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Nursing II > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

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1
Q

Developmental Dysplasia of Hip treatments

A

surgery, Pavlik harness, Bryants traction, Spica cast

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2
Q

Children with DDH have to wear pavlik harness for how long?

A

3-6months

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3
Q

Spica cast

A

cast that covers one whole leg and part of the other. Used in DDH

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4
Q

Clubbed foot treatments

A

cast application, corrective shoes, surgical correction

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5
Q

Scoliosis

A

permanent lateral curvature of spine

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6
Q

scoliosis problems

A

breathing

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7
Q

Idiopathic scoliosis treatment <20 degrees

A

none

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8
Q

idiopathic scoliosis treatment 20-40 degrees

A

milwaukee brace to prevent further curvature

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9
Q

Milwaukee brace is used for

A

scoliosis. wear 23/24 hrs a day

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10
Q

idiopathic scoliosis treatment >40 degrees

A

Harrington rods are put in place

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11
Q

Harrington rods are used for?

A

idiopathic scoliosis treatment >40 degrees

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12
Q

Osteogenesis Imperfecta (OI)

A

brittle bone fractures with minimal stress. Defect collagen synthesis

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13
Q

Defect collagen synthesis

A

OI

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14
Q

OI symptoms

A

blue sclera, deafness, dentinogenisis (tooth probs)

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15
Q

OI treatments

A

IM rods, reclast (biophosphonate), NO BPs, encourage independence

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16
Q

Reclast (biophosphonate) is used for?

A

OI & osteoporosis It decreased serum calcium, decreases fractures

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17
Q

Slipped Capital Femoral Epiphysis

A

slipping of the femoral head in relation to neck

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18
Q

Slipped Capital Femoral Epiphysis usually occurs in what kinds of people?

A

obese or rapidly growing kids

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19
Q

Slipped Capital Femoral Epiphysis symptoms

A

hip, knee, groin pain (long duration), Limp, decreased ROM

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20
Q

Hallmark sign of Slipped Capital Femoral Epiphysis

A

Lack of internal rotation

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21
Q

Slipped Capital Femoral Epiphysis treatment

A

bedrest, NWB, crutches, surgical pinning, teach s/s for other hip

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22
Q

Legg-Calve-Perthes Disease

A

avascular necrosis of the head of femur

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23
Q

age of peak incidence for Legg-Calve-Perthes Disease

A

4-8 years old

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24
Q

Legg-Calve-Perthes Disease symptoms

A

pain in the hip accompanied by spasm and limited motion, progress thru 4 stages, knee of thigh pain, limp

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25
Q

Legg-Calve-Perthes Disease diagnostics

A

arthrogram (they put dye into body to see where it builds up)

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26
Q

Legg-Calve-Perthes Disease treatment

A

Hip spica cast for left hip for Legg-Calve-Perthes, petrie brace

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27
Q

petrie brace

A

metal bar that goes between legs for Legg-Calve-Perthes Disease

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28
Q

Osgood-Schlatter Disease

A

thickening and enlargement of tibial tuberosity. Athletes

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29
Q

Osgood-Schlatter Disease symptoms

A

painful swelling, cosmetic deformity. They will grow out of it

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30
Q

Osgood-Schlatter Disease treatments

A

Rest, ice, stretch hamstrings, casting, they’ll grow out of it

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31
Q

Osgood-Schlatter Disease diagnostics

A

x-ray

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32
Q

Rheumatoid Arthritis

A

chronic, systemic, inflammation of connective tissue in joints.

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33
Q

RA etiology

A

EBV initiates autoimmune response

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34
Q

RA symptoms

A

fatigue, anorexia, weight loss, generalized stiffness, fever, warmth, redness, swelling, weak muscles, ligaments, tendons

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35
Q

RA diagnostics

A

Synovial fluid aspiration, CBC, ESR, X-ray

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36
Q

CBC will show what with RA

A

anemia

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37
Q

ESR will be what with RA

A

elevated d/t inflammatory response

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38
Q

RA goals

A

reduce pain & inflammation, preserve function, prevent deformity

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39
Q

Plasmaphoresis is used with RA inorder to

A

to reduce autoimmune response by removing circulating antibodies

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40
Q

RA treatment

A

1.) give NSAIDS/corticosteriods 2.) DMARD’s (Disease-modifying antirheumatic drugs, surgery

41
Q

DMARDs

A

Gold, D-penicillamine, Antimalarial agents (Plaquenil)-monitor visual acuity q 6 months sulfasalzine

42
Q

Plaquenil

A

antimalarial agent used for RA & SLE. Causes visual probs

43
Q

types of surgery for RA

A

Synovectomy, arthrodesis, arthroplasty

44
Q

Arthrodesis

A

the fusion of two bones. Used for RA surgery

45
Q

Arthroplasty

A

surgery to reshape, reconstruct or replace a diseased or damaged joint

46
Q

JRA polyarticular

A

effecting many joints

47
Q

JRA pauclarticular

A

4 or fewer joints are effected. screening q 6 months

48
Q

JRA systemic s/s

A

high fever, rashswollen lymph nodes

49
Q

JRA s/s

A

eye inflammation, stiff and painful joints, decreased appetite, poor weight gain, slow growth

50
Q

JRA exercise

A

ROM, bike, swim

51
Q

JRA treatment

A

NSAIDS, DMARDs, Cytotoxic (methotrexate), steriods

52
Q

Cytotoxic (methotrexate) is used for

A

JRA. Used in chemo. Are we going to set them up for cancer later on?

53
Q

SLE does what to the body

A

attacks the organs

54
Q

SLE s/s

A

joint pain, butterfly rash, oral ulcers, alopecia, renal failure, seizures, depression,

55
Q

SLE teaching

A

avoid sun exposure, limit stress,

56
Q

SLE treatments

A

Plaquenil, Cytoxan (immunosuppressive drugs), NSAIDS, high dose steriods

57
Q

Osteoarthritis

A

degenerative joint disease. Bone on bone rubbing

58
Q

Osteoarthritis(DJD) diagnostics

A

x-ray, bone scan, CT, MRI

59
Q

Osteoarthritis treatments

A

Opioids, heat, cold, joint arthroplasty, TENS, NSAIDs, Glucosamine, ASA, corticosteriods, Surgery if nothing else works

60
Q

For a Total joint Arthroplasty (TJA) what is stopped 1 week before the surgery and what is given 1 hour before surgery

A

NSAIDS are stopped 1 week before surgery and an IV antibiotic is given 1 hour before surgery

61
Q

With a Total Hip Arthroplasty (THA) a patient can become…

A

hypotensive. After 4 or 5 hip revisions there isn’t much you can do

62
Q

THA postoperative care

A

abductor pillow, turn patient with pillow between legs. don’t let legs cross, don’t want knee to go higher than hip

63
Q

THA discharge instructions

A

No driving for 6 weeks, resume sexual activity when comfortable, prophylactic antibiotic coverage for invasive procedures (dental work)

64
Q

TKA discharge instructions

A

no driving, continue dvt prophalyxsis, antibiotics for dental work, home care c physical therapy, don’t put a pillow under knee cap

65
Q

Osteoporosis

A

most common, porous bone

66
Q

How does estrogen effect Bone mass density

A

An estrogen deficiency rapidly decreases BMD, up to 20% during the first 5-7 yrs post-menopause

67
Q

Surgically induced menopause does what to BMD

A

it results in severe decrease in BMD

68
Q

type 1 osteoporosis

A

postmenopausal, accelerated bone loss

69
Q

type II osteoporosis

A

senile. male & female, age >70 related to nutrition, decreased physical activity, non-accelerated bone loss

70
Q

Secondary osteoporosis

A

male & femal, occurs at any age. Its a result of a disease process or medical treatment

71
Q

osteoporosis: which fractures are seen with elderly men

A

vertebral compression fractures

72
Q

osteoporosis risk factors

A

smoking, sedentary, alcohol use

73
Q

Osteoporosis prevention

A

weight bearing exercises, medications, proper nutrition, education

74
Q

recommended amount of Calcium D for 35-50 yr olds

A

1000mg

75
Q

recommended amount of Calcium D for pregnant women

A

1200-1500mg

76
Q

recommended amount of Calcium D for 51-64 yrs old on ERT/ 51+ not on ERT

A

1000mg/1500mg

77
Q

Calcium bicarbonate vs. Calcium Citrate

A

relief of indigestion, heart burn vs adjunct in the prevention of postmenopausal osteoporosis

78
Q

Estrogen replacement therapy should be started when?

A

within 3 years of menopause

79
Q

Estrogen replacement therapy increases which risk and what should be added in no hysterectomy?

A

increases endometrial cancer. Progesterone must be added if no hysterectomy

80
Q

Osteoporosis meds

A

Antiresorptive meds that slow bone loss (bisphosphonates, calcitonin, denosumab, estrogen/estrogen agonists/antagonists-Evista) & Anabolic drugs that increase the rate of bone formation (PTH- Fortteo)

81
Q

bisphosphonates, calcitonin, denosumab, estrogen do what?

A

antiresorptive meds that slow bone loss

82
Q

PTH-Fortteo do what?

A

Anabolic drugs that increase the rate of bone formation

83
Q

Bonica, Reclast, Actonel, Fosamax are what kinds of drugs

A

Bisphosphonates. Osteonecrosis of the jaw (ONJ) is a side effect

84
Q

Kyphotic deformity

A

seen with osteoporosis. Its the normal posterior curvature of the thoracic and sacral spine

85
Q

What GI/Bowel alterations will you see with a patient with osteoporosis?

A

a protrusion of the abdomen

86
Q

When would you do surgery for HIVD?

A

if leg pain longer than 6 weeks.

87
Q

What surgical interventions are there for HIVD

A

minimally invasive discectomy, laminectomy (remove part of lamina), spinal fusion (realign vertebra)

88
Q

HIVD postop complications

A

CSF leakage (look for yellow fluid), nerve root injury, bowel bladder changes, hematoma

89
Q

Conservative treatment for HIVD

A

rest 3 days max, ice or heat, analgesics, physical therapy, epidural steriods

90
Q

what do you look at postop for HIVD

A

Need to look at orthostatic hypotension. Log rolling

91
Q

Gout is what kind of disorder?

A

metabolic

92
Q

what is elevated in Gout?

A

serum uric acid-hyperuricemia >7.5, ESR levels/sed rate

93
Q

With Gout, urate crystals are found in..

A

synovial fluid, surrounding tissues. Uric acid excrete in urine <800 mg/24hrs

94
Q

Gout diagnostics

A

x-ray, urate crystal aspiration

95
Q

Hammer toe

A

claw toe is the dorsiflextion of the 1st phlanx with plantar flexion of the 2nd and 3rd phlanges

96
Q

Zyloprim, Colchicine, NSAIDS (Indocin), corticosteroids are meds to treat?

A

Gout

97
Q

Hallux Valgus

A

Bunion. Enlargement and lateral displacement of the first metatarsal. Congenital but most from wearing pointed shoes

98
Q

daily colchicine and urosuric agents(allopurinol) are for?

A

Chronic Gout

Nursing II (16 decks)

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