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Medical-Surgical Nursing > musculoskeletal, fractures, amputations > Flashcards

musculoskeletal, fractures, amputations Flashcards

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1
Q

what is the pathophysiology of osteoarthritis?

A

degeneration of articular cartilage with hypertrophy of the underlying and adjacent bone.

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2
Q

what class is the drug “leflunomide/Arava”? which type of arthritis is it used to treat?

A

DMARD RA

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3
Q

To control chronic pain for osteoarthritis, how frequently should the analgesics be administered?

A

regularly

every 4-6 hours

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4
Q

What could be put on a toilet seat for a patient who had a total hop replacement?

A

raised toilet seat

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5
Q

what is the main benefit of a CPM?

A

maintain range of motion and flexibility and reduce scar tissue formation

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6
Q

What in the body does a connective tissue disease affect?

A

bone, cartilage, ligaments and tendons

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7
Q

the patient who is most likely to develop a connective tissue disease is usually this gender?

A

female - women

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8
Q

The function of connective tissue of the body?

A

bind structures together, provide support for individual organs and a framework for the body as a whole, store fat, transport substances, provide protection and play a role in the repair of damaged tissue

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9
Q

when collecting a health history from the patient with a connective tissue disease, what would the nurse be certain to inquire about?

A

past accidents and injuries

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10
Q

what characteristic is diagnostic of rheumatoid arthritis?

A

symmetrical joint changes

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11
Q

if a patient is taking “alendronate/Fosamax” what does the nurse tell the patient, that is required of the patient?

A

don’t lie down for 30 minutes

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12
Q

Why are glucocorticoid medications are used as the last choice in the treatment of rheumatoid arthritis?

A

suppresses normal immune responses like inflammation

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13
Q

What is the physiological reason a patient with osteoporosis should maintain a regular exercise program?

A

promotes formation of the bones

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14
Q

what type of teaching on the renal would need to be done by the nurse for a diagnosis of gout?

A

kidney stones

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15
Q

immediately after surgery, for a patient who had a total knee placement, the nurse would carefully want to assess and document what?

A

circulation in the affected limb

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16
Q

know, for a postmenopausal woman, who is not taking hormone replacement therapy, how many mg of elemental calcium, should the patient take on a daily basis?

A

1200-1500mg

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17
Q

what diagnostic test result would be positive for muscle degeneration, in a patient with “polimyositis”?

A

muscle biopsy

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18
Q

what would be included in the nurses teaching for a patient with carpal tunnel syndrome instructions?

A

splinting, to prevent flexion and hyperextension

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19
Q

Be familiar with discharge instructions that should be given to a patient who had a total hip replacement.

A

don’t flex more than 90 degrees, and rotating foot out

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20
Q

what is an exercise that would benefit a patient with bursitis of the shoulder?

A

walking the fingers up the wall

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21
Q

how does “probenecid/benemid work? and what does it do for gout?

A

increases urinary excretion of uric acid, reduces buildup of uric acid in joints, takes several weeks to take affect.

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22
Q

2 days after surgery for a patient with a crushed pelvis,, know what the signs and symptoms of a fat embolism are?

A

trouble breathing, respiratory distress, petechia, tachycardia, tachypnea, fever, confusion, decreased consciousness

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23
Q

what would a nurse teach an older patient with a newly casted Colles fracture?

A

move shoulders to prevent stiffness and contractures

24
Q

With a patient who has osteomyelitis after multiple fractures, what type of surgery would follow antibiotic therapy?

A

removal of dead bone, hardware or both

25
Q

know the signs and symptoms of compartment syndrome

A

pain with touch or moving that can’t be removed with opioid medication. Edema, pallor, weak or unequal pulses, cyanosis, tingling, numbness, paresthesia, relived with a faciotomy

26
Q

with a patient who was just admitted for a pelvic fracture, what would be the nurses assessment of “most concern”

A

urinary output, perforated bladder

27
Q

what is the “cardinal sign” of a broken hip?

A

abducted leg, loss of function, eversion of foot

28
Q

what nursing discharge teaching would be related to cast care for a patient with a fractured radius, in a plaster of paris cast?

A

elevate it

29
Q

what a nurse assisting with an application of a short arm plaster cast would do with the stockinet?

A

make sure it fits properly so there is no skin breakdown

30
Q

for a patient who sustains a fractured hip and femur in an MVS, who is in russells traction for several weeks, what main complication will the nursing care focus on?

A

DVT

31
Q

for a 78 year old patient with a history of osteoporosis who fell with a subcapital femoral fracture, who is scheduled for ORIF, what type of traction would the patient be placed in?

A

buck’s

32
Q

what is a comminuted fracture?

A

broken into multiple small pieces

33
Q

describe the walking instructions to a patient who has avascular necrosis of the hips and needs to walk with crutches using a 4 point gate.

A

advance right crutch, left foot, left crutch, right foot

34
Q

if a patient has a compound fracture, where does a nurse assess for pulses?

A

distal to the injury

35
Q

what are the signs and symptoms of an infection underneath a cast?

A

fever

36
Q

what is the highest priority nursing diagnosis after surgery for a patient with an open reduction and external fixation of the ankle?

A

risk for infection

37
Q

when a patient has been placed in full “Spica cast” and complains of nausea and abdominal distention, what syndrome should the LVN report?

A

cast syndrome

38
Q

What is the finding that would produce the most concern when performing pin care for a patient with an external fixator?

A

drainage

39
Q

if a nurse is performing a neurovascular assessment of a patient in skeletal traction, what abnormal sign does the nurse want to assess?

A

impaired circulation

40
Q

how should weights that applying traction hang?

A

freely

41
Q

what is a greenstick fracture?

A

not broken all the way through

42
Q

what does early ambulation with a pelvic fracture prevent?

A

DVT

43
Q

if a patient who is having his leg amputated and is also having a prosthesis fitting during surgery, what does the pre-op teaching plan include regarding dressings?

A

rigid dressings are used to accommodate the prosthesis

44
Q

how long is it before a patient with a BKA can bear weight?

A

3 months

45
Q

if you have a patient who is 80 years old and has had vascular problems and is scheduled for left BKA, how would you know the patient understands the procedure?

A

he can repeat back to you that he knows he will be getting a prosthetic

46
Q

what are the two diagnostic tests that are done pre-op for a patient having a BKA

A

wbc, and vascular studies

47
Q

if a patient has an elbow disarticulation, how will the limb be severed?

A

through the joint

48
Q

what is the thermographic finding of cool spots in a certain are indicating

A

decreased blood flow

49
Q

what can a patient with PVD and diabetes do to prevent an amputation, regarding vasoconstriction

A

stop smoking

50
Q

what pre-operative exercises should be done for a patient undergoing a lower-extremity amputation, what type of training?

A

strengthen upper body

51
Q

what is the greatest danger in the early post operative period for a patient after amputation?

A

hemorrhage

52
Q

if a patient comes into the ER with an amputated thumb for a lawn mower accident in a glass jar, what should the nurse do?

A

wrap the part in a moist cloth and then put it in a sealed bag in ice water

53
Q

if you are a home health nurse for a patient who has a below the elbow prosthesis and they have a limb that is red, edematous, and warm to the touch, what should you do?

A

leave the prosthesis off

54
Q

what does post operative care for a patient with replantation of the right thumb include?

A

elevation of the limb

55
Q

what are late signs and symptoms of hemorrhage in the post operative period after an amputation>

A

hypotension and cyanosis

56
Q

what post operative complication of an amputation should always be reported to a physician?

A

hemorrhage

Medical-Surgical Nursing (11 decks)

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