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Nursing Across The Lifespan 1 (Exam 2 Prep) > Musculoskeletal Panopto Part 2 > Flashcards

Musculoskeletal Panopto Part 2 Flashcards

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1
Q

How should a Fracture be treated?

A

Immobilize it with a Splint / Cast / Traction (Skeletal or Skin)

Surgery

A Pulley Weight

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2
Q

What will occur if Bone Unalignment or Skin Unalignment goes untreated?

A

Poor Perfusion + Necrosis

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3
Q

A pt has a Fracture, and it’s being treated via a Pulley Weight. The weight itself is elevated off of the floor.
Is this good or bad?

A

Good, Pulley Weights should always be elevated off the floor

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4
Q

How should you know how many lbs a Pulley Weight should be?

A

The Provider will order a specific amount of weight

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5
Q

What is Skin Traction also called?

A

Buck’s Traction

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6
Q

When repositioning a pt with a Pulley Weight attached to their limb, what needs to be done?

A

Have another nurse come in and Stabilize the Pulley Weight so that it doesn’t hurt the pt during repositioning

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7
Q

What is the difference between Skin Traction and Bone Traction?

A

Skin Traction = Realigning the muscle to the bone

Bone Traction = Realigning the bone to the other bones

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8
Q

How often should the Pin Sites be cleaned for Bone Traction? What should be used?

A

Once Per Shift + Use Soap & Water or whatever is ordered by the Provider

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9
Q

What is the main thing that you need to monitor for Bone Traction?

A

Infection

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10
Q

What is Closed Reduction?

A

It’s a surgery that can be performed in the OR or at Bedside + Replaces a Dislocated Bone back into the Socket

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11
Q

What is our role as a nurse for students who undergo a Closed Reduction?

A

We act as a support for the pt + Provide Analgesics + Prepare them.

The provider is the one actually doing the procedure.

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12
Q

What is Open Reduction Internal Fixation (ORIF)?

A

It’s one of the most common treatment options for Fractures in the Elderly + Promotes Early Mobilization

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13
Q

What is an External Reduction Closed Fixation (ERCF)?

A

Less Common than a ORIF + May be tried before an ORIF.

The Physician manipulates a Fracture to try and reduce it.

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14
Q

What is one of the main differences between an ERCF and a ORIF?

A

ERCF = External Hardware or a Graft may be used to keep the Fracture in place.

ORIF = The Fracture’s Repaired using Hardware, puts the limb back into alignment.

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15
Q

What Neurological Symptoms might a pt with Back Pain experience? Why?

A

Impaired Strength in Hands / Feet + Sensation + Reflexes.

This is because the Nerve Root or Spinal Cord may be getting affected by something.

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16
Q

How long would a Sub-Acute disorder last? How does this differ from Chronic or Acute?

A

Acute = <1 Month

Sub-Acute = 1-3 Months

Chronic = 3+ Months

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17
Q

What are the most common causes of Back Pain?

A

Disorders of the Spinal Structure (Mechanical in nature):
Herniated Disk / Slipped Disk + Nerve Root Pain + Compression Fractures + Osteoarthritis + Spinal Stenosis

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18
Q

What is Spinal Stenosis?

A

The Spinal Column Becomes Narrowed

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19
Q

What are some Lesser Common Causes of Back Pain?

A

Cancer + Infection + Inflammation

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20
Q

What might cause a Bacterial Infection to occur in the Spinal Column?

A

Impenetrating Trauma (Accidents, Surgery, etc.)

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21
Q

What are some serious Non-Mechanical causes of Back Pain?

A

Abdominal Aneurysm + Aortic Dissection + Angina + Meningitis

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22
Q

What kind’s of pt’s are closely associated with Back Pain?

A

Cardiac pt’s

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23
Q

What groups of people are at risk for Back Pain?

A

Elderly + Obese + Physically Demanding Jobs + Depression + Osteoarthritis

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24
Q

What do the Elderly with Persistent Lower Back Pain need to be assessed for?

A

Aortic Aneurysm + CT of the Lower Spine (Rule’s out any possible Cancer) + Assess any adverse effects caused by the meds for their back pain (Opioids Depress the CNS)

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25
Q

What are the diagnostics used for Back Pain?

A

Stork Test + Adam’s Test + X-Ray + MRI + CT Scan + Electromyography & Nerve Conduction Velocity

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26
Q

What is the Stork’s Test used to do?

A

Assesses for a Inter-Arterial Deficit

27
Q

How does a Stork’s Test work?

A

You view how the spine moves / bends.

The pt stands on one leg, their balance + how their back bends is evaluated.

28
Q

What is the Adam’s Test used to do?

A

Assesses for Scoliosis

29
Q

In what environment is the Adam’s Test used a lot?

A

In Schools to evaluate Kids for Scoliosis

30
Q

How does the Adam’s Test work?

A

The pt will bend forward, the Provider evaluates the Curvature of the Spine

31
Q

How does Electromyography & Nerve Conduction Velocity work?

A

Prongs are attached to the pt’s muscle of wherever needs assessed, those Prongs send jolts of electricity to the Nerves to view how they react.

This is used to assess for any Nerve Damage.

32
Q

Low Back Pain often doesn’t have an Underlying Cause.
True or false?

A

True

33
Q

Who might a pt with Back Pain need to be referred to?

A

A Social Worker / Case Worker

34
Q

What can prevent Low Back Pain from becoming Chronic?

A

Strengthening Poor Muscle Groups / Strengthening their Core

35
Q

What are the Non-Pharmacological treatments for back pain?

A

Rest + Massage + TENS Unit (If Prescribed) + Physical Therapy + Stretching + Spinal Manipulation / Immobilization + Acupuncture

36
Q

What are some Pharmacological treatments for back pain?

A

NSAID’s (Motrin) + Non-Opioids + Opioids (if necessary) + Corticosteroids (Muscle Relaxers)

37
Q

For back pain, what med would you normally want to start with first?

A

Motrin

38
Q

What do Muscle Relaxers and Opioids do?

A

Depress the CNS (Monitor Respiratory Status and for changes in LOC)

39
Q

What are the reasons for a Surgical Amputation?

A

Uncontrolled Diabetes, Gangrenous Wounds, etc.

40
Q

What kind of disease is a major cause for Amputation?

A

Peripheral Vascular Disease (Smoking + Diabetes + Atherosclerosis)

41
Q

What is the level of an Amputation determined by?

A

Tissue Viability

42
Q

What are some surgeries for back pain?

A

Lumbar Laminectomy + Cervical Laminectomy

43
Q

In order for something to be considered an amputation, does it have to be a complete removal of the limb or can it also be just partial?

A

Can be just partial removal of the limb

44
Q

What are the risk factors for Amputation?

A

Traumatic Injury + Uncontrolled Diabetes + Smoking (Because it promotes Peripheral Vascular Disease) + Aging

45
Q

Poor blood flow of the limb that can lead to Amputation =

A

Peripheral Vascular Disease

46
Q

What problems can Phantom Pain cause?

A

Fall Risk + Difficulties with Prosthesis Training

47
Q

What meds can help treat Phantom Pain?

A

Antiepileptic Meds + Antidepressants

48
Q

How can you tell if someone may have to undergo an amputation during a head to toe assessment?

A

Pale / Necrotic Limb + Absent Pulse + Area may not Blanche + Foul Odor if Infected or Gangrene

49
Q

What diagnostic studies are used to determine if an Amputation may be necessary?

A

Doppler Studies + Invasive Angiogram + Ankle Brachial Index (ABI)

50
Q

What is an Invasive Angiogram?

A

Injecting dye into a limb and then viewing it on the ultrasound screen to see if it’s able to flow or not

51
Q

What kind of ABI value would indicates a blockage or stiffening of the arteries in the leg?

A

A result that’s higher or lower than that of the arm

52
Q

What does the ABI determine the presence of?

A

Arterial Disease in a Limb

53
Q

Who would determine whether or not an Invasive Angiogram should be done?

A

The Provider

54
Q

For a pt with a newly amputated limb, what kind of dressing should they have wrapped around it? Why?

A

A Figure 8 Pressure Dressing

(It helps it keep its shape so that a Prosthesis can be applied, without doing this you can’t get a prosthesis on your pt)

55
Q

What is a Contracture?

A

A shortening and hardening of muscles that causes a joint to become deformed and stiff/rigid, thus limiting ROM

56
Q

How can Hip Contractures be prevented for amputation pt’s?

A

Lay Prone for 1 hr at least 3 times a day

57
Q

What is done by Physical Therapists and not a nurse?

A

Desensitization Techniques (Massaging / Vibration + Taping of the Amputation Site + Progressive Load Bearing on the Limb)

58
Q

When can a Prosthetic be fitted to a pt with a newly amputated limb?

A

After Edema goes down + the Surgical Site has Healed.

(~7-10 Weeks After Surgery).

59
Q

The first Prosthetic should last for a while when getting fitted for one after an Amputation.
True or false?

A

False, the initial prosthetic is temporary. They’ll need to go through different sizes as the amputated limb undergoes changes in size and shape as it heals

60
Q

When can a pt start to expect a more permanent Prosthesis after an amputation?

A

~The First 18 Months After Surgery

61
Q

Is it the nurse’s role to help get a pt’s prosthesis fitted?

A

No

62
Q

For amputations, when might IV analgesics be necessary?

A

The immediate post-op phase

63
Q

What should be avoided on a stump?

A

Body Oil or Lotion (The Stump should not be Soft, it needs to be Hard in order for a Prosthesis to be applied)

64
Q

How does a nurse assess a pt’s mobility?

A

The Bedside Assessment Mobility Tool (BMAT) gives the nurse a Rubric to assess the pt

Nursing Across The Lifespan 1 (Exam 2 Prep) (11 decks)

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