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Adult Nursing II - Exam 1 > Week 1 > Flashcards

Week 1 Flashcards

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
**Malignant Bone Tumor:** **Signs & symptoms** | **Musculoskeletal - KNOW THIS!!!**
**S&S of hypercalcemia due to bone loss from immoblity** * **Decreased neuro excitement** * **Bone pain** * Dysrhythmias * Constipation * Nausea & Vomiting
26
**What measures should be taken for patients who have undergone hip prosthesis?** | **Musculoskeletal - KNOW THIS!!!**
* **Position the leg in ABDUCTION** (to prevent dislocation) * **Do not flex hip more than 90 degrees** * **Avoid internal rotation**
27
**Discharge Instructions for patients who have undergone joint replacements** | **Musculoskeletal - KNOW THIS!!!**
* 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
**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**
**c.) The affected extremity is shortened, abducted, & extremily rotated**
29
**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**
**d.) Practice getting the patient out of bed by having her slightly flex her hips**
30
**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**
**c.) monitor BP frequently**
31
**What is a contusion?** | **Musculoskeletal Trauma - KNOW THIS!!!**
**soft tissue injury** * ecchymosis / hematoma
32
**What is a strain?** | **Musculoskeletal Trauma - KNOW THIS!!!**
**Injury to muscle or tendon** * pain * swelling
33
**What is a sprain?** | **Musculoskeletal Trauma - KNOW THIS!!!**
**Torn or stretched ligament** * pain * swelling
34
**What is a joint dislocation?** | **Musculoskeletal Trauma - KNOW THIS!!!**
**Articulating surfaces of the joint are not in contact** * pain * deformity
35
**What is subluxation?** | **Musculoskeletal Trauma - KNOW THIS!!!**
**Partial or incomplete dislocation**
36
**How are soft tissue injuries treated?** | **Musculoskeletal Trauma - KNOW THIS!!!**
* **R**est * **I**ce * **C**ompression * **E**levation * **Immobilization**
37
**What do pelvic & femur fractures put patients at high risk of developing?** | **Musculoskeletal Trauma**
**Hemorrhage & fat emoblisms**
38
**What is a fat embolism? What are signs & symptoms? What can cause this?** | **Musculoskeletal Trauma - KNOW THIS!!!**
**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
**What is a fat emoblism?** | **Musculoskeletal Trauma - KNOW THIS!!!**
**Fat globules move into the blood stream & occlude major blood vessels**
40
**What causes fat embolisms to occur?** | **Musculoskeletal Trauma - KNOW THIS!!!**
long bone fractures
41
**What are signs & symptoms of fat emboli?** | **Musculoskeletal Trauma - KNOW THIS!!!**
* **Hypoxemia** * **Neuro compromise** * **PETECHIAE RASH W/OUT BLANCHING** * **Tachypnea** * **Tachycardia** * Chest pain * Low grade fever * Crackles
42
**What is compartment syndrome? What are signs & symptoms? How is it treated?** | **Musculoskeletal Trauma - KNOW THIS!!!**
**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
**What are signs & symptoms of compartment syndrome?** | **Musculoskeletal Trauma - KNOW THIS!!!**
* **UNRELENTING PAIN OUT OF PROPORTION TO INJURY** * **Pain medications DON'T help** * Numbness & tingling (mid stage) * Decrease in pulse strength (late stage)
44
**Cast Care** * **How to deal with an itch** * **Purpose** * **Positioning** * **Signs & Symptoms to Report** * **Cast Assessment** | **Musculoskeletal Trauma**
* 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
**What is Buck's Traction?** | **Musculoskeletal Trauma - KNOW THIS!!!**
**Skin Traction** * **Uses:** fractures, broken bones, correct contractures or deformities, knee immobilization **Uses weights as traction**
46
**Traction Care Assessment** | **Musculoskeletal Trauma - KNOW THIS!!!**
* **T**emperature * **R**opes hang freely * **A**lignment * **C**irculation Checks * *P*allor * *P*aresthesia * *P*ain * *P*aralysis * *P*ulse (late sign of compartment syndrome) * **T**ype & location of fracture * **I**ncreased fluid intake * **O**verhead trapeze * **N**o weights on the bed or floor
47
**How often should pin sites for patients with traction be checked & cared for?** | **Musculoskeletal Trauma - KNOW THIS!!!**
Every 8 hours
48
**What is phantom limb pain?** | **Musculoskeletal Trauma - KNOW THIS!!!**
**Perception of pain or discomfort of a limb that's no longer there** ## Footnote * 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
**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.) Weak pedal pulses**
50
**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**
**c.) Every 8 hours**
51
**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**
**c.) A 30-year-old male who drinks alcohol occasionally & has a BMI of 28**
52
**Amputations** * Nursing Interventions * Complications | **Musculoskeletal Trauma - KNOW THIS!!!**
**Nursing Interventions:** * Assist the patient with achieving physical mobility **Complications: Phantom limb pain,** infection, etc.
53
**List & explain the different types of burns** | **Burn Management**
**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
**What are the phases of burn injury?** | **Burn Management**
**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
**What are the primary goals during the EMERGENT (resuscitative) phase of burn injury?** | **Burn Management - KNOW THIS!!!**
* **Stop the injury:** extinguish flames, cool the burn, irrigate chemical burns * **ABCs:** establish **a**irway, **b**reathing, & **c**irculation * **Start O2 & large bore IVs** * **Remove restrictive objects & cover all wounds**
56
**What are the primary goals during the ACUTE (intermediate) phase of burn injury?** | **Burn Management - KNOW THIS!!!**
* **Begin fluid resuscitation** * **Insert foley catheter** * **Patient w/ burns exceeding 20 - 25% shoudl have NG tube & suction**
57
**Nursing Management of Patients with Burn Injury?** | **Burn Management - KNOW THIS!!!**
* ABCs * Vitals & hemodynamic status * Monitor for fluid volume deficit * Assess extent of burn
58
**What are complications & collaborative problems associated with burns?** | **Burn Management - KNOW THIS!!!**
* Acute respiratory failure * Acute renal failure * Heart failure & pulmonary edema * Sepsis

Adult Nursing II - Exam 1 (6 decks)

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