musculoskeletal exam 4 questions Flashcards
most common MS complaint
back pain
what nonpharmacological treatments should you consider with DDD?
hot/cold compress
lumbar support belts
alternate rest and activity
limit standing or sitting for long periods
weight loss or management
stretching the paraspinal muscles regularly
exercise recommended but with PT or MD approval
what is osteomyelitis
bone infection
patients at risk for osteomyelitis
immunocompromised
obesity
geriatric
chronic illness
postop – anyone who had orthopedic surgery
long-term steroid use
signs and symptoms of osteomyelitis
chills
high fever
rapid pulse
general malaise
local bone pain
redness
swollen
warm to touch
drainage if open wound
risk factors for osteoporosis
low vitamin D
thin
postmenopausal women
bariatric or GI issues
hypoparathyroidism
Cushing’s
what medications increase risks for osteoporosis
long term steroid use
PPIs
depo-provera for birth control
what complication can occur with osteoporosis
fractures
most accurate diagnosis for osteoporosis
DEXA scan
three drug classes to treat osteoporosis and their routes
Bisphosphonates – PO daily/weekly/monthly; IV quarterly/annually
estrogen agonists/antagonists – PO daily
RANKL inhibitor – SQ every 6 months
what conditions can cause osteomalacia
decrease activated vitamin D and failed calcium absorption
GI issues
hyperparathyroidism
malnutrition
long term use of anticonvulsants
in addition to treating the underlying cause what other treatment may be necessary for osteomalacia
sun/vitamin D
walking devices/braces
dietary education – calcium rich foods
a bone x-ray and biopsy will show what of an osteomalacia patient
demineralization of bone
an osteomalacia patient will have low ___ levels and high ____ levels
low calcium; high ALP
three nursing considerations for a patient with Paget’s disease
high fall risk – safety
pain management
hearing loss
complication often associated with osteosarcoma
fractures
serum diagnostic tests often associated with malignancy of bone tumors
elevated ALP or calcium levels
What diagnostic study is specific for diagnosing osteomyelitis or bone tumors?
bone scan
treatment for osteosarcoma
surgical removal of tumor
radiation
injury to a joint that causes adjoining bones to no longer touch each other
dislocation
a minor or incomplete dislocation in which the joint surfaces still touch but are not in normal relation to each other
subluxation
both dislocation and subluxation are ____
emergencies
what assessment findings would you see in both dislocation and subluxation
dislocation = obvious change in joint position
subluxation = no obvious deformity
what complication could occur if dislocation/subluxation is not treated
avascular necrosis
muscle strain
ligament and tendon sprains
nerve damage
What diagnostic radiologic test is used for diagnosing osteoarthritis of a joint?
basic xray – least invasive and rules out AVN
sprain is caused by an ____; strain is cause by ______
injury; overstretching
What two assessment findings are important is determining the degree of a sprain or strain?
pain and ROM
what diagnostic tests should be done if nurse suspects a third degree sprain/strain?
basic x ray (rules out AVN)
most common complications associated with MS injuries or surgeries
DVT
infection
avascular necrosis
compartment syndrome
fat embolism
symptoms of AVN
pain and movement and rest
limited ROM
first complaint of AVN
pain
risk factors for AVN
ages 30-50
people who use steroids or drink alcohol
gaucher disease
caisson disease
chemotherapy and radiation
AVN treatment
NSAIDS
traction
joint replacement in the big joints is necessary
compartment syndrome
Edema/bleed increase pressure in compartment that is restrictive (like a cast) – cell death – tissue necrosis and dysfunction
signs and symptoms of compartment syndrome
pain that is not relieved with meds
quick onset – 6 hours after injury or injury repair
6 Ps
compartment syndrome treatment
fasciotomy
who is at risk for fat embolus
Those who go through orthopedic trauma, specifically long bone fractures
What are the signs and symptoms of fat embolus?
Hypoxia
Neuro changes – mental confusion
Rash
Tachypnea
Dyspnea
Tachycardia
Chest pain
fat embolism can occur up to ____ hours after fracture
72
What nursing assessments are imperative to prevent these complications?
neurovascular checks
vital signs
pain assessment
most ominous sign of compartment syndrome
pulselessness
first sign of compartment syndrome
pain
What treatments should you expect with someone who has plantar fasciitis?
Stretching, orthopedic supports, change shoes, arch support, and possible corticoid steroid injections
