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Med Surg Quiz #1 Term 3 > Term 3 > Flashcards

Term 3 Flashcards

0
Q

What is rheumatoid arthritis ?

A
  • A systemic inflammatory disease

- it affects the whole body

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1
Q

What are 3 different type of arthritis ?

A

Osteoarthritis
Gout
Rheumatoid arthritis

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2
Q

What are signs and symptoms of rhematoid arthritis ?

A

Painful joints

Morning stiffness

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3
Q

Why is morning stiffness common rhematoid arthritis ?

A
  • Patient did not use their joint all night

- When joint is not used it stiffens

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4
Q

What do patients with rhematoid arthritis have to do to prevent joint deformity ?

A
  • Excersize in moderation

- Pace activities

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5
Q

What caused joint deformity in patients with RA ?

A
  • immobility

- an inflammatory process

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6
Q

How long should an RA patient use their joint ?

A
  • to the point of pain

- when it becomes uncomfortable stop and rest the joint

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7
Q

When you have RA , what happens if you don’t use the joint ?

A

The tendons and ligament shrink upon contraction

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8
Q

When the tendons and ligaments shrink upon contraction , what does it cause ?

A

Joint deformities

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9
Q

What is bony ankalosis , that sometimes happen with patients with RA ?

A

An overgrowth of bones

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10
Q

What produces bony ankalosis ?

A

The osteoblasts produce it and becomes irregular and tend to infringe on other joints and break off

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11
Q

What can bony ankalosis do ?

A
  • it fuses joints together

- It’s not a good thing

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12
Q

Why do patients with RA do ROM ?

A

-it assist with the prevention & the reduction of the affects of the disease
Within the limits of pain

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13
Q

What test are done to diagnose RA ?

A
  • sedimentation

- ESR ( Erythrocyte sedimentation rate )

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14
Q

What kind of surgery is done if a joint was destroyed because of RA ?

A

Arthroplasty

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15
Q

What is arthroplasty ?

A

To repair a damaged joint orthopedicaly

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16
Q

What causes gout ?

A

An excess overproduction of uric acid

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17
Q

Where does uric acid crystals settle ?

A

In the great toe joint ( big toe joint )

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18
Q

What does the uric acid in the great toe cause ?

A

An inflammatory process

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19
Q

What type of test is done for uric acid ?

A

Uric acid test

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20
Q

What type of diet is used for patients with gout ? To limit it

A

No purine diet (organ meat )

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21
Q

What is the treatment or prevention for gout ?

A

Low purine diet

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22
Q

What kind of disease is osteoarthritis ? ( degenerative arthritis )

A
  • a degenerative disease

- wear and tear disease

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23
Q

What does osteoarthritis affect / what joint ?

A

The weight bearing joint

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24
Q

How does rhematoid arthritis affect the joint / on what side ?

A

Bilaterally

On both side

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25
Q

How/where does osteoarthritis affect the joint, on what side ?

A
  • One joint

- On one side of the body

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26
Q

What are signs and symptoms of osteoarthritis ? How does a patient feel when they wake up in the morning ?

A

Feel fine

- because joint were not being used

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27
Q

How does a osteoarthritis patient feel when they start using their joint ?

A
  • They become uncomfortable

- Patient should stop activity and rest the joint , then start again

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28
Q

What are sign and symptom of osteoporosis ? (Degenerative disease )

A

Pathological fractures

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29
Q

What causes osteoporosis ?

A
  • Decrease bone density
  • Demineralization
  • loss of phropous and calcium in the bone
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30
Q

What type of people is osteoporosis common in ?

A

Females

Post menopausesal

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31
Q

What are patient with osteoporosis more vulnerable too ?

A
  • Pathological fractures
  • Hip break (cause pt to fall )
  • Compression fracture of the vertebrae
  • pain and injury
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32
Q

Where do pathological fracture commonly occur ?

A

Hips and knees

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33
Q

What is the disease process for pathological fratures with patient with osteoporosis ?

A

Insufficient bone mass

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34
Q

What is the cause of pathological fractures with a patient with osteoporosis ?

A

Weak bones

Brittle bones

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35
Q

What is the treatment for osteoporosis ?

A

Calcium supplement
Low diet to keep phrospous and calcium in the bone
No smoking
No alcohol

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36
Q

What is osteomyelitis ?

A

-Infection of the bone surrounding tissue

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37
Q

What is osteomyelitis treated with ?

A

Antibiotics

38
Q

What is green stick fracture ?

A
  • Splinter on one side and bends on the other

- Like the branch of a tree

39
Q

What is a closed fracture (simple fracture ) ?

A

Skin intact over the break

40
Q

What is a pathological fracture ?

A
  • Osteoporosis
  • Caused by a disease
  • Malnutrition
41
Q

What is a compound fracture (open ) ?

A

Break in the skin with or without portrution of the bone

42
Q

What is the most dangerous type of fracture ?

A

Compound fracture

43
Q

What kind of shot would a patient with compound fracture get ?

A
  • Tetanus shot

- because it opens into the tissue

44
Q

What is a commutive fracture ?

A
  • bone is broken into small pieces
45
Q

What is fatty embolism syndrome ? S/s

A

Confusion
Petechia (classic )
Restlessness- as a result of hypoxia
Dyspnea

46
Q

Where are petechia found ?

A

Neck, chest , axillary area

Like a fine rash

47
Q

What is compartment syndrome ?

A

When muscle are contained within the fossia an tend to swell

48
Q

What are s/s of compartment syndrome ?

A

-Abnormal nerovascular checks
- severe pain (opioids do not relieve )
- edema
- parthesia
Numbness/ tingling
Inability to wiggle toes or feet
Absent /decrease pulse - arterial blood

49
Q

What does arterial blood do ?

A

Carries oxygen

50
Q

What is thrombosis ?

A
  • clot formation
  • positive Homans sign
  • pain / redness
  • warmth in the leg
51
Q

Post op care for RA/OA

A

Respiratory and circulatory complication

For replacement -Drains in the knee or hip joint

52
Q

What are nursing intervention for RA /OA after surgery ?

A

Check gravitational bleeding / slide your hand under the pt and feel

53
Q

What is gravitational bleeding ? Hip or knee surgery

A

Seeking the lowest point

Behind the neck , buttocks or knee

54
Q

What are we checking when doing nerovascular check ?

A 
Loc
Pulselessnes distal and proximal 
Sensation 
Capillary refill 
Color - should not be blanch or cynotic  
 temp /Warm
55
Q

How can you tell if a pulse is absent or different from each other ?

A

Check them together at the same time ?

56
Q

Where do you check capillary refill and for how long ?

A

The toe or thumb for 3 sec

57
Q

What is the best way to change a patient in traction bed linens ?

A

Top to bottom
Bottom to top
Avoid changing side to side

58
Q

If your caring for a cast in traction and you don’t get out of bed , what good body mechanics would you use ?

A

Wide sterdy base

It decrease the risk of injury

59
Q

If your having hip replacement surgery what don’t you want to do ?

A
  • Don’t internally rotate the feet (stand pigeon toe
  • don’t bend over to pic up items of the floor (pop ball out of the acetabulum )
  • don’t sit with legs crossed ( it put strain in the joint )
60
Q

If a patient is in skinner skeletal traction, what is the purpose of good body alignment ,o

A
  • for healing purposes
  • To keep the bone in alignment
  • to prevent muscle spasm
  • To prevent contracture from happening
61
Q

How do you handle a wet cast / new ?

A

Palms of the hand

62
Q

What do we have to be concerned about with cast care ?

A

Skin integrity

Sensation

63
Q

What is bucks traction ? (Skin traction )

A

A straight pull on the limb

64
Q

What is Bryant’s traction ? (Skin traction )

A
  • Vertical extension of the lower extremities
  • used with children only
  • butt if off the bed
65
Q

What is Russell traction ? ;Skin traction )

A

Popliteal Sling placed behind the knee/neck to create upward pull of the knee (for femur fracture )

66
Q

Skeletal fracture

What is Kirshner wire or steimann pins

A
  • Surgically inserted through the skin and bones

- sterile procedure

67
Q

What is crucfield ? (Skeletal fracture )

A

For spinal fracture

Inserted in the skull

68
Q

What is halo ? (skeletal traction)

A
  • For cervical fracture

- Pins , wire , tongs

69
Q

How do you care for pins ?

A

One swab per pin
Use hydrogen peroxide or Benadine ( depend on the facility )
Normal saline

70
Q

What kind of procedure is used for pins ?

A

Sterile procedure

Sterile gloves

71
Q

What is traction ?

A
  • Balance traction
  • Pullin traction in two direction to align the bone
  • Body acts as counter traction
72
Q

How do you decrease osteoporosis ?

A
  • Regular excersize w / weight bearing
  • Decrease weight to normal
  • Dietary prevention
  • encourage activity
73
Q

How do you care for patients equipment ?

A
  • Inspect ropes , polleys , knots are in alignment
  • the ropes are not frail
  • check for skin care
74
Q

If a patient is inambulatory what do you want to make sure they have ?

A

Adequate hydration

-2000- 2500 cc a day

75
Q

When we have a patient that had amputation , what type of contractures are we concerned about ?

A
  • hip flexion contracture

contractures are shorting of the muscle

76
Q

What kind of position do we expect the doctor to order for and amputation patient ?

A
  • prone position

- 1-2 hrs or as ordered

77
Q

When you have a patient in traction , what do you do with the weight ? Or if the pt is on the floor

A

Don’t touch it

  • if pt on floor pull them up
  • do not change or discontinue the weight
78
Q

What is the best position for a fracture hip / prothethesis pt be kept in ?

A

-Abduction
- if hip abduction pillow
physician can make a order to be turned on any side (specified)

79
Q

A patient that has been on bedrest for a Long time (fracture ,muscle spasm ) what complication can they have , when getting out of bed ?

A

Decrease b/p

Othostatic hypotension

80
Q

What do you do to prevent orthrostatic hypotension ?

A

Dangle the patient

81
Q

When a patient have a fiberglass or plater how should it be position ?

A
  • Elevate above heart level to prevent edema
  • Check toes and fingers for circulation
  • Do not place the cast in a dependent position
82
Q

Before a patient have a planned surgery what should they do ?

A
  • go to rehab

- visit other amputees

83
Q

What is lordosis ?

A

Increase causing Swayback

Curvature of the lumbar

84
Q

What is kyphosis ?

A

Hunchback

Curvature of the Thoriac cavity

85
Q

What is scoliosis ?

A

Unilateral or bilateral curvature

Curvature of lumbar spine

86
Q

Patient with OA , do what kind of procedures on outpatient basis ?

A

Orthoscopic 3-4 incision on the knee

Done under general anesthesia

87
Q

What kind of bandage are patient that had othroscopic produces sent home with ?

A
  • Bandaid on the incision and ABD pad
  • Ace bandage on the entire knee to prevent edema
  • do a neuro check on patient
88
Q

What do you do if you go into a patient room and see something abnormal ?

A

Do a through assessment
Pain assessment
Neuro assessment

89
Q

What sign is associated With DVT ?

A

Homans sign

90
Q

Compression fractures of the vertebrae is common with what type of patient ?

A

Osteoporosis

91
Q

Bouchard’s nodes:

A

:

enlargment of proximal interphalangeal joints

92
Q

Herberden’s nodes

A

OA, appear on dorsigluteal aspect of the distal interphalangeal joints, joints closest to the ends of fingers and toes.

Med Surg Quiz #1 Term 3 (1 decks)

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