Quiz 4 Flashcards
Abduction
moving away from midline of body
Adduction
moving toward midline of body
Dorsiflexion
toes point up toward ankle
Plantar flexion
toes point away from ankle
Pronation
face down
Supination
face up
What is one side effects of steroids? What do steroids do to osteoclast function?
decreased bone density
steroids double the activity of osteoclast function
What do ligaments connect?
bone to bone
What do tendons connect?
bone to muscle
What is the difference between a sprain and a strain?
sprain = ligament
strain = tendon
What is Carpal Tunnel Syndrome?
compression of the median nerve (using wrist alot)
unilateral numbness and tingling
What is Tinel’s Sign?
percussion over the median nerve = sharp pain
What is osteoarthritis?
bone to bone contact during movement = pain and inflammation
Describe pain with osteoarthritis vs rheumatoid arthritis
OA: pain improves w/ rest
RA: pain improves w/ activity
Why are both obesity and being an athlete risk factors for OA?
both putting stress on weight bearing joints
What are assessment findings for OA?
HBC (distal to proximal)
Heberden’s node
Bouchard’s node
CMC joint
What is Rheumatoid arthritis?
autoimmune disease
inflammation of joints
What is the tx for RA?
DMARDs (methotrexate)
heat or warm baths
physical activity
What should one monitor when taking DMARDs?
opportunistic infections bc drug is immunosuppressant
- fever
- unexplained cough (tuberculosis)
- skin and oral lesions
What are assessment findings of RA?
Baker’s cyst - flare up - (behind knee or elbow)
ulnar deviation (late sign)
synovitis in PIP joints
swan neck deformity of joints
What is compartment syndrome?
trauma or casts creates pressure – muscle inflames – muscle dies bc no perfusion
What are the 5Ps of neuromuscular assessment for compartment syndrome?
Pain - out of proportion to injury
Paresthesia
Pulse - late sign - no pulse
Pallor
Paralysis
What can be done to tx compartment syndrome?
fasciotomy
cutting into muscle so muscle can expand
can’t stitch – pack it instead
What is rhabdomyolysis?
breakdown of skeletal muscle from injury, exercise, or muscle contraction
skeletal muscle breaks down–myoglobin in bloodstream–harmful to kidneys–untreated leads to acute kidney injury and/or renal failure
What are the assessment findings of rhabdomyolysis?
fatigue
malaise
oliguria (decreased urine)
confusion
agitation
tea-colored urine
Why is a geriatric patient at risk for rhabdomyolysis after a fall?
if found down for days = no water being drank
What is kyphosis?
hunched back (upper spine)
What is lordosis?
inward curvature of lower spine
What is scoliosis?
lateral curvature of spine
tx: brace or sx
What is gout?
gouty arthritis
attack of pain, inflammation, tenderness of joint
bc of uric acid crystal deposits into joint cavity from high uric acid levels in blood
How is gout treated?
chronic gout: allopurinol (hard on kidneys)
acute gout: PO steroids, NSAIDs, colchicine
What are the assessment findings of gout?
pain
tenderness
redness/warmth
limited ROM
high purine diet (rich person’s diet)
What is important to remember when treating post op patients?
pain and trauma from sx can increase serum blood glucose
What is Buck’s traction? When is it done?
weight pulls leg straight
before sx
What are considerations for post-op THA pts?
avoid bending hip past 90 degrees
no crossing legs
no making figure 4s
abduction pillow
What is Cauda Equina Syndrome?
bilateral lower extremity pain, weakness, and sensory/motor deficits
bladder/bowel incontinence (hallmark symptoms)
emergency bc if left untreated = permanent
What is used after a total knee arthroplasty? What should one be cautious when using?
CPM machine (continuous passive motion machine)
cautious: deep tissue injury or pressure injuries
- make sure areas are padded
What is a hemovac drain?
pulls blood out of joint to prevent hemarthrosis which can lead to hematoma
What are used after a total shoulder arthroplasty?
Donjoy or shoulder sling
What is phantom limb pain? What is the tx?
pain in area where there is a missing limb
tx: mirror therapy (helps brain come to terms)
What is an external fixator? How is it cleaned?
pins and screws above and below fracture to provide stabilization
clean around pins
What is a laminectomy?
removes lamina to decompress the spine
What is a spinal fusion?
joining to or more vertebrae to relieve pain/discomfort
What is a discectomy?
removal of herniated disc to relieve pressure on compressed nerve
What are nursing considerations for post op spine sx pts?
dural tear = pt lies flat 12-24 hrs
logrolling to prevent twisting spine
always have brace before getting out of bed
Cranial nerve II
2
optic nerve (vision)
Cranial nerve V
5
trochlear nerve (chew)
Cranial nerve VII
7
facial (smiling)
Cranial nerve IX
Cranial nerve X
9 glossopharyngeal
10 vagus
(swallow)
What is a cerebrovascular accident? What are the types?
stroke
Hemorrhagic stroke (build up of pressure)
- intracerebral hemorrhage
- subarachnoid hemorrhage
Ischemic stroke
- thrombotic stroke (caused by atherosclerosis)
- embolic stroke (screen for smoking - afib)
- watershed stroke
What medications are used to prevent CVA?
heparin
enoxaparin
lovenox
Why does taking birth control put a pt at risk for a clot?
estrogen increases clotting factors
What electrolyte imbalances cause deep tendon reflexes?
calcium and magnesium
hyper: hyporeflexia
hypo: hyperreflexia
What gait is seen in cerebral palsy?
scissored gait
What is foot drop?
peroneal nerve injury, happens after hip or knee sx
can be seen in bed bound pts
What is menigitis?
inflammation of membranes in brain
s/s: nuchal rigidity, fever, pain, photophobia, N/V
dx: lumbar puncture
precautions: droplet
How can you test for menigitis?
assess neck mobility
Brudzinski’s sign: knees come up when neck is up
Kernig’s sign: pain when legs straight
Describe epidural and subdural hematoma
epidural: above dura mater (fast bleed)
subdural: below dura mater (slow bleed)
What is a consequence with increased intracranial pressure?
brain death
- anisocoria
- pupils blown
How can ICP be decreased?
craniectomy (skull flap taken to relieve pressure)
hypertonic IV fluids - 3% NaCl
