musculoskeletal exam 4 questions

Question 1

most common MS complaint

Answer 1

back pain

Question 2

what nonpharmacological treatments should you consider with DDD?

Answer 2

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

Question 3

what is osteomyelitis

Answer 3

bone infection

Question 4

patients at risk for osteomyelitis

Answer 4

immunocompromised
obesity
geriatric
chronic illness
postop – anyone who had orthopedic surgery
long-term steroid use

Question 5

signs and symptoms of osteomyelitis

Answer 5

chills
high fever
rapid pulse
general malaise
local bone pain
redness
swollen
warm to touch
drainage if open wound

Question 6

risk factors for osteoporosis

Answer 6

low vitamin D
thin
postmenopausal women
bariatric or GI issues
hypoparathyroidism
Cushing’s

Question 7

what medications increase risks for osteoporosis

Answer 7

long term steroid use
PPIs
depo-provera for birth control

Question 8

what complication can occur with osteoporosis

Answer 8

fractures

Question 9

most accurate diagnosis for osteoporosis

Answer 9

DEXA scan

Question 10

three drug classes to treat osteoporosis and their routes

Answer 10

Bisphosphonates – PO daily/weekly/monthly; IV quarterly/annually
estrogen agonists/antagonists – PO daily
RANKL inhibitor – SQ every 6 months

Question 11

what conditions can cause osteomalacia

Answer 11

decrease activated vitamin D and failed calcium absorption
GI issues
hyperparathyroidism
malnutrition
long term use of anticonvulsants

Question 12

in addition to treating the underlying cause what other treatment may be necessary for osteomalacia

Answer 12

sun/vitamin D
walking devices/braces
dietary education – calcium rich foods

Question 13

a bone x-ray and biopsy will show what of an osteomalacia patient

Answer 13

demineralization of bone

Question 14

an osteomalacia patient will have low ___ levels and high ____ levels

Answer 14

low calcium; high ALP

Question 15

three nursing considerations for a patient with Paget’s disease

Answer 15

high fall risk – safety
pain management
hearing loss

Question 16

complication often associated with osteosarcoma

Answer 16

fractures

Question 17

serum diagnostic tests often associated with malignancy of bone tumors

Answer 17

elevated ALP or calcium levels

Question 18

What diagnostic study is specific for diagnosing osteomyelitis or bone tumors?

Answer 18

bone scan

Question 19

treatment for osteosarcoma

Answer 19

surgical removal of tumor
radiation

Question 20

injury to a joint that causes adjoining bones to no longer touch each other

Answer 20

dislocation

Question 21

a minor or incomplete dislocation in which the joint surfaces still touch but are not in normal relation to each other

Answer 21

subluxation

Question 22

both dislocation and subluxation are ____

Answer 22

emergencies

Question 23

what assessment findings would you see in both dislocation and subluxation

Answer 23

dislocation = obvious change in joint position
subluxation = no obvious deformity

Question 24

what complication could occur if dislocation/subluxation is not treated

Answer 24

avascular necrosis
muscle strain
ligament and tendon sprains
nerve damage

Question 25

What diagnostic radiologic test is used for diagnosing osteoarthritis of a joint?

Answer 25

basic xray -- least invasive and rules out AVN

Question 26

sprain is caused by an ____; strain is cause by ______

Answer 26

injury; overstretching

Question 27

What two assessment findings are important is determining the degree of a sprain or strain?

Answer 27

pain and ROM

Question 28

what diagnostic tests should be done if nurse suspects a third degree sprain/strain?

Answer 28

basic x ray (rules out AVN)

Question 29

most common complications associated with MS injuries or surgeries

Answer 29

DVT infection avascular necrosis compartment syndrome fat embolism

Question 30

symptoms of AVN

Answer 30

pain and movement and rest limited ROM

Question 31

first complaint of AVN

Answer 31

pain

Question 32

risk factors for AVN

Answer 32

ages 30-50 people who use steroids or drink alcohol gaucher disease caisson disease chemotherapy and radiation

Question 33

AVN treatment

Answer 33

NSAIDS traction joint replacement in the big joints is necessary

Question 34

compartment syndrome

Answer 34

Edema/bleed increase pressure in compartment that is restrictive (like a cast) -- cell death -- tissue necrosis and dysfunction

Question 35

signs and symptoms of compartment syndrome

Answer 35

pain that is not relieved with meds quick onset -- 6 hours after injury or injury repair 6 Ps

Question 36

compartment syndrome treatment

Answer 36

fasciotomy

Question 37

who is at risk for fat embolus

Answer 37

Those who go through orthopedic trauma, specifically long bone fractures

Question 38

What are the signs and symptoms of fat embolus?

Answer 38

Hypoxia Neuro changes -- mental confusion Rash Tachypnea Dyspnea Tachycardia Chest pain

Question 39

fat embolism can occur up to ____ hours after fracture

Answer 39

72

Question 40

What nursing assessments are imperative to prevent these complications?

Answer 40

neurovascular checks vital signs pain assessment

Question 41

most ominous sign of compartment syndrome

Answer 41

pulselessness

Question 42

first sign of compartment syndrome

Answer 42

pain

Question 43

What treatments should you expect with someone who has plantar fasciitis?

Answer 43

Stretching, orthopedic supports, change shoes, arch support, and possible corticoid steroid injections