Musculoskeletal

Question 1

What is Osteoarthritis (OA)?

Answer 1

Noninflammatory form of Arthritis. AKA Degenerative joint Disease

Question 2

What are the risk factors of Osteoarthritis?

Answer 2

Age, Female, obesity, occupation, sports, previous injury, and genetics.

Question 3

What assessment findings will the nurse expect to fine in a patient with Osteoarthritis?

Answer 3

Chronic joint pain, stiffness/decreased ROM, crepitus, Heberden’s and Bouchard’s nodes, joint effusion.

Question 4

What type of analgesics are used to treat OA?

Answer 4

Acetaminophen, and topical drugs- lidocaine 5% patches, salicylates-OTC aspercreme or buspirone.

Question 5

What are the patient risks/effects of each type of analgesic?

Answer 5

Acetaminophen- if taking more than 4000mg daily you are at an increased risk of liver damage.
NSAIDs- can cause severe GI side effects, bleeding, ad acute kidney failure.

Question 6

What pt. population should not take COX-2 inhibitor Celecoxib?

Answer 6

Hypertension, kidney disease, and cardiovascular disease.

Question 7

Bending the joint- decreases the angle between the bones.

Answer 7

Flexion

Question 8

Straightening the limb

Answer 8

extension

Question 9

Movement away from midline

Answer 9

Abduction

Question 10

Movement towards the midline

Answer 10

Adduction

Question 11

Movement around a longitudinal axis

Answer 11

Rotation

Question 12

Movement in a circular motion

Answer 12

Circumduction

Question 13

Turning the palm of the hand upwards

Answer 13

Supination

Question 14

Turning the palm of the hand downwards

Answer 14

Pronation

Question 15

Turning the sole of the foot inwards

Answer 15

Inversion

Question 16

Turning the sole of the foot outwards

Answer 16

Exersion

Question 17

Shrugging your shoulder up towards ear

Answer 17

Elevation

Question 18

Shrugging your shoulder downwards

Answer 18

Depression

Question 19

Name the essential components of a neurovascular check/assessment.

Answer 19

Color (pallor), temperature (polar), movement (paralysis), sensation (paresthesia), palpation of pulses (pulselessness-weak or absent), and pain (pain present)

6 P’s ( ) indicate neurovascular compromise.

Question 20

Normal levels of serum calcium

Answer 20

9.0-10.5

Question 21

What does serum calcium levels indicate

Answer 21

Indicator of bone density

Question 22

Hyper- calcium levels indicate?

Answer 22

Metastatic cancer, bone fx in healing stage

Question 23

Hypo- calcium levels indicate?

Answer 23

osteoporosis and osteomalacia increased risk of fx,

Question 24

What does parathyroid hormone do?

Answer 24

stimulates calcium retention when levels are low.

Question 25

What does calcitonin do?

Answer 25

Helps reduce serum calcium when levels are high through excretion.

Question 26

What helps with the absorption of calcium and phosphorus in the body?

Answer 26

Vitamin D

Question 27

What can cause elevation in creatine kinase?

Answer 27

muscle trauma, progressive muscular dystrophy

Question 28

Normal range of phosphorus?

Answer 28

3.0-4.5

Question 29

What type of relationship does calcium and phosphorus have?

Answer 29

inverse relationship.

Question 30

Bone specific diagnostic lab. Bone, liver, and gallbladder, increases when bone cells are growing or active.

Answer 30

Alkaline phosphatase

Question 31

What is a DEXA scan?

Answer 31

Dual x-ray absorptiometry- type of scan that measures bone mineral density in the hip, wrist, or vertebral column. Used as a screening tool for diagnosis and follow up of treatment for osteoporosis.

Question 32

What complications are patients at risk for post biopsy?

Answer 32

Bleeding at the puncture site, and for tenderness, redness, or warmth that could indicate infection.

Question 33

What is Lordosis? What population might you expect to find it?

Answer 33

Large inward sway of the lower back. Common in adults with abdominal obesity.

Question 34

What is Scoliosis? Common population?

Answer 34

Lateral curvature of the spine. Common in adolescents.

Question 35

What is Kyphosis? Common population?

Answer 35

Outward curvature of the upper back. Common in older women.

Question 36

What are some common changes in the musculoskeletal system related to aging?

Answer 36

Decreased bone density, increased bone prominence, kyphotic posture: widened gait, shift in the center of gravity, cartilage degeneration (arthritis), decreased ROM, muscle atrophy, decreased strength, slowed movement.

Question 37

What are some of the primary symptoms of Muscular Dystrophies?

Answer 37

Progressive muscle weakness, wasting of skeletal or voluntary muscle groups, and increase serum muscle enzyme levels.

Question 38

What are the primary causes of mortality with Muscular Dystrophies?

Answer 38

Respiratory failure and cardiac failure.

Question 39

What is osteoporosis?

Answer 39

A chronic disease of cellular regulation in which bone loss causes significant decreased density and possible fracture.

Question 40

What is osteopenia?

Answer 40

Low bone mass

Question 41

What are the risk factors for osteoporosis?/

Answer 41

genetics, postmenopausal women, low calcium in diet, carbonated and caffeinated beverages-calcium loss, low vitamin D levels, sedentary lifestyle, alcohol and tobacco use.

Question 42

What are assessment findings common for osteoporosis patients?

Answer 42

fragility factures, dowager's hump (kyphosis), loss of height, pain with lifting, bending, stooping.

Question 43

What are important pt. teaching points regarding pt. safety and prevention of falls/fx in a pt with osteoporosis?

Answer 43

The importance of nutritional therapy, exercise, lifestyle changes, and drug therapy to slow the bone resorption and form new bone tissue.

Question 44

What enhances the absorption of calcium

Answer 44

Vitamin D

Question 45

What are pts at risk of developing when taking a calcium supplement?

Answer 45

Hypercalcemia

Question 46

Who should not take bisphosphonates?

Answer 46

Patients who are sensitive to aspirin

Question 47

What is a serious side effected of bisphosphonates?

Answer 47

Esophagitis, esophageal ulcers, and gastric ulcers.

Question 48

What is osteomalacia?

Answer 48

loss of bone due to vitamin D deficiency

Question 49

What is the treatment of osteomalacia

Answer 49

Vitamin D supplement, sunlight exposure

Question 50

What is Paget's Disease?

Answer 50

Bone is excessively broken down and recycled (osteoclastic) and reformed/built (osteoblastic)

Question 51

What are common assessment findings in Paget's disease?

Answer 51

Hx of fragility fx (femur and humerus) bone pain, bow legged appearance.

Question 52

What are common causes of osteomyelitis?

Answer 52

Urinary tract infections, long term IV catheters, long term hemodialysis and IV drug users, poor dental hygiene and gum infections, salmonelle infections of the GI tract, MRSA, penetrating trauma.

Question 53

How is osteomyelitis treated?

Answer 53

Antibiotics (4-6 weeks), opioid analgesia, and surgical intervention

Question 54

What is "total joint arthroplasty?

Answer 54

surgical procedure when arthric joints are removed and replaced with prosthesis joints.

Question 55

What is the special positioning for a patient following total hip replacement?

Answer 55

Do not adduct from the body, keep in alignment, cushion the heel to prevent sores.

Question 56

What anticoagulants might help reduce risk of thromboembolism?

Answer 56

Heparin and warfarin

Question 57

Antidote of heparin

Answer 57

Protamine sulfate

Question 58

Antidote of warfarin

Answer 58

vitamin k

Question 59

What is the purpose of ta continuous passive motion machine

Answer 59

a device that slowly and gently moves your joint would your in bed.