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musculoskeletal disorders Flashcards

1
Q

what are some causes of low back pain

A
  • “akward movement”
  • trauma/fall
  • OA of spine
  • osteoporosis of vertebrae
  • scoliosis
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2
Q

how will the client with low back pain present

A
  • acute or chronic
  • radiculopathy
  • sciatica (shoot sharp pain from back to thigh)
  • most common: sacral and lumbar
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3
Q

what are some diagnostic tests for low back pain

A
  • xray
  • CT/CRI
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4
Q

what meds can help for chronic low back pain

A
  • TCAs (amitriptyline)
  • SSRIs (duloxetine)
  • atypical anticonvulsants (gabapentin)
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5
Q

whats a complication of low back pain

A

loss of bowel or bladder function => something more severe is going on -> get CT/MRI

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6
Q

how can nurses help with low back pain

A
  • education
  • self limiting with rest
  • avoid strain
  • take prescrubed meds for acute (short tem opioids, muscle relaxants and possible steroids)
  • daily pains = NSAIDs
  • hot/cold
  • chiropractic care
  • orthopedica shoes/lumbar support
  • limit sitting
  • condition exercises
  • good body posture and mechanics
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7
Q

what NSAIDS may be used for low back pain

A
  • ibuprofen/motrin/naproxen/ASA/aleve
  • ketorlac or tramadol (stronger)
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8
Q

what muscle relaxants can be used for low back pain

A

cyclobenzaprine

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9
Q

what TCAs/atypical anticonvulsants may be used for low back pain

A
  • amitriptyline
  • duloxetine
  • gabapentin
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10
Q

what opioids may be used for low back pain

A
  • hydrocodone/acetaminophen (vicoden or norco)
  • oxycodone/acetaminophen (percosnack)

used for acute not chronic pain

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11
Q

describe the relationship between calcium and vitamin D

A

calcium and vitamin D work together to protect bones

calcium helps build and maintain bones

vitamin D helps the body absorb calcium

so even if you have enough calcium you can do shit with it if you dont have vitamin D

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12
Q

what are some causes of osteoporosis

A
  • smaller fram
  • postmenopausal
  • malnutrition
  • bariatric surgery
  • GI malabsorption disorders
  • immobilization
  • corticosteroids
  • meds
  • tobacco/alcohol use
  • sedentary lifestyle
  • reduced calcitonin, estrogen
  • increased PTH
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13
Q

whats happening with osteoporosis

A
  • Reduced bone mass
  • Deterioration of bone matrix
  • Diminished architectural strength
  • Fracture easily under stress
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14
Q

how will a client with osteoporosis

A
  • early = no symptoms
  • back pain (collapsed vertebra)
  • loss of height
  • stooped posture
  • bones fracturing easily
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15
Q

what are some labs and disgnostic tests for osteoporosis

A
  • DEXA Scan, FRAX, X-Ray
  • Serum P & Ca, ALP, Urine Ca Excretion, Hematocrit, ESR
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16
Q

what are some foods that can help with osteoporosis

A
  • Foods high in Ca
  • Cheese, Dairy products, Broccoli, Canned Salmon
  • Dark green leafy veggies
  • Soy products
  • Ca fortified cereals & OJ
17
Q

whats a complication of osteoporosis

A

fracture management

18
Q

how can nurses help with osteoporosis

A
  • educate
  • Diet rich in Ca and Vitamin D
  • Peak bone mass “bank it!”
  • Weight bearing exercises
  • Supplements (Caltrate, Vitamin D)
  • Medication therapy
  • Reduce use of caffeine, tobacco, alcohol & carbonated soft drinks
  • Educate on secondary osteoporosis
19
Q

what meds can be used for osteoporosis

A

Biphosphates
Alendronate (weekly pill)
Risedronate (weekly / monthly pill)
Ibandronate (monthly pill or quarterly IV infusion)
Zoledronic acid (annual infusion)

Antineoplastic
denosumab

Estrogens
raloxifene

20
Q

whats happening with osteomalacia

A
  • soft and weak skeletal bones
  • lower back, pelvis, hips, legs, and ribs
21
Q

what are some causes of osteomalacia

A
  • Lack of Vitamin D (sunlight & dietary)
  • Renal failure
  • GI disorders (Celiac)
  • Hyperparathyroidism
  • Medications
  • Malnutrition
22
Q

how will a client with osteomalacia present

A
  • Pain & Tenderness to bones (Worse when ambulating)
  • Bowing of bones (kyphosis / legs)
  • Possible pathologic fxs
  • Waddling gait
  • Possible Steatorrhea
  • Pain not relieved by rest (as progresses)
23
Q

where does the proccess of activation of vitamin D occur?

A

liver then the kidney

24
Q

what happens to the bones without vitamin D

A

they become thin, brittle, or misshaphen

25
Q

what are some labs and diagnostics for osteomalacia

A

X-Ray (demineralization)
Serum Ca / P levels & ALP
Urine Ca & Creatinine

26
Q

what foods can help with osteomalacia

A
  • same as osteoporosis
  • may need supplements
27
Q

whats a complication of osteomalacia

A

fractures

28
Q

how can nurses help with osteomalacia

A
  • educate
  • Discuss dietary changes (foods w/ D & Ca)
  • Supplements for liver / kidney issues
  • Sunlight therapy!
  • Braces may help with pain / deformity
  • S&S of fracture
  • Safety to prevent fractures
29
Q

whats heppening with osteomyletis

A

bone infection

30
Q

what are some causes of osteomyelitis

A
  • Bloodstream (often staph)
  • Nearby tissue infection
  • Open fractures / ORIF
  • Complicated DM
  • Immunocompromised / Poor Circulation
31
Q

how will a client with osteomyelitis present

A
  • May be asymptomatic
  • VS changes (fever, tachycardia)
  • Swelling, warmth & redness over area
  • Pain to affected area
  • Fatigue
32
Q

what are some labs and diagnostics for osteomyelitis

A
  • CBC and blood cultures
  • CT/MRI
  • ESR
33
Q

what meds amy help with osteomyelitis

A
  • strong IV antibiotics, then move on to oral
  • long term (3-6wks) for both
34
Q

what are some acute interventions for osteomyelitis

A
  • surgery (remove areas of dead bone)
  • ORIF reversal ot treatment
  • strong IV antibiotics
35
Q

what are some complications of osteomyelitis

A
  • avascular necrosis
  • amputation
  • sepsis -> dead
36
Q

how can nurses help with osteomyelitis

A
  • educate
  • Smoking cessation
  • Safety
  • Monitor for worsening infection (discuss S&S)
  • Prolong elective orthopedic surgery’s if needed
  • Remove urinary catheters ASAP
  • Aseptic postop wound care
  • Prompt management of soft tissue infections
  • At home wound care
  • Clients with DM – inspect feet daily

adults (51 decks)

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