muscoskeletal Flashcards
dorsiflexion vs plantar flexion
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)
abduction
abduction is the movement of a limb away from the body’s midline
abdominal aortic aneurysm
caused by uncontrolled hypertension and atherosclerosis. but when it is happening, I does drop BP, and causes lots of abdominal pain
bolutism
caused by cdiff, it inhibits the release of acetylcholine causing muscle weakness, paralysis, and other symptoms.
foods high in magnesium
BSS
bananas, fish, spinach, kale, beans
low in magnesium: onions, mushrooms,
types of stroke
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
older adults skin
dec. dermal flow
degeneration of elastic fibers
devpt of actinic lentigo (dark spots)
loss of subcutaneous fat
thinning of subcatenous layer
dry itchy skin
decrease platelets causes
bruising, common in neutropenia
and fatigue is common w/ low RBC in anemia
both symptoms are common in a leukemia pt receiving chemo
burn measurement for face, arm, legs
face: 4.5%
each arm is 9%
each leg is 18%
when rn put straight Cath, client drain nonstop and is at 800ml of urine, what to do?
stop the drainage b/c it can cause harm (ex: bladder spasm, etc..)
contralateral stimulation
right side hurt, so I rub left side
might also do scratching, applying heat/cold
client w/ cystic fibrosis has a 101.2F temp, what to do
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
when someone just fell, what do the 1st
stabilize the cervical spine, try to make sure that the client does not move.
after this then you can check for lacerations
isometric exercise involve
applying pressure against a stable object like pressing hands together or pushing an extremity against a wall
acupressure
using pins and needle to provide pressure
helps w/ pain, nausea, anxiety, stress, sleep
PANSS
what might cause urinary incontinence? vs urinary retention?
bed rest (immobility), dementia, difficulty walking, cholinergics
urinary retention: enlarged prostate, vaginal prolapse, anticholinergics, antihistamine
anticholinergic side effects, ex 2 meds
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
types of pain
visceral
neuropathic
phantom
radiating
cutaneous or superficial somatic
nocireceptors
no need to know all by head, explaining 3 is fine
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
what to do if a pt only wants to shower once a week
try to understand and accept their decision. don’t force dignity.
what helps prevent contractures
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
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
1 inch = 2.54cm
6 inches x 2.54 = 15cm
pain relief w/ hemmorhoids during pregnancy
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
clear liquid diet
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.
full liquid
milk is full of nutrients
full: milk, diary, pulp, tomato juicee, sherbert, milkship, frozen yogurt, pudding
what happen to a patient’s calcium when they’re bedridden
it can cause calcium bone loss, but in some ind. hypercalcemia may occur w/ prolonged immobility (in critically ill patients)
lumbar spine
easiest place to get back injury
compartment syndrome
s/s
do they have pulse in extremity?
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.
diabetic ketoacisodis main s/s and interventions
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
at what angle should pt sits when self administering peritoneal dialysis
client should sit at a 20 degree angle when self administering peritoneal dialysis
if the outflow is less than the input volume, change position.
dvt
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.
cellulitis
caused by bacterial infection
can be treated with ice packs to reduce pain and swelling.
and also elevate affected extremity
rhabdoMyolsis
what type of pain?
interventions?
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
inc. reticulocyte
causes swelling, fever. med: hydroxychloroquine to reduce swelling
which disease
systematic lupus
sickle cell disease also causes inc. reculocyte counts.
osteomyelitis s/s, labs?
name 5 s/s
which labs are elevated?
osteomyelitis infection of the bone. s/s: bone pain, fever, tachycardia, leukocytosis
leukocytosis (high wbc) is seen in infections.
sickle cell s/s
labs?
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.
miosis pupils is the same as —- ——- and is a normal/abnormal finding
miosis pupils is same as pupillary constriction and is a normal finding
positioning after cardiac cath
supine or hob below 30 degrees. Fowler or low fowler is contraindicated b/c it may disrupt clot formation and cause hemorrhage
position for dehiscence or evisceration
low fowlers with knees bent
evisceration: cover skin w/ sterile gauze
emergency surgery
