Musculoskeletal Flashcards
The treatment for sprains known as RICE stands for what?
Rest, Ice, Compression and Elevation
What exactly is a sprain?
Torn ligaments that hold the bone together to form a joint
What symptoms would be expected in a 1st degree sprain?
minimal swelling and loss of function, but no abnormal movement
What characterizes a 3rd degree sprain?
3rd degree = complete tearing of tissue fibers and loss of function
What symptoms would be present in a 2nd degree sprain?
Severe pain, especially with weight bearing, swelling and bleeding – with some loss of function
What is the definition of a strain?
A strain is a pulling or tearing of either muscle, tendon or both
A joint “dislocation” means what?
Stretching and tearing of ligaments around a joint with complete displacement of the bone.
What is a joint subluxation?
A partial or incomplete displacement of the joint surface
Carpal Tunnel syndrome occurs when?
When the median nerve in the wrist is compressed by and inflamed, edematous flexor tendon sheath
What is a Phalen’s sign?
Phalen’s sign is said to be positive if there is numbness with wrist flexion.
What is a positive Tinel’s sign?
Tapping over the median nerve the causes tingling and electric shock sensation.
In a patient with Carpal Tunnel syndrome: what would the MRI show?
Compression and flattening of the median nerve
What is a McMurray’s test?
Turning the foot side-to-side while bending the knee back and forth
What is the most common injury to the knee?
An ACL injury
What in the “common cause” of ACL injury?
twisting motion
What test indicates ACL injury?
Lachman’s test
What is crepitation?
A crackling or rattling sound made by the fractured ends of bone
What is the difference in an open reduction and a closed reduction?
Open = surgical incision. Closed = manipulation
How much calcium should an adult who is less than 50 years old consume daily?
1000 mg/day
How much calcium should an adult who is over 50 years old consume daily?
1200 mg/day
Calcium is rich in what foods?
- Dairy
- Green Leafy Veggies
- Sardines
- Canned Salmon
- Broccoli
- Fortified OJ
A nurse with a lateral curvature of their spine has what medical condition?
Scoliosis
Humpback is technically referred to as?
Kyphosis
What effect does Vitamin D have?
It promotes calcium and phosphate absorption, increased serum calcium and phosphorus levels
What is Fosamax given for?
Osteoporosis
After age 50, which gender is more affected by Osteoarthritis?
Women
What factor puts women at higher risk for Osteoarthritis?
Estrogen reduction at menopause
OA results from damage to what?
Cartilage
What is the big difference beween RA and OA?
RA is an auto-immune inflammatory disease; OA is not an auto-immune inflammatory disease–it is a degenerative disease.
Are there systemic manifestations in OA or RA?
RA only; OA has no systemic manifestations
In the early stages of OA, what helps the pain?
Rest
What two nodes are frequently deformed in patients with OA?
Heberden’s and Bouchard’s nodes
What is a test frequently performed in the diagnosis of OA?
Synovial Fluid Analysis: in patients with OA, the fluid will be clear yellow with no inflammation
What is the primary intervention for patients with OA?
Non-pharmacological; drugs serve only as an adjunct
Other than gender, what is a significant risk factor for OA?
Obesity
What is the maximum dose of Tylenol to take in a 6-hour period?
1000 mg
How much Tylenol can be taken in a 24-hour period?
4 grams (4000 mg)
What is the characteristic trademark of Gout?
Hyperuricemia; excessive uric acid production or decreased uric acid excretion by the kidneys
Uric acid is an end waste product of what?
Purine metabolism (breakdown)
What is the most important nursing intervention for a patient with Gout?
Avoid pressure on the affected area
What diet is recommended for patients with gout?
Low-purine: eggs, fruit, cheese, nuts, sugar, gello and veggies
What food items should be recognized as “high-purine”?
Meat, shellfish, spinach, legumes and sweet breads
What are the two types of skeletal muscle relaxants?
Centrally and peripherally acting
Flexeril is contraindicated for patients with what conditions?
MAOI’s and cardiac disorders
Flexeril should be used cautiously in patient with what?
Urinary retention, glaucoma, and increased intraoccular pressure
What is the MOA of Allopurinol?
Allopurinol inhibits the conversion of purine to uric acid
The nurse should tell the patient on Allopurinol to immediately report signs of what?
Rash
A patient taking Colchine should avoid what?
Grapefruit
Colchicine is contraindicated for who?
Patients with renal, hepatic, cardiac or severe GI disorders
What is the effect of Calcitonin?
Increases osetoblasts and slows bone loss
What are S/E of Calcitonin?
Rhinitis, Sinusitis, Epistaxis and flushing of the face
What is the MOA of Fosamax and Boniva?
inhibits osteclasts
Fosamax and Boniva must be given 30-60 minutes before eating to avoid what?
Esophageal erosion
What drug class is Evista?
Selective Estrogen Receptor Modulator
What are severe side effects of Evista?
DVT and stroke in women with CAD
What must a patient on Lortab be monitored for?
Respiratory depression
What signs or symptoms seen in a post-operative total hip replacement patient require calling the doctor ASAP?
Shortening or rotation of the surgical leg (indicates subluxation or dislocation)
What is the primary nursing priority post-op for a patient who had a total hip replacement?
Prevent hip dislocation
What steps does the nurse caring for a post-op THR need to take to prevent dislocation?
Prevent hip adduction and hyperflexion
What will post-arthroplasty patient need before procedures for the rest of their life?
Prophylactic antibiotics
What exercises should a patient, post-op TKR, do to maintain ROM and muscle tone?
Isometric quadriceps flexing and straight leg raises
What is plantar fasciitis?
inflamed tendon in the bottom of the foot that causes pain in the anterior medial aspect of the heel–that generally diminishes with stretching of the foot and the Achilles tendon
What is hallux vulgus?
deformity of the big toe; bony enlargement of the first metatarsal head
What is hallux rigidus?
Painful stiffness of the first MTP joint caused by osteoarthritis
“Hammer toe” is characterized by what?
flexion deformity and callus formation on the 2nd through 5th toes
What is osteomalacia?
softening of the bone
What are the appropriate nursing interventions for a acute sprain?
RICE = rest, ice, compression and elevation
What is appropriate nursing management of an acute dislocation or subluxation?
Nursing efforts should be pain relief with support and protection of the affected joint. The nurse MUST resist the impulse to immediately reduce a dislocation without evaluation by a clinician.
What would be an indication of a dislocation?
Deformity, local pain and loss of function
What are possible complications of a dislocation?
Avascular necrosis and compartment syndrome
What is fat embolism?
It is when fat globules (that serve as emboli) enter the bloodstream after a traumatic skeletal injury
What presentation would a patient experiencing fat embolism syndrome have?
Chest pain, tachypnea, dyspnea, apprehension: all of the symptoms of impaired oxygenation. Sudden onset petechiae is a important sign to notice as well.
What are expected manifestations of carpal tunnel syndrome?
Weakness of the thumb, burning pain, impaired sensation and clumsiness performing fine hand movements
What is the treatment for carpal tunnel?
Rest and immobilization (possible splinting of the wrist) and corticosteroid injection
What is a transverse fracture?
Break straight across
What is spiral fracture?
A break in a spiral; an “S” shape
What is a greenstick fracture?
An incomplete fracture with one side splintered and the other bent
What is a comminuted fracture?
A fracture with two or more fragments
What is an oblique fracture?
The break is at an angle
What is a pathologic fracture?
A spontaneous fracture at the site of bone damage
What is a stress fracture?
Fracture that occurs in a bone subject to repeated stress (like running)
