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test 3 Flashcards

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1
Q

hematoma

A

contusion with a large amount of bleeding

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2
Q

strain

A

stretching injury to a muscle or muscle tendon unit caused by mechanical overload
back
swelling, tenderness, sharp or dull pain

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3
Q

sprain

A

injury to a ligament surrounding a joint
loss of ability to use, rapid swelling, pain
ankle or knee

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4
Q

treatment of strains, sprains and contusions

A 
Rest
Ice-1st 24hrs
Compression
Elevation above heart
severe injury may require surgery
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5
Q

diagnosis of S,S and C

A

X-ray show fracture

MRI-soft tissue

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6
Q

meds for S,S and C

A

analgesics
NSAIDS
muscle relaxants

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7
Q

dislocation

A

loss of articulation of the bone ends in the joint capsule following severe trauma
most common is shoulder

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8
Q

assessment of dislocation

A 
5P
pain
pallor
paresthesias
pulse
paralysis
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9
Q

treatment of dislocation

A

immobilization if necessary
pain relief
pt education

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10
Q

Phases of bone healing

A

inflammatory
reparative
remodeling

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11
Q

inflammatory phase

A

bleeding at site
may not see bruising right away
tissue tear

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12
Q

reparative phase

A

callus forms
2-3 weeks soft callus
4-8 weeks hard callus
2-3 months for repair

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13
Q

remodeling

A

new bone is laid down

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14
Q

osteoblasts

A

form new woven bone

may take a yr or more

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15
Q

osteoclasts

A

dissolve away callous as it is replaced by mature bone

bone may not be completely healed when cast removed

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16
Q

healing influenced by

A 
age
health
nutrition
treatment sought
physical acitivty
location and type of fx
time for healing
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17
Q

complications of hip fractures

A 
big deal
pressure ulcers
pneumonia
anesthesia
50% of those over 80 don't go back to same living conditions
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18
Q

emergency care of fx

A

immobilization of fx
maintain tissue perfusion
open wounds

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19
Q

immobilization of fracture

A

above and below joint
maintain alignment
be creative
no stress on injury

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20
Q

maintain tissue perfusion

A

evaluate before/ after splinting

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21
Q

open wounds

A

sterile dressings

protect site from bacteria exposure

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22
Q

diagnostic tests for fx

A

history of incident and assess
x-ray
additional tests for other concerns

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23
Q

medications for fracture

A 
pain meds-narcotics
NSAIDS
antibiotics
anticoagulation
stool softener
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24
Q

NSAIDS for fx

A

beware of bleeding

may interfere with initial bone healing

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25
Q

antibiotics for fx

A

open fractures

potential for infection

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26
Q

treatment of fx

A

surgery-in OR in 6hrs
Ext fixation-pins above and below
ORIF-put in alignment

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27
Q

traction

A

application of straightening or pulling force to maintain or return fracture bone in normal alignment, prevent muscle spasms
complications of bedrest

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28
Q

complications of immobility

A

skin breakdown
problems urinating
constipation
kidney stones

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29
Q

casting

A

rigid device applied to immobilize bones and promote healing
long term splint
extends above and below fx

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30
Q

plaster cast

A

needs 48-72hrs to dry
wait to dry to bear weight
swelling will cause cast to be too tight
don’t get wet

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31
Q

fiberglass cast

A

used in ER for nondisplaced fx
hardens within an hr
can get wet

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32
Q

complications from casts

A 
compartment syndrome
fat embolism syndrome
VTE
infection
reflex sympathetic dystrophy
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33
Q

compartment syndrome

A

excess pressure in limited space constricting structures within and reducing circulation to muscles and nerves
bruising, swelling, compression
results from hemorrhage, edema or swelling
may result in ischemia
develops in 48hrs

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34
Q

symptoms of compartment syndrom

A

increasing pain in distal
decreased sensation
loss of motion
decreased distal pulses

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35
Q

interventions for compartment syndrome

A

bivalve cast
fasciotomy
elevate limb
call OR

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36
Q

fat embolism

A

fat globules lodge in pulmonary capillaries, no blood flow

long bone fracture

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37
Q

symptoms of fat embolism

A

dyspnea
cyanosis
petechiae on chest

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38
Q

VTE

A

blood clot forms in intimal lining of large vein

keep an eye on respiratory status

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39
Q

Precursors to VTE

A

venous stasis
injury to blood vessels
altered blood coagulation

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40
Q

symptoms of VTE

A

swelling
tenderness
pain sometimes

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41
Q

treatment of VTE

A 
early immobilization
TED hose
anticoagulants
heparin
coumadin
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42
Q

delayed or non-union

A 
prolonged healing of the bones beyond usual period
poor nutrition
severe trauma
age 
poor alignment
inadequate immobilization
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43
Q

treatment of delayed or non-union

A

surgery

debridement

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44
Q

amputation

A

partial or total removal of body part

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45
Q

causes of amputation

A

PVD/PAD
poor circulation
trauma
interruption of blood flow either acute or chronic

46
Q

goals of amputation

A

alleviate pain, ulcerations
maintain healthy tissue
increase functional outcome

47
Q

amputation site healing

A

assess circulation
rigid or compression dressing to prevent infection
stump wrapped in ACE wrap to prevent edema and maintain shape

48
Q

complications of amputations

A

infection delayed circulation if circulation isn’t good
chronic stump pain
phantom limb pain(lyrica,neurontin)
contracture

49
Q

repetitive use injuries

A

carpal tunnel

bursitis

50
Q

carpal tunnel

A 
compression of median nerve in wrist
numbness and tingling in thumb and index finger
pain
inferes with sleep
surgery to fix
51
Q

bursitis

A

inflammation of bursa(enclosed sac between muscle and tendon)
tender, hot, red, swollen joint with pain of flexion
shoulder and hip most common

52
Q

collaborative care of repetitive use injuries

A

pain relief-splint
increasing mobility
rehabilitation
avoid activities that increase risk

53
Q

treatment of repetitive use injuries

A

NSAIDS to decrease inflammation
steriod injections into site
immobilization
surgery

54
Q

osteoarthritis

A

most common form of all arthritis
loss of articular cartilage and hypertrophy of bones at articular cartilage
male more often until age 55

55
Q

risk factors of osteoarthritis

A 
age 
excessive weight
inactivity
strenuous, repetitive exercise
hormonal factors
genetics
56
Q

patho of osteoarthritis

A

cartilage lining joints degenerates, falls apart

bone spurs form along edges of joints

57
Q

symptoms of osteoarthritis

A 
gradual, progressive onset
pain and stiffness
referred pain
immobility
decreased ROM
boney overgrowth
58
Q

treatment of osteoarthritis

A 
Tylenol
NSAIDS
corticosteroid joint injections
PT 
rest
using ambulation devices
weight loss
analgesic and anti-inflammatory meds
surgery
59
Q

joint arthroplasty

A

total joint
most common for hips and knees
also done for shoulder and elbows

60
Q

complimentary therapies for osteoarthritis

A

magnet or copper therapy
anti-inflammatory diet
nutritional supplements
yoga

61
Q

osteoarthritis nursing care

A 
promote comfort
maintain mobility
pain 
mobility
self-care deficit
62
Q

low back pain

A

most often due to strain of muscles and tendons of back caused by abnormal stress or overuse

63
Q

patho of low back pain

A

local pain-figure out cause
radicular pain-herniated disc
muscle spasm pain-may be accompanied by poor posture

64
Q

symptoms of low back pain

A

mild to chronic pain
gait
loss of bowl or bladder movement

65
Q

treatment of low back pain

A 
NSAIDS 
steroids
avoid narcotics
lying down initially
application of heat/ice
PT
66
Q

nursing diagnosis for low back pain

A

acute pain
deficit knowledge
risk for impaired adjustment

67
Q

back pain with herniated disc

A

rupture of cartilage surround disc with protusion of nucleus pulposus
pain radiates
L4, L5, C5-6, L5-S1
changes with aging

68
Q

pahto of herniated disc

A

occurs spontaneously or with trauma
abrupt herniation causes pain and muscle spasm
gradual occurs with degenerative changes

69
Q

symptoms of lumbar disc

A

recurrent episodes of pain, radiate to butt and lower extremities
foot drop
paresthesias and numbness

70
Q

symptoms of cervical disc

A

pain in should, arm or neck

paresthesias and muscle spasm

71
Q

diagnosis of herniated disc

A

MRI
CT
X-Ray if not done before
EMG

72
Q

contusion

A

bleeding into the soft tissue
blunt force
bruise

73
Q

shingles

A 
varicella zoster virus
people over 50, especially immunocompromised
lesions follow path of dermatome
very painful
lesions 3-5 day
recovery 3-6 weeks
chicken pox vaccine
74
Q

treatment of shingles

A

nerve blocks

antiviral agents-acyclovir

75
Q

nursing diagnosis for shingles

A

acute pain
disturbed sleep pattern
risk for 2nd infection

76
Q

migraine headaches

A

dilation and inflammation of intracranial arteries

77
Q

migraine triggers

A 
stress
hormones
BS levels
fatigue
bright light
78
Q

symptoms of migraines

A 
one sided throbbing pain
hypersensitivity
pain
N/V
aura
79
Q

migraine meds

A 
NSAIDS
narcotics
caffeine containing meds
triptanes
topomax
elavil
80
Q

migraine nursing diagnosis

A

pain meds
minimize light, noise and activity
application of heat and cold
education

81
Q

seizures

A

episodes of abnormal, sudden discharge of electrical activity within the brain
idiopathic or primary
secondary or acquired

82
Q

acquired seizure cause

A

head injury
CNS infection
brain tumor

83
Q

seizure prevention

A

safety
lead poisioning
high risk pregnancy
childhood infections

84
Q

tonic-clonic seizure

A

most common in adults
aura
post idal

85
Q

complex partial

A

limited area of the brain
1-3 min
dont recall
aura

86
Q

absence

A

most common

lasts seconds

87
Q

simple partial

A

repetitive movements with memory and awareness

aura

88
Q

status epilepticus

A

lasts over 5 min

in and out for 30

89
Q

meds for control of seizures

A

IV valium

ativan

90
Q

seizure lifestyle concerns

A

eliminate factors that cause
have a regular routine
impact on employment and transportation

91
Q

seizure nursing diagnosis

A

altered brain perfusion
alteration of self image
low self esteem
anxiety

92
Q

dilantin

A 
seizure med
most widely used
empty stomach
purple glove syndrome-reaction
measle like rash-reaction
93
Q

tegretol

A

preferred due to fewer side effects
increasing doses over time
rash and photosensitivity-reaction

94
Q

depakote

A

always give with food

rare to have side effects

95
Q

trigeminal neuralgia

A

chronic disease involving cranial nerve 5
idiopathic
flu, trauma, infection

96
Q

symptoms of trigeminal neuralgia

A

sudden, severe facial pain
frequent or remission
unilateral

97
Q

triggers of trigeminal neuralgia

A

infection
viral infection
trauma
pressure on trigger zone

98
Q

meds for trigeminal neuralgia

A

anticonvulsants-tegretol
neurontin
muscle relaxants
lyrica

99
Q

microvascular decompression

A

small incision

quick pain relief

100
Q

steriotactic radiosurgery

A

elderly
radiation aimed at the spot
relief in 3-4 weeks

101
Q

rhizotomy

A

severe nerve root by injection

102
Q

tigeminal neuralgia nursing diagnosis

A

pain

risk for altered nutrition

103
Q

bells palsy

A 
7th cranial nerve disorder
unilateral weakness of the facial muscles
paralysis of the face
80% recover
self care deficit, prevent injuries
104
Q

symptoms of bells palsy

A 
minimal to severe
sudden onset
pain behind ear or jaw before paralysis
numbness/stiffness on affected side
impaired taste
105
Q

bells palsy meds

A

acyclovir-antiviral
steroids
anti-inflammatory-prednisone

106
Q

polyneuropathy

A 
more than one area affected
distal to proximal
numbness and tingling
pain
slow progression
107
Q

mononeuropathy

A

single nerve
carpal tunnel, shingles
trauma, compression

108
Q

visceral neuropathies

A

cv-no increase in HR with exercise
GI- change in motility
GU- sexual dysfuction

109
Q

meds for peripheral disorders

A

neurontin
lyrica
cymbalta

110
Q

prevention of peripheral disorders

A

irreversible
treat underlying disease
symptom managment

nursing 103 test 3 (1 decks)

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