Musculoskeletal System Flashcards
What are the common symptoms of rheumatoid arthristis?
- morning stiffness
- weight loss
- swelling of both hands and wrists
What methods would a nurse use to assess rheumatoid arthritis?
- Inspection
- Palpation
- strength testing
- Avoid ROM b/c ROM promotes pain
What activity recommendations should the nurse provide to a client with rheumatoid arthritis?
- Do not exercise painful, swollen joints
- Do not exercise any joint to the point of pain
- Perform exercises slowly and smoothly; avoid jerky movements
Avoiding sunlight is key in the management of
Lupus erythematosus
What four factors trigger lupus?
- Sunlight
- Stress
- Pregnancy
- Drugs
What population is at the highest risk for osteoporosis?
Postmenopausal, thin white women.
What is a great source of calcium that is available over the counter encouraged for osteoporosis?
Tums
The main cause of factures in older adults is
Osteoporosis
What are the four classifications of fractures
Complete: A break across the entire cross section of the bone
Incomplete: A break across only part of the bone
Closed: No break in the skin
Open: Broken bone protrudes through skin or mucous membranes
What type of fracture is more difficult to heal: An extracapsular fracture or an intracapsular fracture?
Intracapsular because of a decrease in blood flow
How do you properly used crutches?
The client advances both crutches and the impaired leg at the same time. The client then swings the uninvolved leg a head to the crutches
What side is the cane placed on?
The affected side
What time frame is a patient most at risk for developing a fat emboli post fracture?
36 hours
What is the initial symptom of a fat emboli?
Confusion due to hypoxemia
In clients with hip fractures what is the most common complication?
Thromboemboli
What are prevention strategies for thromboemoli?
- Passive ROM
- use of elastic stockings
- elevation of the foot of the bed to 25 degrees
- low dose heparin therapy
Where do you check for compartment syndrome?
Distal to the injury
What are the 5P’s for neurovascular functioning?
Pain Paresthesia Pulse Pallor Paralysis
What is the biggest complication post op for a joint replacement/.
Infection
Fractures of bone predispose the client to anemia, especially if long bones are involved. Check pts hematocrit….
every 3-4 days to monitor erythropoiesis
What complications are immobile clients prone to
- Skin integrity
- formation of urinary calculi- limit milk
- venous thrombosis
How long do you elevate the stump post operatively?
24 hours
What happens if the stump is elevated too high?
contracture
What time frame do you not elevate the stump?
after 48 hours
how often does an amputee need to be in the prone position?
Three times a day to prevent hip flexion contracture
Differentiate between RA and OA in terms of joint involvement?
RA - occurs bilaterally
OA- occurs asymmetrically
Identify the categories of drugs commonly used to treat arthritis
- NSAIDS
- Corticosteroids
Identify pain relief interventions for clients with arthritis
- Warm, moist heat
- Diversionary activities
- medications
What measures should the nurse encourage female clients to take to prevent osteoporosis?
- Possible estrogen replacement after menopause
- High calcium and vitamin D intake beginning in early adulthood
- Calcium supplements after menopause
- weight bearing exercise
What are the common side effects of salicylates?
- Gi irritation,
- tinnitus
- thrombocytopenia
- mild liver enzyme elevation
What is the priority nursing intervention used with clients taking NSAIDS
Administer or teach clients to take drugs with food or milk
List three most common joints that are replaced
Hips
Knee
Finger
Describe postoperative residual stump care for the first 48 hours
- Elevate residual limb for the first 24 hours
- Do not elevate residual limb after 48 hours
- Keep residual limb in the extended position
- Turn client prone three times a day to prevent flexion contracture
Describe nursing care for the client who is experiencing phantom pain after amputation
Be aware that phantom pain is real and will eventually disappear. Administer pain medication . Phantom pain responds to medication
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?
A fat embolism
What are the immediate nursing actions if fat embolism is suspected in a client with a fracture or other orthopedic condition?
Notify the physician stat, draw blood gases,
administer o2 according to blood gas results, assist with endotracheal intubation and treatment of respiratory failure
List three problems associated with immobility?
Venous thrombosis
urinary calculi
skin integrity problems
List three nursing intervention for the prevention of thromboembolism in immobilized client with musculoskeletal problems.
- Passive ROM
- elastic stockings
- elevation of the foot of the bed to 25 degrees to increase venous return.
