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Adult Nursing II - Exam 1 > Week 1 > Flashcards

Week 1 Flashcards

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1
Q

What are common conditions of the upper extremities?

Musculoskeletal - upper extremities

A

Bursitis
* inflammation of bursae which are fluid-filled sacs that surround joints

Tendonitis
* inflammation of muscle tendon sheath (due to repetitive stretching)

Loose bodies (“joint mice”)
* breakdown of bone causing discomfort
* knees, hips, ankels, etc.

Impingement (shoulder injury)

Carpal tunnel syndrome
* Caused by repetition
* Affects the median nerve
* Tests: Tinel’s sign & Fallen sign

Ganglion (Cyst)

Dupuytren Contracture
* contraction of 4th & 5th finger

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2
Q

What are Tinel’s sign & Fallen sign and what are they used for?

Musculoskeletal - upper extremities

A

Used to check for Carpal Tunnel Syndrome

  • Tinel’s Sign: tap on median nerve & see if pt has numbness or tinglng
  • Fallen Sign: numbness & tingling in hands = carpel tunnel
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3
Q

What is dupuytren contracture?

Musculoskeletal - upper extremities

A

Contraction of the 4th & 5th finger

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4
Q

What are common conditions of the lower extremities / feet?

musculoskeletal - lower extremities

A
  • Plantar Fasciitis

Corn & Callus
* overgrowth of thick layers of skin

Ingrown Toenail
* free edge of nail penetrates skin putting pt at risk of infection

Hammer toe
* wear open toed shoes

Hallux valgus (Bunion)

Flat Feet (pes planus)

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5
Q

What is osteoarthritis?

Musculoskeletal

A

Inflammation & breakdown of cartilage from wear & tear

  • specific to certain joints
  • characterized by discomfort, pain, swelling, warmth at the site
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6
Q

What are the two types of osteoarthritis?

Musculoskeletal

A

Primary: idiopathic

Secondary: result of another issue / dx

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7
Q

What re common risk factors for osteoarthritis?

Musculoskeletal - KNOW THIS!!!

A
  • Older women
  • Occupation with repetition
  • Obesity
  • Hx of frequent injury to a specific site
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8
Q

What is osteoarthritis? What are the 2 types? What are signs & symptoms?

Musculoskeletal - KNOW THIS!!!

A

Non-inflammatory degenerative disorder of the joints

1.) Primary: idiopathic; no known cause
2.) Secondary: result from prior injury or disease

Signs & Symptoms
* limited movement of affected joint
* pain
* stiffness (morning stiffness for first 30 minutes after waking up)
* slow decrease in ROM
* functional impairment
* NO SYSTEMIC SX

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9
Q

What are signs & symptoms of osteoarthritis?

Musculoskeletal - KNOW THIS!!!

A
  • pain
  • limited movement of affected joint
  • morning stiffness
  • slow decrease in ROM
  • functional impairment
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10
Q

What are bone spurs?

musculoskeletal

A

bone enters the joint space causing the joint space to narrow

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11
Q

What is osteoporosis? What are known risk factors? What are the signs & symptoms? How is it treated?

Musculoskeletal - KNOW THIS!!!

A

decrease in bone mineral density & bone mass due to low calcium levels

Risk Factors: Age & hormonal changes (post menopause, underweight, certain meds, etc.)

Tx: calcium & vitamin D, bisphosphonates (give w/ full glass of water

Signs & Symptoms:
* Fractures
* Rounding of upper back (hunchback)
* Asymptomatic
* Inches of height
* Lower back pain

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12
Q

What is osteoporosis?

Musculoskeletal - KNOW THIS!!!

A

Low mineral density & bone mass due to low levels of calcium

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13
Q

Risk factors for osteoporosis

Musculoskeletal - KNOW THIS!!!

A
  • Age & Hormonal changes
  • Lifestyle
  • LOW CALCIUM INTAKE
  • Caucasian or Asain
  • Inherited
  • Underweight
  • Medications

post-menopause, underweight, certain medications

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14
Q

Signs & Symptoms of Osteoporosis

Musculoskeletal - KNOW THIS!!!

A
  • Fractures
  • Rounding of upper back (hunchback)
  • Asymptomatic
  • Inches of height
  • Lower back pain
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15
Q

What is the treatment for osteoporosis?

Musculoskeletal - KNOW THIS!!!

A
  • Vitamin D & Calcium
  • Bisphosphonates (give w/ full glass of water & on empty stomach)
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16
Q

What is Osteomalacia and what is the cause? What are signs & symptoms? What can this diagnosis lead to?

Musculoskeletal - KNOW THIS!!!

A

Softening & weakening of long bones (Rickets in children) due to Vitamin D deficiency

Signs & Symptoms:
* pain
* tenderness
* bowing of bones
* pathological fractures
* changes in gait

Can cause: GI disorders, hyperparathyroidism, renal insufficiency, dietary deficiency

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17
Q

What is osteomalacia & what causes it?

Musculoskeletal - KNOW THIS!!!

A

softening or weakening of long bones due to vitamin D deficiency

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18
Q

What are signs & symptoms of osteomalacia?

Musculoskeletal

A
  • pain
  • tenderness
  • bowing of long bones
  • changes in gait
  • pathological fractures
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19
Q

What is Paget’s disease?

Musculoskeletal

A

localized bone turnover

Risk Factors: men, aging, familial predisposition

  • usually asymptomatic
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20
Q

What is Septic Arthritis? What are the signs & symptoms? What is the treatment? Who is at risk for it?

Musculoskeletal - KNOW THIS!!!

A

infection of joint (synovial) fluid & joint tissues

Signs & Symptoms:
* warm
* painful joints
* decreased ROM
* signs of infection (fever, warmth, chills, etc.)

Treatment: immobilization of joint, pain releif, & abx

Risk: older adults & those with comorbidities (DM, HTN, etc.)

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21
Q

What is septic arthritis?

Musculoskeletal - KNOW THIS!!!

A

infection of joint (synovial) fluid & joint tissues

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22
Q

What are signs & symptoms of septic arthritis?

Musculoskeletal - KNOW THIS!!!

A
  • painful joints
  • warmth
  • signs of infection (fever, chills, diaphoresis, erythema, edema, pain)
  • decreased ROM
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23
Q

What is the treatment for septic arthrits?

Musculoskeletal - KNOW THIS!!–RED!

A
  • Immobilization of Joints (for pain relief)
  • Antibiotics
  • Pain relief
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24
Q

What is osteomyelitis? What causes it? How does it spread? What are the signs & symptoms?

Musculoskeletal

A

Infection of the bone

Causes:
* due to soft tissue infection (pressure injury that went deep to bone)
* direct bone contamination - bone surgery w/ unclean tools

Bloodborne (spreads from one site to the next)

Signs & Symptoms
* pain
* edema
* drainage
* leukocytosis
* fever
* swelling
* redness

25
Q

Malignant Bone Tumor:

Signs & symptoms

Musculoskeletal - KNOW THIS!!!

A

S&S of hypercalcemia due to bone loss from immoblity

  • Decreased neuro excitement
  • Bone pain
  • Dysrhythmias
  • Constipation
  • Nausea & Vomiting
26
Q

What measures should be taken for patients who have undergone hip prosthesis?

Musculoskeletal - KNOW THIS!!!

A
  • Position the leg in ABDUCTION (to prevent dislocation)
  • Do not flex hip more than 90 degrees
  • Avoid internal rotation
27
Q

Discharge Instructions for patients who have undergone joint replacements

Musculoskeletal - KNOW THIS!!!

A
  • Take pain medications as directed
  • Wear supportive stockings
  • Schedule a specific appointment for staple removal
  • Check for infection
  • Provide HCPs, dentists, etc. information about joint replacement
  • Don’t sit for more than 30 - 45 minutes
  • Don’t cross your legs
28
Q

A patient presents to the ED after falling from a roof. A fracture of the femoral neck is suspected. Which of these assesments best supports this diagnosis?

a.) The patient reports pain in the affected leg
b.) A large hematoma is visible in the affected extremity
c.) The affected extremity is shortened, abducted, & extremely rotated
d.) The affected extremity is edematous

Musculoskeletal

A

c.) The affected extremity is shortened, abducted, & extremily rotated

29
Q

The morning of the second post-op day following hip surgery for a fractured right hip, the nurse will ambulate the patient. The first intervention is to:

a.) Get the patient up in a chair after dangling at the bedside
b.) Use a walker for balance when getting the patient out of bed
c.) Have the patient put minimal weight on the affected side when getting up
d.) Practice getting the patient out of bed by having her slightly flex her hips

Musculoskeletal

A

d.) Practice getting the patient out of bed by having her slightly flex her hips

30
Q

The nurse is caring for a patient wiht a pelvic fracture. Which is the nurse’s priority action to prevent complications?

a.) monitor temperature daily
b.) insert a urethral catheter
c.) monitor BP frequently
d.) turn the patient every 2 hours

Musculoskeletal

A

c.) monitor BP frequently

31
Q

What is a contusion?

Musculoskeletal Trauma - KNOW THIS!!!

A

soft tissue injury

  • ecchymosis / hematoma
32
Q

What is a strain?

Musculoskeletal Trauma - KNOW THIS!!!

A

Injury to muscle or tendon

  • pain
  • swelling
33
Q

What is a sprain?

Musculoskeletal Trauma - KNOW THIS!!!

A

Torn or stretched ligament

  • pain
  • swelling
34
Q

What is a joint dislocation?

Musculoskeletal Trauma - KNOW THIS!!!

A

Articulating surfaces of the joint are not in contact

  • pain
  • deformity
35
Q

What is subluxation?

Musculoskeletal Trauma - KNOW THIS!!!

A

Partial or incomplete dislocation

36
Q

How are soft tissue injuries treated?

Musculoskeletal Trauma - KNOW THIS!!!

A
  • Rest
  • Ice
  • Compression
  • Elevation
  • Immobilization
37
Q

What do pelvic & femur fractures put patients at high risk of developing?

Musculoskeletal Trauma

A

Hemorrhage & fat emoblisms

38
Q

What is a fat embolism? What are signs & symptoms? What can cause this?

Musculoskeletal Trauma - KNOW THIS!!!

A

Fat globules move into the blood stream & block blood vessels after long bone fractures occur

Signs & Symptoms:
* Hypoxemia
* Neuro compromise
* PETECHIAE w/out blancing
* Tachypnea
* Tachycardia
* Chest pain
* Low-grade fever
* Crackles

39
Q

What is a fat emoblism?

Musculoskeletal Trauma - KNOW THIS!!!

A

Fat globules move into the blood stream & occlude major blood vessels

40
Q

What causes fat embolisms to occur?

Musculoskeletal Trauma - KNOW THIS!!!

A

long bone fractures

41
Q

What are signs & symptoms of fat emboli?

Musculoskeletal Trauma - KNOW THIS!!!

A
  • Hypoxemia
  • Neuro compromise
  • PETECHIAE RASH W/OUT BLANCHING
  • Tachypnea
  • Tachycardia
  • Chest pain
  • Low grade fever
  • Crackles
42
Q

What is compartment syndrome? What are signs & symptoms? How is it treated?

Musculoskeletal Trauma - KNOW THIS!!!

A

Compromised circulation due to high pressure (swelling or bleeding) within a muscle compartment (of an extremity)

Signs & Symptoms:
* UNRELENTING PAIN OUT OF PROPORTION TO INJURY
* Pain medications DON’T help
* Decrease in pulse strength (late sign)
* Numbness & tingling (middle sign)

Treatment: Fasciotomy

43
Q

What are signs & symptoms of compartment syndrome?

Musculoskeletal Trauma - KNOW THIS!!!

A
  • UNRELENTING PAIN OUT OF PROPORTION TO INJURY
  • Pain medications DON’T help
  • Numbness & tingling (mid stage)
  • Decrease in pulse strength (late stage)
44
Q

Cast Care

  • How to deal with an itch
  • Purpose
  • Positioning
  • Signs & Symptoms to Report
  • Cast Assessment

Musculoskeletal Trauma

A
  • Don’t cover with plastic & keep the cast dry
  • Don’t put anything in/down it for itching & don’t scratch; use antihistamines
  • Purpose: immobilize a reduced fracture, correct a deformity, apply uniform pressure to soft tissue, support to stabilize a joint
  • Positioning: Elevate extremity & use a sling

Signs & Symptoms to report:
* persistent pain or swelling
* changes in sensation
* movement
* skin color or temperature changes
* signs of infection or pressure areas

Assessment: Monitor neurovascular status & for potential complications

Non-Plaster (fiberglass): lighter, HEAT activated

Plaster: heavier, cold activated

45
Q

What is Buck’s Traction?

Musculoskeletal Trauma - KNOW THIS!!!

A

Skin Traction

  • Uses: fractures, broken bones, correct contractures or deformities, knee immobilization

Uses weights as traction

46
Q

Traction Care Assessment

Musculoskeletal Trauma - KNOW THIS!!!

A
  • Temperature
  • Ropes hang freely
  • Alignment
  • Circulation Checks
    • Pallor
    • Paresthesia
    • Pain
    • Paralysis
    • Pulse (late sign of compartment syndrome)
  • Type & location of fracture
  • Increased fluid intake
  • Overhead trapeze
  • No weights on the bed or floor
47
Q

How often should pin sites for patients with traction be checked & cared for?

Musculoskeletal Trauma - KNOW THIS!!!

A

Every 8 hours

48
Q

What is phantom limb pain?

Musculoskeletal Trauma - KNOW THIS!!!

A

Perception of pain or discomfort of a limb that’s no longer there

  • Experienced immediately to post-op up to 2-3 months after amputation
  • Feeling that extremity is crushed, cramped, twisted into abnormal position, (might be) intense burning, cramping, etc.
49
Q

The nurse is caring for a patient iwth Buck’s traction & is monitoring the patient for complications of the traction. Which assessment finding indicates a complication?

a.) Weak pedal pulses
b.) Drainage at the pin sites
c.) Complaints of discomfort
d.) Warm toes with brisk capillary refills

Musculoskeletal Trauma

A

a.) Weak pedal pulses

50
Q

How often must the nurse inspect the traction pin site for signs of inflammation & evidence of infection?

a.) Every 2 hours
b.) Every 4 hours
c.) Every 8 hours
d.) Every 16 hours

Musculoskeletal Trauma

A

c.) Every 8 hours

51
Q

Which patient is NOT at risk for osteoporosis?

a.) A 50-year-old female whose last menstrual period was 7 years ago
b.) A 45-year-old male patient who has been taking glucocorticoids for the last 6 months
c.) A 30-year-old male who drinks alcohol occasionally & has a BMI of 28
d.) A 35-year-old female who has a history of seizures & takes Dilantin regularly

Musculoskeletal Trauma

A

c.) A 30-year-old male who drinks alcohol occasionally & has a BMI of 28

52
Q

Amputations

  • Nursing Interventions
  • Complications

Musculoskeletal Trauma - KNOW THIS!!!

A

Nursing Interventions:
* Assist the patient with achieving physical mobility

Complications: Phantom limb pain, infection, etc.

53
Q

List & explain the different types of burns

Burn Management

A

First Degree: superficial
* sunburn

Second Degree: partial thickness
* dermis & epidermis ; shiny & moist; red/pink; blisters present; scars left behind; blanching is present

Third Degree: full thickness
* epidermis, dermis, hair follicles, sweat glands, & nerves destroyed; skin will not heal; black, yellow, or red; matte / dry; eschar (burned, dead tissue)

Fourth Degree: deep full thickness
* all layers of skin are destroyed
* extends to muscles, ligaments, & bone
* black & charred
* no sensation
* skin graft needed

54
Q

What are the phases of burn injury?

Burn Management

A

1.) Emergent / Resuscitative: onset of injury –> completion of fluid resuscitation

2.) Acute / Intermediate: beginning of diuresis –> wound closure

3.) Rehabilitation: wound closure –> return of physical & psychosocial adjustment

55
Q

What are the primary goals during the EMERGENT (resuscitative) phase of burn injury?

Burn Management - KNOW THIS!!!

A
  • Stop the injury: extinguish flames, cool the burn, irrigate chemical burns
  • ABCs: establish airway, breathing, & circulation
  • Start O2 & large bore IVs
  • Remove restrictive objects & cover all wounds
56
Q

What are the primary goals during the ACUTE (intermediate) phase of burn injury?

Burn Management - KNOW THIS!!!

A
  • Begin fluid resuscitation
  • Insert foley catheter
  • Patient w/ burns exceeding 20 - 25% shoudl have NG tube & suction
57
Q

Nursing Management of Patients with Burn Injury?

Burn Management - KNOW THIS!!!

A
  • ABCs
  • Vitals & hemodynamic status
  • Monitor for fluid volume deficit
  • Assess extent of burn
58
Q

What are complications & collaborative problems associated with burns?

Burn Management - KNOW THIS!!!

A
  • Acute respiratory failure
  • Acute renal failure
  • Heart failure & pulmonary edema
  • Sepsis

Adult Nursing II - Exam 1 (6 decks)

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