answer 29

client should sit at a 20 degree angle when self administering peritoneal dialysis
if the outflow is less than the input volume, change position.

Question 30

dvt

Answer 30

erythema, warthm. can be palpable, swelling

diff w/ compartment is compartment is cool,
dvt is warmth (venous thromboembolism in leg)
confirm diagnosis with doppler ultrasound.

Question 31

cellulitis

Answer 31

caused by bacterial infection

can be treated with ice packs to reduce pain and swelling.
and also elevate affected extremity

Question 32

rhabdoMyolsis
what type of pain?
interventions?

Answer 32

muscle pain, not joint pain
myoglobin is released into the blood.

interventions: IV fluids (fluid ressusitation immediately to prevent organ failure)

-measure creatnine to assess for muscle damage
-obtaining ecg to assess for hyperkalemia

adverse reaction: disseminated intravascular coagulant: bleeding around IV site

Question 33

inc. reticulocyte
causes swelling, fever. med: hydroxychloroquine to reduce swelling
which disease

Answer 33

systematic lupus

sickle cell disease also causes inc. reculocyte counts.

Question 34

osteomyelitis s/s, labs?
name 5 s/s
which labs are elevated?

Answer 34

osteomyelitis infection of the bone. s/s: bone pain, fever, tachycardia, leukocytosis

leukocytosis (high wbc) is seen in infections.

Question 35

sickle cell s/s
labs?

Answer 35

inc. leukocyte counts, bone pain, leukocytosis, tachycardia

leukocytosis occurs either w/ infection or w/ inflammation. if cells are inflamed (like in sickle cells, that will cause leukocytosis)
inc. reticulocyte counts: bone marrow is replacing damage or dead RBC.

Question 36

miosis pupils is the same as —- ——- and is a normal/abnormal finding

Answer 36

miosis pupils is same as pupillary constriction and is a normal finding

Question 37

positioning after cardiac cath

Answer 37

supine or hob below 30 degrees. Fowler or low fowler is contraindicated b/c it may disrupt clot formation and cause hemorrhage

Question 38

position for dehiscence or evisceration

Answer 38

low fowlers with knees bent

evisceration: cover skin w/ sterile gauze
emergency surgery