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Practical nursing 102 > Unit 4 > Flashcards

Unit 4 Flashcards

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1
Q

What is fibromyalgia?

A

a disorder characterized by widespread musculoskeletal pain accompanied by pain, fatigue, and sleep/mood issues

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2
Q

tx for fibromyalgia

A 
pain-relievers
antiseizure drugs
anti-depressants
Physical therapy
occupational therapy
counseling
acupuncture
massage therapy
yoga
tai chi
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3
Q

What is something to teach a pt with fibromyalgia

A 
stress management
sleep hygiene
exercise regularly
pace yourself
maintain a healthy lifestyle
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4
Q

what is an amputation?

A

the removal of a limb due to disease process or trauma

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5
Q

What are some concerns after surgery?

A

depressing, bleeding/hemorrage, contractures, DVT, PE, pain control

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6
Q

How does an amputation effect one’s mobility

A

they often have to learn how to walk with a prosthesis or move with a wheelchair

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7
Q

What is OA?

A

Osteoarthritis a disease of the joint that affects all the joints structure. Cartilage and bone ends slowly break down.

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8
Q

Risk factors for OA

A

Heredity, age, obesity, activities causing stress

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9
Q

What is RA

A

Rheumatoid arthritis.
a chronic, progressive, systematic inflammatory disease that destroys synovial joints and other connective tissues, including organs, joints become deformed.

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10
Q

What is the main difference between OA and RA

A

OA the joint is inflammed

RA the joint is deformed

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11
Q

Believed causes of OA or primary causes

A

Primary-idiopathic (cause unknown)
obesity
activities causing joint stress
overuse

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12
Q

Known causes of OA or secondary causes

A 
trauma
sepsis
congenial abnormalities
metabolic disorders
rheunatoid arthriis
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13
Q

Believed causes of RA

A

peridonatal disease, family hx

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14
Q

Known causes of RA

A

Autoimmune

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15
Q

Treatments for OA

A 
Exercise
weight control
muscle relaxants
Acetaminophen
heat and cold therapy
surgery
complementary and alternative therapies(acupressure, hydrotherapy, imagery, music therapy)
Total joint replacement therapy
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16
Q

Treatments for RA

A 
Antibiotics, 
heat and cold therapy, NSAIDS, 
biological response midifier, 
Prednisone, 
Disease modifying anti rheumatic drug (DMARD), 
T-cell modulators, 
balanced rest and activity
Surgery for total joint replacement
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17
Q

diagnostic testing for OA

A

X-Ray, MRI

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18
Q

Diagnostic testing for RA

A

Labs: increased WBC and PLT
IGG test
MRI

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19
Q

early S/S of RA

A

Bilateral and symmetrical joint inflammation
redness, warmth, swelling, stiffness, pain
Stiffness after resting (morning stiffness)
Activity decreases pain and stiffness
low-gread fever, weakness, fatigue, anorexia (mild weight loss)
organ system involvement

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20
Q

Late S/S of RA

A

Joint deformity

Secondary osteoporosis

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21
Q

S/S of OA

A

Joint pain and stiffness occur
Pain increases with activity and decreases with rest
Nodes on joints of fingers appear (heberdennodes, bouchard nodes)

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22
Q

When instilling eyedrops and eye ointments what is the frist thing one should do?

A

Assist the pt to a sitting position with their head tilted back slightly

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23
Q

When instilling eye drops or eye ointments what should you do with the lower lid?

A

pull it down to expose the conjunctival sac

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24
Q

How long should pt keep their eyes shut after instilling eye drops or ointment

A

1-2 mins

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25
Q

What should you always avoid when instilling eye medications

A

Always avoid the tip of the bottle or tube to the eye because this can cause pathogens to enter the medication

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26
Q

What should you instruct the pt to do after you instill eye ointment?

A

cloase eyelids for 2-3 mins and gently move eyes around under the lids.

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27
Q

How high do you hold the eyedropper above the eye when instilling eye drops?

A

1/2 - 3/4 in

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28
Q

What are flexion contractures?

A

Permanent muscle contractions with fibrosis of connective tissue that occue from lack of use of a muscle or muscle group

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29
Q

What are flexion contractures specific to?

A

Usually amputation due to improper movement that decrease the angle bewteen two adjacent bones. More likely with hip or knee joint

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30
Q

What does a flexion contracture prevent?

A

walking with a prosthesis

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31
Q

Ways to avoid flexion contractures

A

Avoid sitting straight up for long periods
pt should lay prone for 30 (or as long as tolerated) for 3 times a day to help prevent
Trapeze bar can help with strengthening upper body muscles

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32
Q

What causes Flexion contractures?

A

Poor positioning after amputation
Sitting for long periods of time after an amputation
Elevated stump more than 24 hrs

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33
Q

What is a facture?

A

A break in a bone usually secondary to trauma or a pathological condition.
Can be minor and treated on an ambulatory basis or complex with surgical intervention and rehabilitation

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34
Q

How can a fracture be treated

A 
Closed reduction (internal)
Slpints
CAsts
traction
open reduction (surgical) with internal fixation
external fixation
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35
Q

S/S of something being wrong with a fracture

A

Pulslessness, cool skin, dusky skin color, numbness, tingling (neurovascular)
Warmth, redness (infection
Monitor vitals (hemorrage)
ShOB, swelling or tightness in extremity (DVT, PE)
6 P’s of compartmental syndrome
Fat embolism

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36
Q

Early signs of a fat emoblism

A

Pulmonary; Dyspnea, tachypnea, cyanosis

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37
Q

Main signs of a fat embolism

A

REspiratory distress, cerebral involvment (drowsiness, confusion, skin patechia)

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38
Q

Causes of low back pain

A

Most prevalent from age 30-60
FAmily hx of back pain or hx of back injury
Job or occupation that requires heavy lifting, twisting or repettitive
Smoking (linked disk degeneration)
Overweight
Having poor posture
osteoarthritis

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39
Q

S/S of lower back pain

A

Dull or Sharp low back pain usually constant
Possible stiff, flexed posture
Pain aggravated by coughing, sneezing or straining
Muscle spasams, cramping, stiffness, often ina location closest to the affected disk
pain radiates to the buttocks
sciatic nerve compression
numbness/tingling of the leg

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40
Q

What kind of positioning is important for low back pain?

A

Semi-flowlers with pillow under flexed knees can alleviate pain associated with LBP from a herniated disk
When sitting in a recliner, elevate the head and legs
Avoid twisting and turning the vertebral column while changing position
Sleep on a firm matress

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41
Q

What is MS?

A

Multiple sclerosis.
A chronic neurological disease that typically resulting in impaired and worsening function of voluntary muscle. It is a autoimmune disorder that affects nerve cells in the brain and spinal cord

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42
Q

Probable causes of MS

A

Occurs twice as often in females
Onset beteen 20-40 yrs of age
Smokers
those with vit D deficiencies

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43
Q

ACTUAL causes of MS

A 
Viruses/infectious agents
environmental stressors (temp)
Physical injury
Emotional stress
pregnancy
fatigue
overexertion
Hot shower/bath
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44
Q

S/S of MS

A 
Fatigue
pain/paresthesia
Diplopia, changes in peripheral vision, decreased visual acuity, scotomas (patches of blindness), periods of blindness
Temporary or worsening of vision and other neurologic functions after exertion or exposure o heat
Temporary tinnitus, vertigo, decreased hearing acuity
Dysphagia
Dysarthria (slurred and nasal speech)
Muscle spasticity
Ataxia or muascle weakness
Nystagmus
Bowel dysfunction 
Cognitive changes
Sexual dysfunction
 Anger, depression, euphoria
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45
Q

How do Visual disturbances usually occur with MS

A

In one eye at a time

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46
Q

How does muscle spasticity effect MS pt’s?

A

It causes bowel and bladder dysfunction, constipation, areflexia (muscles do not respond to stimuli), urgency nocturia

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47
Q

What are the neuro effects MS has on pt’s?

A

Difficulty concentrating or forgetfulness

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48
Q

MS pt’s have muscle weakness and fatuige which makes them what kind of risk?

A

Fall risk

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49
Q

How is death for MS pt’s commonly caused?

A

Pnemonia around 20-35 y/o

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50
Q

What is neurogenic shock?

A

Nervous system injury or dysfunction that causes extensive dialation of peripheral blood vessels.

51
Q

What are some causes of neurogenic shock?

A

Spinal cord injury, general anesthesia, fever, metabolic disturbances, and brain contusion and concussion

52
Q

S/S of the early phase of neurogenic shock

A

Hypotension, AMS, bradycardia, warm, dry skin

53
Q

S/S of the late phase of neurogenic shock

A

Tachycardia, tachypnea, cool clammy skin

54
Q

Races at highest risk for neuropathy:

A

Native Americans, hispanics, African Americans

55
Q

What is neuropathy?

A

Nerve damage outside of the brain and spinal cord causing weakness, numbness and pain usually in the hands and feet. It can also effect other areas of the body.

56
Q

What can cause neuropathy?

A 
Autoimmune diseases
Diabetes
Infection
Inherited disorder
connective tissue disease
hypothyroidism
Tumors
Exposure to toxins
Bone marrow disorder
Alcoholism
Medications
Trauma
Pressure on the nerves
Vitamin deficiencies (vitamin B, E, and nicacin)
57
Q

S/S of Neuropathy

A

Intense, shooting, burning, or described as pins and needles

58
Q

What is osteoperosis

A

(porous bone) a metabolic disorder in which there is low bone mass and deterioration of bone structure, resulting in fragile bones that are prone to fracture.

59
Q

S/S of osteoperosis

A 
Bone fracture (often first sign)
Have a vertebral compression fracture
loss of height--up to 6 in
development of a curved spine (kyphosis)
back pain
increased fatigue
depression
ADL's may be limited
60
Q

Tx for osteoperosis

A 
Calcium
Vitamin D
Weight bearing exercises
Medications (antiresorpitive meds, anabolic meds)
Diet
61
Q

Way to prevent Osteoperosis:

A 
Practicing a healthy lifestyle
Consuming recommended amounts of calcium 
Vitamin D
Weight bearing exercises
avoiding alcohol
not smoking
Bone density scan
62
Q

Recommended amount of calcium

A

1,000 mg/day for 10-50 yrs

1,200 mg/day for 50 + y/o

63
Q

Recommended amount of Vitamin D

A

600 IU 15 mcg/day for 1-70 y/o

800 mg IU 20mg for 71+

64
Q

That is range of motion?

A

the movement of a body part or joint to help prevent contractures

65
Q

Active range of motion

A

Pt does not need help

66
Q

Passive range of motion

A

Pt DOES need help

67
Q

When preforming ROM you should never what?

A

Move joint past the point of resistance or pain

68
Q

How do you assess active ROM?

A

Have pt repeat movements while nurse demonstates

69
Q

When do you admin pain meds for ROM?

A

30 mins before exercise

70
Q

How often should TCD be preformed?

A

every 2 hr

71
Q

How high should the bed be to help prevent a PE?

A

45 degree angle

72
Q

What postion should be encouraged to help prevent PE?

A

Veritical rather than horizontal

73
Q

How often should the incentive spirometer be encouraged

A

Taking 10-20 deep breaths every hr

74
Q

What is a sprain?

A

An excessive streching of ligaments from twisting movements during sports activity, exercise, or fall

75
Q

How is a sprain diagnosed?

A

X-ray
MRI
CT-scan
Ultrasound

76
Q

Pharmacological treatments for sprains

A

NSAIDS
Ibuprofen
Naproxen
Acetaminophen

77
Q

Non-Pharmacological tx for a sprain

A 
RICE
Rest
Ice
Compression
Elevate
14-20 on/off
78
Q

What is a cast?

A

A way to provide stronger support for fractures

79
Q

Walking cast

A

a cast with a rubber walking pad at the bottom to assist with ambulation

80
Q

Spica casts

A

a portion of the trunk and one or two extremities; typically used on children who have congenital hip dysplasia

81
Q

Body cast

A

encircles trunk of body

82
Q

Plaster casts

A

heavy
not water resistant
can take 24-72 hr to dry

83
Q

Synthetic fiberglass casts

A

light, stronger, water resistant, dry very quickly (in 30 mins) and are most used

84
Q

What is fibromyalgia?

A

a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues

85
Q

What are suspected causes of fibromyalgia?

A

Genetics
Infections
psychological stress
physical trauma

86
Q

What are S/S of fibromyalgia?

A

widespread pain
fatigue
cognitive difficulties

87
Q

What are some tx for fibromyalgia?

A

antidepressants, pain relievers, physical therapy

88
Q

Testing for fibromyalgia

A

CBC

Pain for 3 months

89
Q

An antispasticity agent, skeletal muscle relaxant

A

Baclofen

90
Q

An antispasticity agant that can improve bowel and bladder function for MS pt’s or spinal cord injury pt’s

A

Baclofen

91
Q

Antispasticity agent that can cause drowsiness or dizziness

A

Baclofen

92
Q

What symptoms should be reported to the doctor?

A

Frequent urination
bowel issues
confusion
ringing in the head

93
Q

If you miss a dose of Baclofen it should be taken…

A

within an hour and NEVER double dose

94
Q

If a pt experiences AMS when taking Baclofen nurse should

A

Discontinue immediately

95
Q

Baclofen should be taken with…

A

Food or milk to decrease gastric irritation

96
Q

When taking cymbalta what should be assessed before during therapy?

A

Suicidal Ideaions

97
Q

Pt’s taking cymbalta should be monitored for…

A

Seritonin Syndrome

98
Q

When a patient is taking cymbalta they should be told to rise…

A

slowly because of orthostatic hypotension

99
Q

An antidepressant that is often used for pt’s with fibromyalgia and neuropathy

A

Cymbalta

100
Q

How long after disconinuing an MAO inhibitor can you start taking cymbalta?

A

14 days

101
Q

Cymbalta can cause an increased risk of

A

Low BP

102
Q

When cymbalta is given too close to an MAO inhibitor it can cause

A

fatal reactions such as heart irregulate and elevated temps

103
Q

A topical pain med used for rheumatoid arthritis or osteoarthritis.

A

Capsaicin

104
Q

Pain should be assessed before during and after therapy

A

Capsaicin

105
Q

If capsaicin gets in the eyes…

A

area should be flushed with water and washed with warm water

106
Q

Capsaicin can increase

A

Blood pressure

107
Q

When tx herpes or shingles with capsaicin you should not apply cream until

A

lesions have healed completely

108
Q

Muscle relaxant used for patients with spinal cord innjury’s, stroke’s, cerebral palsy, or MS

A

Dantrium

109
Q

Dantrium causes

A

Photosensitivity
falls
drooling

110
Q

Dantrium requires periodic testing to monitor

A

CBC and Liver/renal function

111
Q

Dantrium is used for the emergency tx of

A

maligant hypothermia

112
Q

If gastric irritation becomes a problem then…

A

capsules can be opened and put into fruit juices or other liquids

113
Q

When taking dantrium If diahrrea persists

A

Drug should be discontinued

114
Q

an antifibromyalgia agent that can cause neuroleptic malignant syndrome and cannot be taken with MAO inhibitors

A

Savella

115
Q

What should be assessed before and during savella therapy?

A

Suicidal ideations

116
Q

neuroleptic malignant syndrome

A

106-110 fever during surgery

family hx increases chances

117
Q

Anantidepressant used to tx anxiety, insomnia, tx resistant depression, and chronic pain syndromes

A

Amitriptyline

118
Q

During the emergency management of a fracture, you should olf splint the affected limb if…

A

there is NO bleeding

119
Q

During the emergency management of a fracture, if you find there is bleeding you should

A

what to splint and apply pressure

cover the pt to preserve body heat until limb can be assessed.

120
Q

During emergency management of a fracture, how would you splint the affected limb if it was a leg?

A

assess for bleeding first
It can be splinted to the other leg
if you have to move it support the limb above and below the fracture site.
apply splint and padding over clothing
Assess for color warmth circulation and movement

121
Q

During emergency management of a fracture, how would you splint the affected limb if it was an arm

A

Assess it for bleeding first
It can be splinted to the chest
if the limb as to be moved then support it above and below the fracture site.
Apply splint and padding over clothing
Assess for color warmth circulation and movement

122
Q

During the emergency management of a fracture, if you find the bone is protruding what should you do?

A

Cover with clean (sterile preffered) dressing

123
Q

During the emergency management of a fracture, should you attempt to realign or straighten the extremity?

A

NO

124
Q

During the emergency management of a fracture, what should you do after splint and padding is applied?

A

assess for color, warmth, circulation, and movement

Practical nursing 102 (5 decks)

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