Musculoskeletal System

Question 1

Differentiate between rheumatoid arthritis and OA in terms of joint involvement.

Answer 1

Rheumatoid arthritis occurs bilaterally. OA occurs asymmetrically.

Question 2

Identify the categories of drugs commonly used to treat arthritis.

Answer 2

NSAIDs, of which salicylates are the cornerstone of treatment, and corticosteroids (used when arthritic symptoms are severe)

Question 3

Identify pain relief interventions for clients with arthritis.

Answer 3

Warm, moist heat (compresses, baths, showers); diversionary activities (imaging, distraction, self-hyponosis, biofeedback); and medications

Question 4

What measures should the nurse encourage female clients to take to prevent osteoporosis?

Answer 4

Possible estrogen replacement after menopause, high calcium and vitamin D intake beginning in early adulthood, calcium supplements after menopause, and weight-bearing exercise

Question 5

What are the common side effects of salicylates?

Answer 5

GI irritation, tinnitus, thrombocytopenia, mild liver enzyme elevation

Question 6

What is the priority nursing intervention used with clients taking NSAIDs?

Answer 6

Administer or teach client to take drugs with food or milk

Question 7

List three of the most common joints that are replaced.

Answer 7

Hip, knee, finger

Question 8

Describe postoperative residual limb (stump) care (after amputation) for the first 48 hours.

Answer 8

Elevate residual limb (stump) for first 24 hours. Do not elevate residual limp (stump) after 48 hours. Keep residual limb (stump) in extended position, and turn client to prone position three times a day to prevent flexion contracture.

Question 9

Describe nursing care for the client who is experiencing phantom pain after amputation.

Answer 9

Be aware that phantom pain is real and will eventually disappear. Administer pain medication; phantom pain responds to medication.

Question 10

A nurse discovers that a client who is in traction for a long bone fracture has a slight fever, is short of breath, and is restless. What does the client most likely have?

Answer 10

A fat embolism, which is characterized by hypoxemia, respiratory distress, irritability, restlessness, fever, and petechiae.

Question 11

What are the immediate nursing actions if fat embolization is suspected in a client with a fracture or other orthopedic condition?

Answer 11

Notify physician stat, draw blood gases, administer O2 according to blood gas results, assist with endotracheal intubation and treatment of respiratory failure

Question 12

List three problems associated with immobility.

Answer 12

Venous thrombosis, urinary calculi, skin integrity problems

Question 13

List three nursing interventions for the prevention of thromboembolism in immobilized clients with musculoskeletal problems.

Answer 13

Passive ROM exercises, elastic stockings, and elevation of foot of bed 25 degrees to increase venous return