MUSCULOSKELETAL Flashcards
What is ankylosing spondylitis?
inflammatory disease affecting the spine which is characerized by stiffness and fusion of joints which lead to restrited spinal mobility.
What are interventions to decrease ankylosing spondylitis?
- manage pain with moist heat and NSAIDs
- take immunosuppressants as prescribed to reduce inflammation and increase mobility
- sleep on the back on a firm mattress to prevent spinal deformity
How can hip flexion contractures be avoided?
- teach clients to lie prone several times a day and to avoid sitting in a chair for longer than 1 hour to avoid this complication.
- the residual limb should not be elevated with above the knee amputations
What does a fat emboli look like?
- petechial hemorrhages (pin sized red spots) on the chest
- altered mental status (confusion)
- restlessness (respiratory distress)
How can hip disclocation be prevent following total hip replacement?
hip dislocation is prevented by using an abductor pillow to maintain the hip in a straight and neutral position.
How should the leg be placed after cast placement?
the nurse should elevate the client’s limb above the herat for the first 48 hours to increase venous return and decrease eedema in the affectetd extremity.
What is carpal tunnel?
pain and paresthesia of the hand caused by median nerve compression within the carpal tunnel of the wrist
How is carpal tunnel best managed?
clients with carpal tunnel manage symptoms with wrist immobilizatioon splints. splinting and immobilation of the wrist (especially during sleep) reduces pain by prevneting flexion or extention.
What are interventions to help with a sprain?
- no activity for the 24-48 hours after sprain occurs to promote healing.
- ice or cold therapy should be applied to reduce pain and swelling
- elevate the extemity above the heart on pillows to help reduce swelling and promote fluid return
- mild analgesia can be taken every 6 hours
What is rhabdomyolysis?
occurs when muscle fibers are released into the blood, usually after an intense muscle injury . acute renal failure then can occur when elevated myoglobin levels overwhelm the kidney’s infiltration rate..
What is the nurses’s PRIORITY when treating a patient who has rhabdomyolysis?
The priority is to prevent kidney damage using rapid IV fluid resuscitation to flush the damaging myoglobin pigment from the body.
What are characteristics of osteoarthritis?
- pain
- crepitus
- morning stiffness that subsides 30 minutes after rising
What is the best intervention for a client with RA that is worse in the morning?
the best intervention is to take a warm bath or shower when first awakening as heat decreases stiffness and promotes muscle relaxation and mobility.
How fast is physical therapy performed after a total knee arhtroplasty (replacement)?
physical therapy is a priority and immediately iniated after surgery, and the client should be fully weight bearing by discharge.
How can a nurse help care for a halo external fixation device?
- clean pin sites with sterile solution
- place foam inserts under pressure points to prevent pressure injury
- keep a small pillow under the client’s head when supine to reduce pressure on the device
- NEVER grab the device frame or pins.
What are appropriate actions for a client in Buck’s traction?
- client shuld lie supine (maximum of 20-30 degrees). elevating the head further promotes sliding
- loosen velcro straps if the boot is too tight as they can impair neurovasculat status
- weights should be free hanging at all times, but the nurse can support the weight while the client is repositioned up in bed to prevent excessive pull on the extremity
Does a client have to wear a brace all the time?
most braces are worn for 18-23 hours per day and removed for bathing and exercise. Clients should never shower while wearing a hard braces as padding will absorb the moisture and promote skin breakdown.
What are clinical manifestations of a hip fraction?
- muscle spasm in the injured area
- shortening of the affected extremity: occurs because the fracture can reduce the length of the bone
- abducition or adduction of the affected extremity depending on location
How can the client help prevent disease progression of RA?
.1 joint protection is needed because fibrosis from RA can shorten tendons and ligaments when the joints are flexed for prolonged periods
- medications sucha s methotrexate and other DMARDss should be taken every day regardless of symptoms
What complications should the nurse assess for with a client who is on crutches?
muscle weakness, tingling or numbness.
What are good food sources of calicum and vitamin D?
What are teaching points to assist the client in appropriate use of a cane?
- cane length should equal the distance from the client’s greater trochanter to the floor because incorrect cane lenght can cause back injury
- hold the cane on the stronger side while keeping elbows flexed at a 20 to 30 degree angle
- move the affected leg AFTER moving the cane
- always keep 2 points of support on the floor at all times
What is gout?
inflammatory condition caused by ineffective metabolism of purines, which cause uric acid accumulation in the blood. urice acid typically forms in the joints.
What is a rotator cuff? What are signs of rotator cuff injury?
4 shoulder muscles and tendons that attach to the humeral head. they allow for rotation of the arm. signs of injury include shoulder pain and weakness.
