musculoskeletal, fractures, amputations Flashcards
what is the pathophysiology of osteoarthritis?
degeneration of articular cartilage with hypertrophy of the underlying and adjacent bone.
what class is the drug “leflunomide/Arava”? which type of arthritis is it used to treat?
DMARD RA
To control chronic pain for osteoarthritis, how frequently should the analgesics be administered?
regularly
every 4-6 hours
What could be put on a toilet seat for a patient who had a total hop replacement?
raised toilet seat
what is the main benefit of a CPM?
maintain range of motion and flexibility and reduce scar tissue formation
What in the body does a connective tissue disease affect?
bone, cartilage, ligaments and tendons
the patient who is most likely to develop a connective tissue disease is usually this gender?
female - women
The function of connective tissue of the body?
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
when collecting a health history from the patient with a connective tissue disease, what would the nurse be certain to inquire about?
past accidents and injuries
what characteristic is diagnostic of rheumatoid arthritis?
symmetrical joint changes
if a patient is taking “alendronate/Fosamax” what does the nurse tell the patient, that is required of the patient?
don’t lie down for 30 minutes
Why are glucocorticoid medications are used as the last choice in the treatment of rheumatoid arthritis?
suppresses normal immune responses like inflammation
What is the physiological reason a patient with osteoporosis should maintain a regular exercise program?
promotes formation of the bones
what type of teaching on the renal would need to be done by the nurse for a diagnosis of gout?
kidney stones
immediately after surgery, for a patient who had a total knee placement, the nurse would carefully want to assess and document what?
circulation in the affected limb
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?
1200-1500mg
what diagnostic test result would be positive for muscle degeneration, in a patient with “polimyositis”?
muscle biopsy
what would be included in the nurses teaching for a patient with carpal tunnel syndrome instructions?
splinting, to prevent flexion and hyperextension
Be familiar with discharge instructions that should be given to a patient who had a total hip replacement.
don’t flex more than 90 degrees, and rotating foot out
what is an exercise that would benefit a patient with bursitis of the shoulder?
walking the fingers up the wall
how does “probenecid/benemid work? and what does it do for gout?
increases urinary excretion of uric acid, reduces buildup of uric acid in joints, takes several weeks to take affect.
2 days after surgery for a patient with a crushed pelvis,, know what the signs and symptoms of a fat embolism are?
trouble breathing, respiratory distress, petechia, tachycardia, tachypnea, fever, confusion, decreased consciousness
what would a nurse teach an older patient with a newly casted Colles fracture?
move shoulders to prevent stiffness and contractures
With a patient who has osteomyelitis after multiple fractures, what type of surgery would follow antibiotic therapy?
removal of dead bone, hardware or both
know the signs and symptoms of compartment syndrome
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
with a patient who was just admitted for a pelvic fracture, what would be the nurses assessment of “most concern”
urinary output, perforated bladder
what is the “cardinal sign” of a broken hip?
abducted leg, loss of function, eversion of foot
what nursing discharge teaching would be related to cast care for a patient with a fractured radius, in a plaster of paris cast?
elevate it
what a nurse assisting with an application of a short arm plaster cast would do with the stockinet?
make sure it fits properly so there is no skin breakdown
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?
DVT
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?
buck’s
what is a comminuted fracture?
broken into multiple small pieces
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.
advance right crutch, left foot, left crutch, right foot
if a patient has a compound fracture, where does a nurse assess for pulses?
distal to the injury
what are the signs and symptoms of an infection underneath a cast?
fever
what is the highest priority nursing diagnosis after surgery for a patient with an open reduction and external fixation of the ankle?
risk for infection
when a patient has been placed in full “Spica cast” and complains of nausea and abdominal distention, what syndrome should the LVN report?
cast syndrome
What is the finding that would produce the most concern when performing pin care for a patient with an external fixator?
drainage
if a nurse is performing a neurovascular assessment of a patient in skeletal traction, what abnormal sign does the nurse want to assess?
impaired circulation
how should weights that applying traction hang?
freely
what is a greenstick fracture?
not broken all the way through
what does early ambulation with a pelvic fracture prevent?
DVT
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?
rigid dressings are used to accommodate the prosthesis
how long is it before a patient with a BKA can bear weight?
3 months
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?
he can repeat back to you that he knows he will be getting a prosthetic
what are the two diagnostic tests that are done pre-op for a patient having a BKA
wbc, and vascular studies
if a patient has an elbow disarticulation, how will the limb be severed?
through the joint
what is the thermographic finding of cool spots in a certain are indicating
decreased blood flow
what can a patient with PVD and diabetes do to prevent an amputation, regarding vasoconstriction
stop smoking
what pre-operative exercises should be done for a patient undergoing a lower-extremity amputation, what type of training?
strengthen upper body
what is the greatest danger in the early post operative period for a patient after amputation?
hemorrhage
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?
wrap the part in a moist cloth and then put it in a sealed bag in ice water
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?
leave the prosthesis off
what does post operative care for a patient with replantation of the right thumb include?
elevation of the limb
what are late signs and symptoms of hemorrhage in the post operative period after an amputation>
hypotension and cyanosis
what post operative complication of an amputation should always be reported to a physician?
hemorrhage
