Musculoskeletal Pt 2

Question 1

how do you manage fractures

Answer 1

RICE

rest, ice, compression, elevation

Question 2

an attempt to prevent movement-reason for spams

Answer 2

splintage

Question 3

naturally occurring phenomenon related to pain that causes guarding, muscle spasms, and avoidance of further use

Answer 3

physiologic splintage

Question 4

immobilization of bones with devices such as casts, splints and braces

Answer 4

External orthopedic splintage-

Question 5

immoblization of bones with with screws, pins, rods or plates to hold the opposing ends of the fracture in place ORIF-can

Answer 5

Internal Fixation

Question 6

stages of fractures

Answer 6

hematoma, pre callus, callus, remodeling

Question 7

blood flow, could be prevented by fracture or friction

Answer 7

ischemia

Question 8

what can impair bone healing

Answer 8

Severity, type of bone, management of fracture, infection, ischemia,, age of patient, nutrition, chronic diseases

Question 9

what conditions can cause an endocrine imbalance

Answer 9

diabetes or thyroid issues

Question 10

factors that hinder callus formation

Answer 10

Infection at the site of injury
Bone necrosis
Anemia or other systemic conditions
Endocrine imbalance
Poor dietary intake

Question 11

Used when a cast would not allow proper alignment of the fracture
Proper cleaning to prevent infection is required

Answer 11

external fixator

Question 12

describe an wound that has an external fixator

Answer 12

Should not be infected, or have pus, or be bleeding
May have a little serosanguinous
Clean with saline and put on antibiotic ointment

Question 13

Aligns the ends of a fracture by pulling the limb into a straight position
Helps manage muscle spasm r/t fracture

Answer 13

traction

Question 14

Application of a low electrical current to the fracture

Promotes the speed of bone healing

Answer 14

bone stimulation

Question 15

When fat enters the circulation)
12-48 hrs after fracture
Usually associated with fx of long bone or pelvis (fx of hip is at highest risk)

Answer 15

fat embolism syndrome

Question 16

symptoms of pulmonary embolus

Answer 16

Hemoptysis (coughing up of blood), pleuritic chest pain, dyspnea, rales

Question 17

who is at risk for DVT

Answer 17

Anyone who is immobile is at risk for DVT

Question 18

4-12 hrs after fracture
Progressive pain distal to fracture
5 Ps

Answer 18

compartment syndrome

Question 19

what do you do for compartment syndrome

Answer 19

cut off blood supply to muscle

Question 20

most common procedure performed in people over 85.

Answer 20

repair of fractured hip

Question 21

types of hip fractures

Answer 21

Intracapsular
Extracapsular
Intertrocanteric

Question 22

signs/symtptoms of hip fracture

Answer 22

Medical emergency
Severe pain at the fracture site
Inability to move leg voluntarily
Classicshortening and external rotation of the leg

Question 23

Prolonged immobility - 12-16 wks BR (avoids the risks associated with anesthesia)

Answer 23

conservative management of hip fracture

Question 24

Reduction and stabilization of fracture with insertion of internal fixation device

Answer 24

surgical management of hip fracture

Question 25

do not do what things following a hip fracture

Answer 25

``` flex more than 90o force hip into adduction or internal rotation cross legs put on own shoes and socks x 8 weeks sit in chairs that do not have armrests ```

Question 26

what SHOULD you do following a hip fracture

Answer 26

``` Keep in extension and abduction use toilet seat raiser place/use shower chair use pillow between legs x 8 weeks notify of increased pain inform dentist of prosthetic device ```

Question 27

classic signs of hip fracture

Answer 27

Severe pain at the fracture site Inability to move leg voluntarily External Rotation

Question 28

postoperative care of total hip replacement

Answer 28

hip is kept in extension and abduction to prevent dislocation of the hip

Question 29

Acute or chronic infection of bone (confirmed by positive wound culture) Usually staph aureus Direct or indirect

Answer 29

Osteomyelitis

Question 30

symptoms of osteomyelitis

Answer 30

Pain, temperature, swelling, warmth, redness

Question 31

treatment of osteomyelitis

Answer 31

Aggressive antibiotics 6-8 wks

Question 32

important nursing care of osteomyelitis

Answer 32

Aseptic technique, no heat or exercise to affected area which will increase circulation

Question 33

A disorder in which bone mass is lost to the point where the skeleton is no longer able to withstand unexpected or normal mechanical forces.

Answer 33

osteoporosis

Question 34

describe osteoporosis

Answer 34

Bone resorption > bone formation

Question 35

Most common skeletal disorder

Answer 35

osteoporosis

Question 36

remodeling imbalance favors bone resorption fracture due to bone weakness Non-symptomatic until indicated by fracture

Answer 36

Metabolic bone disease (Osteoporosis)

Question 37

what inhibits bone resorption

Answer 37

estrogen

Question 38

when does estrogen decrease thus leading to more fractures

Answer 38

menopause and young women who are training

Question 39

what counteracts osteoporosis risk factors

Answer 39

Weight bearing exercises (walking)

Question 40

osteoporosis risk factors

Answer 40

``` Aging Gender (female) Race (white) Family History Postmenopausal Chronic calcium deficiency Sedentary lifestyle ```

Question 41

who is given corticosteroids thus increasing their risk for osteoporosis

Answer 41

asthmatics

Question 42

what drug is a secondary risk factor for osteoporosis

Answer 42

glucocorticoids

Question 43

clinical manifestations of osteoporosis

Answer 43

back pain, fracture, thoracic kyphosis, loss of height

Question 44

what is the easiest way to diagnose osteoporosis

Answer 44

Bone Mineral Density Measurement

Question 45

education for osteoporosis

Answer 45

Promote calcium intake Decrease caffeine- Excess calcium loss Decrease protein and fat- High protein diet causes bone loss secondary to calcium loss Promote exercise

Question 46

Chronic metabolic disorder in which bone is excessively broken down and reformed leading to weakened bone, bone pain, arthritis, deformity leading to pathologic fractures and osteogenic sarcoma

Answer 46

Paget's disease

Question 47

meds given for Paget's disease

Answer 47

Fosamax, Actonel

Question 48

``` Degenerative Joint Disease Most common form of arthritis in the elderly #1 cause of disability and limitation in those over 74 ```

Answer 48

osteoarthritis

Question 49

Non-inflammatory disease of moveable joints | Deterioration in articular cartilage and formation of new bone at the joint

Answer 49

osteoarthritis

Question 50

pathophysiology of osteoarthritis

Answer 50

Articular cartilage becomes thin, irregular, frayed Probably enzymes breakdown of cartilage Cracks, fissures in articular cartilage Fill w/ synovial fluid