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Amy's Nursing 55 > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

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1
Q

Define CMS.

A

Circulation, motion, sensation; neurovascular check

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2
Q

Which physiologic changes normally occur with age?

A

Muscle atrophy, decreased bone density, muscle weakness, decreased synovial fluid, decreased tissue over bony prominences, slower nerve reaction time

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3
Q

Define osteoporosis.

A

Chronic metabolic disease characterized by decreased bone density.

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4
Q

Where does hematopoeisis take place?

A

In the red marrow

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5
Q

Which part of the bone stores fat cells?

A

Yellow marrow

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6
Q

What is one major life-threatening complication caused by a break in a bone?

A

Fat embolism syndrome (FES); can occur when the yellow marrow is exposed

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7
Q

Define osteoclasts.

A

Bone-destroying cells

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8
Q

Define osteoblasts.

A

Bone-forming cells

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9
Q

Define kyphosis.

A

Curvature of the thoracic (upper) vertebrae

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10
Q

Define lordosis.

A

Curvature of the lumbar (lower) vertebrae

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11
Q

Define scoliosis.

A

A lateral (S-shaped) curve of the vertebrae

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12
Q

By what age is peak bone mass usually achieved?

A

30

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13
Q

Where is the most common site for musculoskeletal injury?

A

Joints with synovial fluid

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14
Q

In Gordon’s Functional Health Patterns, what does a level 0 represent?

A

Patient is able to provide full self-care

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15
Q

In Gordon’s Functional Health Patterns, what does a level 4 represent?

A

Patient is dependent and does not participate in self-care

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16
Q

In Lovett’s muscle scale, what does a level 0 represent?

A

No joint motion with no evidence of muscle contractility

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17
Q

In Lovett’s muscle scale, what does a level 5 represent?

A

ROM is unimpaired against gravity with full resistance

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18
Q

For a patient with osteoporosis, which lab value abnormalities would you expect to see?

A

Decreased calcium

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19
Q

For a patient with osteomalacia, which lab value abnormalities would you expect to see?

A

Decreased calcium, decreased vitamin D, decreased phosphorus, elevated alkaline phosphatase (ALP)

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20
Q

For a patient with paget’s disease, which lab value abnormalities would you expect to see?

A

Elevated alkaline phosphatase (ALP)

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21
Q

For a patient with muscular dystrophy, which lab value abnormalities would you expect to see?

A

Elevated creatine kinase (CK), elevated aspartate aminotransferase (AST), elevated lactic dehydrogenase (LDH), elevated aldolase (ALD)

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22
Q

For a patient with bone cancer, which lab value abnormalities would you expect to see?

A

Elevated calcium, elevated alkaline phosphatase (ALP)

23
Q

For a patient with bone fractures in the healing stage, which lab value abnormalities would you expect to see?

A

Elevated calcium, elevated phosphorus

24
Q

For a patient with muscle trauma, which lab value abnormalities would you expect to see?

A

Elevated creatine kinase (CK), elevated aspartate aminotransferase (AST)

25
Q

Why would a CT or MRI with contrast be contraindicated?

A

If the patient has an allergy to shellfish or iodine

26
Q

Why would an MRI be contraindicated?

A

If the patient has any irremovable metal in the body(eg. pacemaker, metal hip implant)

27
Q

Define osteoporosis.

A

Loss of bone density

28
Q

Define osteomalacia.

A

Demineralized bone

29
Q

Which blood markers may indicate osteoporosis?

A

N-teleopeptide (NTX) and C-teleopeptide (CTX)

30
Q

What is the single most effective exercise for osteoporosis prevention?

A

Walking for 30 minutes 3-5 times per week

31
Q

What types of foods containing calcium and vitamin D can you recommend to a person who is lactose intolerant?

A

Soy and fortified rice products

32
Q

What type of supplement is oscal?

A

Calcium supplement

33
Q

What type of patient teaching is essential for a patient taking oscal?

A

Drink lots of water (to prevent kidney damage)

34
Q

Why would a patient be prescribed a bisphosphonate such as Fosamax, Boniva or Actonel?

A

For prevention and treatment of osteoporosis

35
Q

What type of patient teaching is necessary for a patient taking a bisphosphonate?

A

Drink lots of water (to prevent kidney damage), take early in morning, sit up for 30-60 minutes after taking (to prevent esophageal irritation)

36
Q

What serious complications are related to Aredia and Reclast?

A

Osteonecrosis (jaw bone death)

37
Q

What contraindication is applied to selective estrogen receptor modulators (SERMs)?

A

Hx of thromboembolism

38
Q

What is Forteo and what is it indicated for?

A

Bone-building agent for treatment of osteoporosis of post-menopausal women with high risk of fracture

39
Q

What is calcitonin?

A

A thyroid hormone that inhibits osteoclastic activity

40
Q

What foods type of foods are good sources of vitamin D?

A

Eggs, chicken, liver, dairy

41
Q

What is ergocalciferol?

A

Vitamin D supplement

42
Q

Define exogenous osteomyelitis.

A

Infection of the bone from an outside source (eg. from stab wound)

43
Q

Define endogenous osteomyelitis.

A

Infection of the bone from an inside source (eg. from uti)

44
Q

Define contiguous osteomyelitis.

A

Infection of the bone from an adjacent tissue

45
Q

Which lab value abnormalities would you expect to see in a patient with osteomyelitis?

A

Elevated ESR, elevated WBC, elevated CRP

46
Q

In which populations might you see a muted reaction to osteomyelitis?

A

Immune compromised (HIV, RA), elderly

47
Q

How is osteomyelitis treated?

A

With antibiotics or hyperbaric oxygen (for special cases only)

48
Q

Which symptoms would you expect to see in a patient with osteosarcoma?

A

Leukocytosis, fever, anemia

49
Q

Which serious complication can be seen in crush syndrome?

A

Kidney failure; rhabdomyolosis (release of myoglobin from muscles to circulation) can occlude distal renal tubules and cause kidney failure

50
Q

Which symptoms are seen in a patient with fat embolism syndrome (FES)?

A

Altered mental status (earliest symptom), followed by respiratory distress and petechiae on the upper body (late symptom)

51
Q

Which lab value abnormalities would you expect to see in a patient with rheumatoid arthritis?

A

Positive ANA, positive rheumatoid factor

52
Q

What is the earliest sign of infection in elderly patients?

A

Change in mentation

53
Q

What effect does immunesuppressive agents (eg. methotrexate) have on the body?

A

They suppress bone marrow to reduce the immune response

54
Q

What effect do corticosteroids (eg. prednisone) have on the body?

A

They decrease inflammatory and immune responses by decreasing the WBC count

Amy's Nursing 55 (9 decks)

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