Muskuloskeletal Disorders

Question 0

2 best txt for lower back pain

Answer 0

Good body mechanics and losing weight

Question 1

5 P’s for neurovascular assessment

Answer 1

1. Pain
2. Paralysis
3. Parasthesia
4. Pallor
5. Pulselessness

Question 2

Risk factors for osteoporosis (modifiable)

Answer 2

Decrease in calcium and/or vit D, caffeine, nicotine, alcohol, medications

Question 3

Meds for osteoporosis

Answer 3

Calcitonin, Fosamax

Question 4

Contraindications for calcitonin

Answer 4

Seafood allergy

Question 5

Administration of Fosamax

Answer 5

1. Do not take with calcium or vit D supplements!
2. Take on empty stomach with full glass of H2O
3. Sit up for 30-60 mins after taking

Question 6

Osteomalacia

Answer 6

Vit D is deficient and the none cannot use Ca and phosphorus adequately

Bone becomes weak and soft

Question 7

Hallmark sign of osteomalacia

Answer 7

Decreased serum Ca and phosphorus

Question 8

Treatment for osteomyelitis

Answer 8

IV abx 3-6 weeks, then PO up to 3mo

Question 9

Septic/infectious arthritis

Answer 9

• Usually caused by staph
• warm, painful, red, edematous joint
• decreased ROM and systemic signs of infection

Question 10

Contusion

Answer 10

Bruising

Question 11

Strain

Answer 11

PULLED muscle or tendon

Question 12

Sprain

Answer 12

Injury

Question 13

Why is a joint dislocation an orthopedic emergency?

Answer 13

It can cause AVN-bone becomes necrotic from lack of blood flow

Question 14

Nursing mgmt of fractures

Answer 14

• Assess 5 P’s
• Remove constrictive clothing and cover open areas with sterile dressing
• Immobilize extremity
• Safety!

Question 15

S/Sx of fat embolism

Answer 15

Hypoxia
Tachypnea
Tachycardia
Chest pain
Fever
AMS
Cough w thick white sputum

Question 16

What do you do if you suspect a fat embolism?

Answer 16

1. Place in high-Fowlers
2. Put on O2
3. Call for help- do not leave your pt!

Question 17

2 hallmark signs of compartment syndrome

Answer 17

• pain that is unrelieved by meds

* pain with passive ROM

Question 18

Mgmt of compartment syndrome

Answer 18

1. Unwrap any compression dressings immediately!
2. Elevate
3. Notify surgeon

Question 19

What should you do before placing a Foley in a pt with a pelvic fracture?

Answer 19

CT should be done ASAP to assess internal damage

Question 20

How should the HOB be positioned with a thoracolumber spine fracture?

Answer 20

Less than 30 degrees

Question 21

NSG care of casts/splints/braces

Answer 21

5 P’s assessment
Support cast on smooth, firm surface while drying
Ice for pain ONLY AFTER cast is FULLY DRY

Question 22

S/sx of pressure ulcer under cast

Answer 22

Area of warmth on cast, drainage, odor

Question 23

Pin care

Answer 23

Sterile procedure
1-2X/day
Can use chlorhexidine, hydrogen peroxide, or saline

Question 24

Levels of amputation

Answer 24

Syme: removes foot @ ankle level
BKA- below knee
AKA-above knee
Upper extremity

Question 25

Complication after amputation- what do you NOT do that could cause a contracture?

Answer 25

DO NOT place residual limb on pillow as it can form a hip flexion contracture

Question 26

Mgmt for phantom limb pain

Answer 26

Increase activity

Tell pt this is very common

Question 27

goals of joint replacement (arthroplasty)

Answer 27

Pain relief and maximization of ROM

Question 28

NSG mgmt of a joint replacement

Answer 28

Ambulatory/PT needs to begin w/in 24hrs

Question 29

Special post-op precautions to avoid dislocation in a pt with a total hip arthroplasty (THA)

Answer 29

• do not bend hip >90 degrees
• no sitting >45 mins
• do not turn affected leg inward or cross center of body
• no flexion, internal, or external rotation
• abduction pillow and raised toilet seat

Question 30

Normal post-op drainage for a THA

Answer 30

• 200-500mL for first 24 hrs

* 30mL/8hr at 48hrs post-op

Question 31

Care for post-op TKA

Answer 31

Compression bandage and ice

Question 32

Normal post-op drainage for a TKA

Answer 32

No more than 400mL for first 24hr

<25mL by 48hrs