Musculoskeletal Flashcards
Osteomylitis
Possibly a result of latent viral infection
Osteomalacia
Older adults, vitamin D deficiency, insufficient exposure to sunlight
Osteomalacia
Unsteady gait, bone tenderness over rib cage, long bone bowing
Paget’s disease
Hip flexion contractures, long bone Boeing, soft skull
Which factors may be associated with osteomalacia?
Vitamin D deficiency, muscle weakness in the pelvic girdle area, muscle weakness in life
Which factors may be associated with Pagets disease?
Apathy or lethargic, urinary or renal stones
The patient is prescribed calcitonin for treatment of pagets disease. What does the nurse advised patient to do?
Alternate nares to prevent nasal mucosal irritation
Patient reports pain in the lower legs and pelvis which is aggravated by activity and worse at night. The nurse observes muscle weakness which appears to be causing a waddling and unsteady gait. What additional information supports the likelihood of osteomalacia in this patient?
Recent immigration from a country where famine is common
An x-ray shows the presence of radiolucent bands and a patient. What is this diagnostic finding specific for?
Osteomalacia
The nurse is assessing a patient reports moderate bone pain in the hip and has a family history of Pagets disease. And performing a musculoskeletal assessment, the nurse pays particular attention to which element?
Size and shape of the skull
A patient with Paget’s disease comes to the clinic for evaluation. Which symptom reported by the patient alerts the nurse to the possibility of osteogenic sarcoma?
Severe bone pain
A patient with Paget’s disease has complications related to bony enlargement of the skull. Which complication is potentially the most serious and life-threatening?
Platybasia, or basilar invagination with brainstem manifestation
The patient with Paget’s disease has a kidney problem associated with an increase or I’m calcium. What is the nursing priority for this patient?
Encourage the patient to increase fluids, unless contraindicated
The patient is having diagnostic testing to determine the probability of Piaget’s disease. If The disease is present which lab result of the nurse expect to see?
Increased serum alkaline phosphate
A patient with Paget’s disease has been prescribed drug therapy. The nurse prepares patient teaching information for which medication as a first-line therapy?
Risedronate (actonel)
The patient was admitted for acute osteomyelitis of the left lower leg. What does the nurse expect to find documented in the patient’s admitting assessment?
Temperature greater than 101, swelling, tenderness, erythremia, and warmth of area
The nurses caring for patient with osteomyelitis. Which lab results are primary concern for this disorder?
White blood cell count and erythrocyte sedimentation rate
Which patient is most likely to be a candidate for hyperbaric oxygen therapy?
Patient with chronic, on remitting osteomyelitis
The patient comes in the emergency department after accidentally puncturing his hand with an automatic nail gun. Which disorder is this patient primarily at risk for?
Osteomyelitis
The nurses caring for a patient with acute osteomyelitis. What assessment findings typically accompany this medical diagnosis?
Fever usually above 101, erythemia on the affected area, swelling around the affected area
The nurses teaching a patient about anabiotic therapy for osteomyelitis. What information does the nurse give to the patient?
Infected one maybe irrigated with one or more types of antibiotic solution
The patient was a long distance runner reports severe pain in the arch of the foot, especially when getting out of bed and with weight-bearing. What does the nurse suspect in this patient?
Plantar fasciitis
The patient is diagnosed with planter fasciitis. What instruction does the nurse gives to the patient about self-care for this condition?
Strap the foot to maintain the arch
Which clinical findings does the nurse assessed in the affected area of a patient with them osteomyelitis?
Erythema, tenderness, swelling, constant bone pain
The nurses caring for a patient with muscular dystrophy. Although all body systems can be affected, the nurse is alert and carefully assesses for which major problem?
Respiratory failure
The nurses caring for several patients on orthopedic trauma unit. Which conditions have a high-risk for development of acute compartment syndrome?
- Lower legs caught between the bumpers of two cars
- Massive infiltration of IV fluid into forearm
- Multiple insect bites to lower legs
- Severe burns to the upper extremities
The patient has a fracture of the right wrist. What is an early sign that indicates this patient may be having a complication?
Patient reports a subjective numbness and tingling
The nurse is assessing a patient for severe pain in the right wrist after falling off the stepstool. How does the nurse assesses patients motor function?
Asking the patient to move the fingers
The patient and traction reports severe pain from a muscle spasm. What is the nurses priority action?
Assess the patient’s body alignment
The nurse is reviewing the orders for a patient was admitted for 24 hour observation of a like fracture. A cast is in place. Which order does the nurse question?
Perform neuro, circulation checks every eight hours
The patient with a leg cast denies pain, Tozer pink, capillary refill is brisk and toes move freely, the leg is elevated with an ice pack. Six hours later the patient reports worsening pain unrelieved by medication. The patient’s toes are cool and capillary refill sluggish. What does the nurse suspect is occurring with this patient
Acute compartmental syndrome
An older adults sustained injury to the lower legs after being trapped underneath the following bookcase. Because this patient is at high risk for crush syndrome, which lab values will the nurse specifically monitor?
Serum potassium level and myoglobin in urine
And older adults has been admitted with a hip fracture. Approximately 20 hours post injury, the patient developed a symptom recognizes an early sign of fat embolism syndrome. Which symptom is the patient displaying?
Change in mental status
Indicate the numeric sequence of bone healing
- Hematoma formation
- Hematoma to granulation tissue
- Osteoblastic proliferation
- Callous formation
- Bone remodeling
Student nurse is assessing a patient with a probable fractured tibia fibula. What assessment technique used by the nurse causes the supervising nurse to intervene?
Pushes on the leg to elicit pain response
The nurses caring for several orthopedic patients were in different types of traction. What should the nurse do in assessing the traction equipment?
- Inspect ropes and knots for fraying are loosening every 8 to 12 hours
- Checking amount of weight being used against the prescribed way
- Observe the traction equipment for proper functioning
The patient was put into traction at 0800 hrs.
Hourly neurological, and circulation checks were ordered for the first 24 hours and then every four hours thereafter. I what time can the nursing staff start performing the every four checks?
O800 hours next day
The nurses educating the patient will have external fixation for treatment of a compound tibial fracture. What information does the nurse including the teaching session?
The device allows for early ambulation
The nurses helping to evaluate several patients to determine candidacy for that Illzaroz external fixation device. Which patient has the best candidate?
Child with a congenital bone deformity whose mother is a licensed practical nurse
An older adult patient has a fractured humorous. The physician is considering the use of electrical bone stimulation Mathson nurse to take a medical history on the patient. With specific condition, which is contraindication for this therapy, does the nurse asked the patient about?
Cardiac pacemaker
The patient is prescribed low intensity post ultrasound treatments for a very slow healing fracture of the right lower leg. What instructions as the nurse give this patient related to the treatment?
Expected dedicate approximately 20 minutes a day for one treatment
The nursing student is assisting with the care of a patient with musculoskeletal pain related to soft tissue injury and bone disruption. Student nurse sees the patient has a PRN order for pain medication. What does the student do first in order to decide when to give the pain medication?
Ask the patient about types of activities that increase the pain
The patient is receiving scheduled and PRN narcotics for severe pain related to musculoskeletal injury. The nurse finds of the patient’s abdomen is distended bowel sounds are hypoactive. Because the nurse suspected that patient is having a medication side effect, which question does the nurse asked the patient?
When was your last bowel movement
The patient comes into the ED after falling off his four wheeler. His lower leg is obviously broken, it is bleeding and bone fragments are protruding from the skin. Whatever fracture this is patient likely have?
An open or compound fracture
The patient comes to the emergency department after slipping out some chalk and her classroom. She did not fall far and was able to walk with assistance of one of her students. Whatever fracture this is patient likely have?
Incomplete
The female patient with osteoporosis come so that you do you after filing suddenly while putting her car door. She said it felt as if her leg gave way. What type of fracture does this patient likely have
Pathologic (spontaneous)
What technique is used to treat nonunion or malunion fractures
Illizarov
True or false
An externalelectrical bone stimulator system is directed at non-healed fracture site
True
True or false
Low intensity Pulse ultrasound is used for slow healing fractures
True
The nurses caring for a patient with an open fracture. What intervention does the nurse perform in the order to prevent infection of the fracture?
Use strict aseptic technique for dressing changes in on the irrigation
The nurse must adjust Crutches to properly fit a patient. Which description illustrates cracked crutch adjustment?
Elbows flexed no more than 30° on the palm is on the hand
An older patients family is trying to find an appropriate cane for the patient to use because of chronic pain in the right ankle. The nurse instruct the family to purchase which type of cane?
One with the top being parallel to the greater trochanter of the femur
What members of the healthcare team will be consulted to teach the patient about proper use of the cane?
Physical therapist and registered nurse
The nurses caring for a patient with an external fixation of a bone fracture. What are the advantages of this type of treatment?
- It is less painful than other treatments
- It allows for earlier ambulation
- It maintains bone alignment
- It’s stabilizes commuted fractures require bone grafting
An older patient with a lower leg fractures having difficulty performing the weight-bearing exercises. Based on the fracture pathophysiology and the patients abilities, which condition could the patient develop?
Pulmonary embolism
The nurse case managers making a home visit to assist in elderly patient with a hip fracture. During the home visit, the nurse reviews home environment safety. Which observations indicate the need for additional teaching?
Floors are clean and shiny and covered with throw rugs
Which is a potentially fatal complication of acute compartment syndrome?
Myoglobinuric renal failure
The patient comes to the ED with crush syndrome from a crush injury to his right upper extremity and a right lower extremity and heavy equipment follow him at the construction site. The patient has signs and symptoms of hypovolemia, hyperkalemia, and compartment syndrome. Masking of care for this patient will focus on preventing which complications?
Cardiac dysrhythmias and acute tubular necrosis
Chronic complication of bone healing is called a vascular necrosis. Which statement about this complication is true?
It involves disrupting the blood supply to the bone
It results in the death of bone tissue
It is most often a complication of hip fractures
A 30-year-old patient was hospitalized for a pair of a fractured tibia and fibula reports shortness of breath. Which complication related to the injury might the patient be experiencing?
Fat embolism
Avascular necrosis
Disruptive blood supply to the bone, resulting in the death of bone tissue
Fat embolism
Fat globules released from the yellow bone marrow into the bloodstream
Malunion
Incorrect fracture healing
Nonunion
Lack of fracture healing
The patient tripped and fell down several stairs reports having heard a popping sound and fears that she’s broken her ankle. How does the nurse initially assessed for fracture in this patient?
Observing for deformity or misalignment
The nurse is assessing the patient and injury to his shoulder and upper arm after being John from Mars. What is the best position for this patient assessment?
Sitting to observe for shoulder droop
The nurses caring for patient with skeletal pins that have been placed for traction. What does the nurse expect to see in the first 48 hours?
Clear fluid drainage weeping from the pin insertion site
What potential adverse effects prevents Demerol from being used in all the results?
Seizures
The unlicensed assistive personnel is assisting the orthopedic physician to cut a window and a patient’s. Once the nurse instruct the UAP to do?
Save the plaster piece that was can be taped in place
The nurses caring for patients and bucks traction. Which task is best to delegate to the UAP?
Turning and repositioning
The nurses instructing in teenage patient with the tibia fibula fracture was treated with internal fixation along like cats. He’s anxious and I want to Castlemere move so that he can resume football practice. Which statement by the patient indicates the need for additional teaching?
I’ll use crutches for two weeks and then the castle be removed
The patient was an unrestrained driver involved in a motor vehicle accident who is sustained the fifth rib fracture. At the patient is being assessed what is the nurses major concern?
Muffled heart sounds
According to the patient’s chart there is a family history of osteoporosis. In order to plan interventions related to this finding, what action does the nurse take?
Review the patient’s dietary intake of calcium
The patient is a middle-aged man with a history of uncontrolled diabetes. His right foot is a dark brownish purple color and there’s no palpable dorsal pedis or posterior to tibial pulse. The nurse prepares the patient for which diagnostic test?
Doppler ultrasound
Pain patient experiences from a bone fracture results from which processes?
Edema, muscle spasms
The patient injured a lower extremity and has been placed in a running traction. What instructions says the nurse gives to the UAP?
Moving the patient out of bed during care can alter the counter traction
The nurse supplies bandages do a patient’s residual limb in order to help shape and strength for a prosthesis. What is the proper technique for the nurse to use
Use a figure 8 wrapping method prevent restriction of blood flow
Skin traction
Involves the use of a fabric fastener boot, belt, or halter which is secured around the body part
Plaster traction
Combined skeletal traction and a plaster cast
Skeletal traction
Pins, wires, tongs, or through surgically inserted directly into bone
An older patient is discharged to home phone and orthopedic injury. Which mobilization device is usually preferred for older patients?
Walker
The nurses interviewing in older adult with a history of osteoporosis reports falling and catching her way on her outstretched dominant hand. This patient is most likely to have sustained what type of fracture?
Colles wrist fracture
