VN 36 test 7 ortho

Question 1

1a. Arthroscopy nursing considerations (pp slide 9 & pg.838):

Answer 1

(Inspection using arthroscope after local anesthetic/injury: AEB swelling & redness, deterioration also able to therapeutic)
 wrap in compression, elevate, ice
 acetaminophen for mild pain
 Ensure that the client has signed the informed consent form.
 Verify that the client has been NPO for at least 6 hours.
 Administer preoperative medications, if ordered.
 Instruct client to report unusual pain, bleeding, drainage, or swelling at the arthroscopic site.
 Advise client to resume usual diet as tolerated.
 Review discharge instructions with the client and explain medication regimen.
 Inspect dressing before discharge.

Question 2

1b. Electromyography nursing considerations (pp slide 8 & pg.839):

Answer 2

(Thin needle placed in muscles to record stimuli responses/muscle weakness)
 If the client experiences discomfort after the study, warm compresses to the area to help relieve discomfort
-no caffeine before test

Question 3

1c. Arthrogram nursing considerations:

Answer 3

(X-ray to view joint & movement)

 Mild analgesic, ice
 Anesthetic w/contrast (check allergy to iodine)
 Avoid strenuous activity
 Might take sample of fluid
 Compression bandage
 Clicking noise expected finding for 2 days

Question 4

1d. Bone Scan (pp slide 9 & pg.838)

Answer 4

 Detects Bone tumors
 Radioisotope: 2-3hrs after scan will occur, check allergies (isotope allergy), increase fluids after
 Asking the client to void immediately before the scan

Question 5

2. Scoliosis testing procedures/Manifestations (pp slide 8)

Answer 5

 Bend forward w/head & arms downward (Adams position)
 Nurse priority: respiratory effect

Manifestation (pg.837):
 Lateral curvature of the spine (s-shaped curvature)

Question 6

3. Bone Density Scan tests for what? (pp slide 9)

Answer 6

 To detect osteopenia/osteoporosis

Question 7

4. Nursing considerations for traumatic bone injury and head injury (PP slide 10)

Answer 7

 Information regarding injury
 Align spine & neutralize the head (slightly elevated), don’t turn head side to side
 Monitor: VS, Neurovascular status, numbness or tingling, look for sx of fat embolism (sob, anxiety, foid, chest pain)
 Support limb w/hands during movement
 Pain management

Question 8

5. Alkaline phosphatase levels & relation to muscular-skeletal system (pp slide 8, MS ATI pg.320)

Answer 8

 Elevated in bone cancers
 Range: 30-120 units/L (elevated levels can make bones weak causing them to break more easily)
 Is a marker of bone formation & bone turnover, and is used in the evaluation of skeletal status.

Question 9

6. Uric acid levels & relation to the muscular skeletal system (Pp slide 8, ATI pg.525)

Answer 9

 Elevated in gout (above 6.8mg/dL)
 Accumulations of uric acid crystals can cause painful inflammation in & around joints.

Question 10

7. Bursitis manifestations (PP slide 4)

Answer 10

 Small sac filled w/synovial fluid
 Reduces friction between areas
 Inflammation causes bursitis

Question 11

8. Orthopedic status w/the elderly (assessment and considerations) (pp slide 5)

Answer 11

 Age related often associated w/joint issues
 Assess decrease in height
 Look for asymmetry in spine by bending back & fourth
 Assess performance of ADL’S

Question 12

9. Kyphosis Manifestations/examination: (PP slide 8)

Answer 12

 Exaggerated convex curvature of the thoracic spine (humpback)
Kyphosis examination:
 Turn to side in relaxed position