Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

H & Illness 4: A & C illness > week 10 : mobility > Flashcards

week 10 : mobility Flashcards

1
Q

issue of mobility what could be the reason/cause ?

A

genetic ( inherited ) e.g duchenne muscular dystrophy

demyelination of nerve fibers

degeneration of neurons in brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

true or false. issue of mobility: one of them being is degeneration of motor neurons and injury to the bone

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

injury to spinal cord ( vertebra or edema pushing on cord ) is also seen as an issue of mobility

A

yes this is true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what else can bring an issue of mobility ?

A

impact on the pt ( mind and body ) and family

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

issue of mobility : impact on nursing care

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

issue of mobility : medications - treat the disease and treat problems caused by decreased mobility , is this true or false.

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what other genetic disease can be a reason for issue in mobility ?

A

change of muscular dystrophy , ms , parkinson disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what injury can be a reason/cause

A

spinal cord injury
higher level injury - higher impact

als and gillian burre

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the impact on the patient ? ( mobility )

A

mind - fatigue, self identity, depression , independence, awareness of how they will die

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

recall that body is the one impacted if there is an issue with the mobiliity , what undergoes this ?

A

cns depression ( significant pain )

— neuropathic pain, and complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

explain how cvs system could have an impact on the patient

A

blood clots and pressure ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what undergoes resp since this would be affected

A

atelectasis and pneumonia patietn can lose ability to clear their resp secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what undergoes GI as this would be a problem

A

GI ability to swallow and get good nutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

GU problem with incontinence /can also have UTIS , is this true ?

A

yes this is true when it comes to mobility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how would pyschosocial be affected?

A

lose their sense of self and identity they have is different ( alot of significant anger ) because they lose their personal independence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

impact on nursing care
resp system ( can pt clear secretions ) ?

if u have a pt who cna cough well their lungs is okay but if ot what possibilities are we looking at ?

A

atelectasis and secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

impact on nursing care : body/limb alignment

what is happening

A

pain, muscle spasm, and perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

turning/repositioning – looking at the skin , how frequent are we turning ?

A

2 to 3 hours ( look at the pressure ulcers )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

it is important to assesment the body and mind why ?

A

no big pressure underneath hand
thinking pressure points and what the skin looks like - help plan their future

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

moblity : what else are they in risk for that we should look out for ?

A

risk of falls ( and working hard is managing pain ) always looking for complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what type of meds are we going to give them

A

prevent potential complications ( e.g dvts )
treat pain ( noiceptive, neurogenic )
treat muscle spasm
maintain general health ( breathing , nutrtion, prevent infeciton )

lets also give them the best mattress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

equipment and skulls needed and used

A

wheelchairs, braces, canes, aspen collar

splints, pillows, roho cushions prosthetics

lifts, turning sheets/sliders , transfer board

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

true or false. staff to assist with mlt
teds/scds, binders, assistive devices ( feeding, writing, bathing )
communciation boars are something we utizlied as equipment and skills needed and used

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

spirometer, feeding tubes, urianry catehrs are also used.

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what type of medications are we going to utilized ?

A

slow disease progression ( nerve impulses )
prevents clots
manage pain
decrease muscle spasms
antidepressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

true or false. it is important that a pt takes a med that decrese fatigue and prevent constipation and gu issues such as bladder

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

meds that prevent a lot of probelms
antidepression is big and decreasing fatigue ( make more energy ). is this true or false.

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

interprofessional
who are we working with ?

A

rt
social worker
rehabilitation units and ltc
sppech language therapist/patholigst
- communicating /swallowing/eating -0 swallowing assemsnet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

recall that : rt
social worker
rehabilitation units and ltc
sppech language therapist/patholigst
- communicating /swallowing/eating -0 swallowing assemsnet
are interprofessional we are going to be working with , who else ?

A

PT
- rom , prevent contractures
-steghtening muscles
-chest physio/pulmonary toileting
OT
- wheelchairs/canes/walkers
-splints
-special cushions (roho ) to relieve pressure
-teach pt how to manage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

mobility-diseases
nursing care - the pt is thinking what ?

A

what is the cause of this disease
curable ? any treatment?
what are the symptoms ?
how can the symptoms be managed?
will this be likely cause my death ?
how bad will it get

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

duchenne muscular dystrophy ( pediatris )

cannot be caught ( basically means the muscle is weakening )

A

this is genetic
chronic progressive and incapacitating disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

respirtory problems for duchenne msucular dystrophy

A

ecause their chest muscles get progressively weaker
there might be another kid that has a cough, this kid might get sick and continue on ( cannot fight it off )n

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

cardiac dysfunction for duchenne muscular dystrophy

A

cardaic rhythym abdnomalities ( encho and ekgs once a year to keep an eye on them )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

obesity ( the child is not able to lose calroues. not active ) for duchenne msucular dystrophy

A

this is true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

social isolation and pt and fmaily coping discussion s- possible transheotomy , ltc, end of life directives for duchenne muscular dystrophy

A

this is true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

these patients die in their 20s and 30s ( shorten life despentencies )
everything gets worst
mobility gets impaired
they also get contractures
( they are a problem ) the goal is to maintain optimal functioning and prevent contractures

in terms of duchenne muscular dystrophy is this true or false

A

this is true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

penumonia/ clearing penumonia and all of that could be seen within duchenne mucucla rdistrophy

A

this is true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

look at slif 4 for the child walking for the musuclar dystorphy for duchenne

A

okym

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

ms describe it

A

chronic progerssibe remission.exacerbation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what is ms

A

autoimmune disorders of cns and demyelination of enrve fibers ( brain sinal cord and optic nerve )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what are the s and s for ms

A

motor, sensory, fatigue, pain , pt manage independence rest adn self care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

dx and minotr for ms

A

hx, s and s
evoked repsonse testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

true or false canada has the hgihest rating for ms

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

not going to the bathroom normally
myelin is basically attack and tried to regenerate

what we see is chronic inflmmation and scaring

A

this is desciring ms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

no discovery yet that fizes this diseases ( the cuase is unknown ) but researches have been dne in mb becauee its so high

yes this is ms

A

yes it is

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what is ms - oerall goal and care

A

funtioning, independance, in daily living, mamage fatigue, mental health , adjust, reduce factors that lead to exacerbations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what is retaline for in ms

A

give ore energy dont ahve a ath later on teh day after a goodnight sleep lots of differnt things to do

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

dvt penumonia pressure ulcer atelectasis patingteaching is help these people help overal healthy life for ms

A

yes this si true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q
  • Triggers/exacerbations
  • Hospitalization
  • Pt teaching

are needed for ms overall goal and care

A

yes this si tru

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what is importnt for ms potarntially

A

learn how to straight cath themselves ( invcontinent out and about is decrease )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

bladder will retain urine and habe reflex emptying , they do not have control over it

A

yes this is true for ms patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

bowel issues and such would what in ms overall goal an care

A

lactulose or peg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

IF THESE PEOPLE ARE HOSPITLIZED ( DIAGNOSTIC WORKUP ) ACUTE EXACERBATIONS ( on bed rest ) fam and friedns need help

A

ms yes this sit rue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

reduce stress/fatigue/ rest throughout the day/. extreme temperatures
very hot temp is very difficult for pts
also extreme cols

anu type of infections ( stomach flue

A

yes this sis true or ms ( autoimmune )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

define if these are signs of duchenne muscular dystrophy ( not walking properly )

shoulders and arms are held back awkwardly

sway back

weak butt muscles ( hip straightens )

add 3 more

A

yes

knees may bend back to take weight

thick lower leg muscles ( the muscle is mostly fat, and not strong )

tight heel cord ( contracture ) child may walk toes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

why does the belly stick out during duchenne muscula dystrophy

A

belly sticks out due to weak belly muscles ( child is poor at situps )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

thin weak tights ( especially front part for duchenne muscle dystrophy )

A

yes this is true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

what is the balance like for ducehnne muscle dystrophy?

A

poor balance : falls often , awakward clumsy if walking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

weak muscles in front of leg cause foot drop, and tip toe contractures : this is true amongst duchenne muscular dystrophy

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

medications for ms

what is our goal here ?

hint** what is steroid used for ?

A

goal is decrease progression of disease and control symptoms

treatment acute exacerbations ( edema, inflammation at site of demyelination )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

define if these medications are being utilize for MS

  • Medications
    – corticosteroid (methylprednisolone, prednisone)
    – immunomodulator (Betaseron, Avonex)
A

yes this is true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

recall if these meds are used for ms : * Medications :

– corticosteroid (methylprednisolone, prednisone)

– immunomodulator (Betaseron, Avonex)

A

– immunosuppressant (Methotrexate, Imuran, Mitoxantrone)

– anticholinergic (Ditropan) – help with bladder symptoms (tone)

– fight fatigue (Ritalin)

– antispasmodic (Baclofen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

what is ritalin for ?

A

we use this in ms
helping to fight fatigue ( to give more energy ) pill taken 3 times a day ( decreae muscle spasm ) getting to know their own body and how theyre body reacts ( side effects )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

what is three biggest indicator of parkinson disease ?

A

tremors
rigidity
bradykinesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

what is parkinson disease disease process?

A

chronic, progressive, degenerative disease of cns

affects movement : slow to move, rigidity and tremors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

what are the s & s : for parkinson disease

A

tremors, rigidity, slow to start moving also depression, fatigue, pain, constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

dx & monitor : Hx and s and s
no dx test
for parkinson disease are those descriptions accurate

A

yes it is accurate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

instead of diagnostics what are we checking for parkinsons pts ?

A

theres no specific diagnostic test

head to toe ( check reflexes, get checked with fam and put it together )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

true or false. patients have swallowing problems because of what ?

A

because of the muscle weakness meds that are helpful for this disease ( dopamine receptors and transmitting neurons )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

recall that remors of the hands even at rest

persistent tremors

are seen with parkinsons
what else ?

A

shuffling gait
unbalanced & small in steps, curved in characteristic way

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

if meds are late for parkinson pt what happens ?

A

if these meds are late — it affects their mobility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

what is our goal in terms of meds for parkinsons

A

correct imbalance of neurotransmitters within the cns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

ng care for parkinson

A

manage issues for mobility, communication, nutrition ( swallowing ) adapt activities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

what are the different type of meds we are giving parkinson pts

A

dopaminergic ( L- dopa, sinemet )

beta adrenergic blocke ( inderal ) - manage tremors

*titrate dose to effect, combination of meds
*symptoms will progress, worsen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

parkinson disease - overall goal and care

can have a risk of what ?

A

risk of falls
we want them to exercise, ( really decrease their muscle atrophy )

decrease contractures also getting exercise plan with physio therapist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

what are different things we are utilizing for parkinson’s disease as an overall goal and care

A

physical exercise
diet
physio
sleep issues
dep and anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

physical exercise
diet
physio

define these in terms of PD

A

have trouble ingesting foods, swallowing or coughing

swllowing assesments may need , maybe diced tomake it easier to chew and swallow

safety alert for falls ( they need to adapt )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

sleep issues
dep and anxiety
cognitive function change

define for PD

A

satin shees, and satin pajamas ( have huge impact on turning and sliding )

dep and anxiety- makes so many changes for them

cognitive function change - notice settle change in their cognitive ( even progress to full dementia )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Severe mobility issues (airway, ventilation)

what is ALS

A

amyotrophic lateral sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

what is the descrption of ALS

A

progressive paralysis, mind is intanct
- no treatment , no cure, supportive care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

what does als patient need eventually ?

A

tracheostomy and ventilator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

what does medically assisted suicide mean ?

A

they know whats going to happen ( hard disease ) and take care of ,
upset and knows whats going to happen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

what is Guillain barre syndrome

A

symmetrical ascending paralysis, demyelination of peripheral nerves , +++ pain peaks at week 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

what is the rate of recovery for gbs

A

85 percent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

what is the treatment for gbs

A

plasmapheresis and ivig

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

what is ivig for gbs

A

intravenous immunoglobulin
infusion get from blood taken

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

the amount of pain for some people
for als no pain ) but for als ( pain ) tingiling , boarding lighting bols
disese peaks aorund 3 weeks meaning bad its gonna get

trueor false.

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

for gbs what happens when u have the stomach flue ?

A

ba stomach flue ( whole immune system goes cracy and theyhave this prolem now ) ‘alot of the time they have them sick before a resp gi problem ( not sick enough to go tot he hospital ) but then they develop this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

cause and symptoms of gbs

obstruction of myelin, known as demyelination

what are the symptoms?

A

paralysis, including loss of breath

loss of reflexes

muscle weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

recall that paralysis, including loss of breath

loss of reflexes

muscle weakness

are all symptoms of gbs what else?

A

prickly, tingling sensations in the arms and legs ( paresthesia )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

mobility - injury/trauma
what type of diagnostics test are we running ?

A

xray, ct scan, mri

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

what is th neurovascular asssment are we doing for mobility - injury/trauma

A

color, temp, cap refull, distal pulses, edema, sensation , motor function , pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

what is the number one priority in neurovascular assesment

A

the number one priority is color

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

what do we want to prevent in mobility- injury/trauma

A

prevent resp complications ( db and coughing ) , spirometry, turning, ROM exercsies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

what is ROM exercsies?

A

range of motion exercises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

aside from resp complications : what else do we want to prevent ? ( for injury/trauma )

A

we want to prevent pressure ulcers

if they havea cast on, we need to think where is the cast hitting them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

pain should improve overtime ( as the bone is healing ) if pain is not improving ( they are a complication ) is this true or false.

A

this is true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

what is critical in our neurovascular assessment

A

distal pulses, edema, sensatin, motor function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

what are the meds that patient is on when they have moblity issues such as injury or trauma

A

manage pain( baclofen, nsaids, narcotics, t3s )
phantom limb pain with amputation
prevent system complications for immobility
- cosntipation ( stool softeners ) , clots ( heparin, enoxaparin )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

if someone had a rib fractures, would we encourage deep breathing and coughing ?

A

bruh no, this is extremely painful and it is not advisable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

given this scenario , look at the mar before
fentanyl only 3 times now 4 times and pain is still there

what do u think could be happening

A

something is cooking up cant lie ( look further )

( pain is getting worst )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

what is the general care for bone injuries
what undergoes alignment

A

midline, neutral position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

wehat is traction in terms of geenral care for bone injuries

A

pulling force to keep alignment ( promtoes bone healing, dec muscle spasm , prevent furhter soft tissue and vessel injury )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

true or false. it is major to assess neurovascular status for our general care for bone injureis

A

yest his is true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

what else are we asesing for in terms of our genral care for bone injrueis

A

surgical site, hematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

assess for complications such as …
for general care for bone injuries

A

infeciton, venous thromboemvolism, ( dvt, pe ) infection ( wound for skin or abscess )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

recall that these are complications that could occur within bone injres what else could occur ?

recall : infection, venous thromboembolism (DVT, PE), infection (wound
fr skin or abscess

A

osteomyelitis/hardware inserted
acute compartment syndrome, fat embolism ( something that can kill the pt )

108
Q

managing pain is also crucial for our general care for bone injuries is this true or false?

bonus : what type of pain are we going to encounter for these patients?

A

muscle spasm, bone pain, soft tissue injury

109
Q

fracture can be open or closed. what does this mean

A

literally open ( see the bone )
close ( cannot see anything but ) but imagine what is going to do with the vessels and cause issues inside

110
Q

what is the biggest risk for open fracture

A

high risk of infection and they should have tetanus immunization ( again increase of infection )

111
Q

what is the RICE acronym

A

rest
ice
compresison
elevation

112
Q

what are we going to assess for fractures and what else after tha

A

assess vascular status/perfusion
additional tissue/vessel damage

113
Q

with fractures bone reducion is one of the option , what does this mean ?

A

bone reduction but closed method ( pulling or open method surgery ) called fixation , aignement , possibltiy traction, immobilize, time to heal

114
Q

for fractures could we utilize splints and orthopedic boots/shoes , cast

A

yes we can !

115
Q

what is the serious consequence that could happen with fractures

A

vertebrae ( SCI - spinal cord injury ) , pelvic, hip

116
Q

what are we giving the pts before bone reduction

A

give pain killers or ketamine or block ( try to pull force and try to pull it back to place )

117
Q

external fixation
what is happening ehre

A

pin site care
vascular assessment
alignment
pain should decrease with time

118
Q

what is the question we are asking the patients : for external fixation

A

is it warm, any pain in his toes ?
( white thing — thick sponge , soak in covid dome and wrap it around bascially the scew from the hardware into the leg bone )

119
Q

how is cast like in external fixation

A

plastic fiber glass
vascular assesment - pain assesment and management complciations ( watch out for it )
and general care

120
Q

what if it swells even more, thinking abt any type, of problems or complications that could happen here : what is this describing

A

external fixation

121
Q

plaster cast go on wet and a then dry give off heat is this true in terms of external fixation

A

yes this is true

122
Q

ORIF - open reduction internal fixation : what is this

A

to stabilize a long bone fracture, a plate and screws outside the bone or a rod inside the bone may be used

123
Q

in terms of infection and weight bear for open reduction internal fixation what undergoes it

A

reduced it - put everything on alignment , internal fixation - inside there they put in hardware

124
Q

leave hardware in or something things have heal up ( take it out ) depends on the situation

true or false in terms of open reduction internal fixation

A

true

124
Q

true or false.u put in a rod or a plate with screw for open reduction internal fixation

A

true

125
Q

traction - skin or skeletal
done operation and xray the operation in the or still not quite an alignment

true or false.

A

true

126
Q

what is skin traction ?

A

short term treatment also uses light weight ( grabbing the skin ) as far weights 2-3 to 4.5 kg ( this is temporary )

127
Q

like a skin tenser, bandages, and then pulling in to the skin

this undergoes what

A

skin traction

128
Q

what is a skeletal traction

A

this is where something is drilled into the patients bone , meaning the skeleton

bone right at the skeleton short term treatment

129
Q

what is a skeletal traction

A

the weight is heavier and reuse for a longer amount of time ( needs more pull to get it aligned )

130
Q

nurses don’t decrease or increase the weight ( don’t touch the wound )
call ortho tech to do it

A

true

131
Q

weight to hang freely - not rest on the floor
bucks traction

A

u cannot have this weight on the ground , nurses do not have to set this up

132
Q

bone fractures NCP
where does this undergo to

A

splinting, traction alignment , analgesia, pressure points

133
Q

through neurovascular status
what undergoes this for bone fractures

A

skin color and temp , moveent, sensation, pulsses , cap refill, pain

134
Q

bone fractures NCP : analgesia
what undergoes this

A

pain shoulde decrease

135
Q

bone fractures ncp
manage edema ( ice, elevate ) this is true in terms of bone fractures.

A

true

136
Q

teach pt about care, clarify activity level ( increasing mobility )

A

they cannot wear bear on that leg ( hip that is fracture, clear the orders )
proper nutrition is important
increase fibre intake and increase fluid intake 2- 3 liters

137
Q

complications of #
assessment and intervention treatment :
skin
blood clots
fat embolism syndrome
infection ( open fractures )

A

this is true

138
Q

acute compartment syndrome what is a possible complication with this

A

possible fasciotomy

139
Q

pressure ulcer, wet/macerated skin : go more in depth about this

A

high risk of breaking down , guy in the collar worries about under his chin and neck

shoulder ( these are patients on gogles ) we always do 2 nurses ( one person sits head of the bed and the other person takes off collar and wet wash cloth )

140
Q

deep vein thrombosis : give details about this

A

mainly blood clot ( big thing here is prevention )
heparin or dalteparin

141
Q

true or false. sometimes they do not work ( gets blood clot ) the whole plan changes

heparin subcut ( give bolus iv heparin ) based continues of heparin no longer subcut

A

true. heparin works fast and gets out of ur skin fast, coumadin takes a while

142
Q

what would u like to increase when it comes to DEEP vein thrombosis

A

increase mobility as much as possible
we want to turn these patients every 2 to 3 hours

make sure we are doing range of motion exercises where they are working with physio

143
Q

what is fat embolism syndrome: go more in depth

A

two long bones
10% of these people die
fat globules from the bone fracture- breaks off and float through your body

144
Q

what is the sign and symptoms of fat emoblism syndrome

A

significant hypoxia, tatchycardia, tachypnea , and dyspnea

145
Q

what is this describing : confuse or pass out ( mental status ) sometimes they can get restless
respiratory rate will go up and try to get more oxygen in and pending
sense of pending due is they think something terrible has happened ( sats will go down )

A

fat embolism syndrome

146
Q

what is typically the signs and symptoms of fat embolism syndrome

A

signs and symptoms is poor oxygenation , and what is usually seen first is the patients mentation

intubated not on ventilator

147
Q

early infection generally occurs for how long ?

A

less than 2 weeks after surgery S & S : increasing local pain, redness, swelling, wound drainage, disturbed wound healing, fever

148
Q

what is typically the infecting organisms for infections

A

typically, infecting organisms are highly virulent ( staphylococcus aureus , gram negative bacilli, clostridial infections ( gas gangrene or tetanus )

149
Q

acute compartment syndrome is what ?

A

huge build up of fluid outside (cast ) inside ( edema )

150
Q

what is this describing : could have outside pressure or inside pressure

A

acute compartment syndrome

151
Q

how do we release pressure when someone has acute compartment syndrome

A

cut cast
fasciotomy
need to regain perfusion

152
Q

true or false. if its not a cast ( inside pressure ) therefore it is edema

bonus: what do they have to do ?

A

fasciotomy

153
Q

how does the doctor make the incision for acute compartment syndrome

A

the doctor will get sterile stuff , scapel and make an incision all the way down there
u can see the body smile, the pressure is so big

154
Q

what is fasciotomy ?

A

not simple to heal
perfusion is not getting to it
DO NOT ELEVATE the leg , it’ll make it worse

155
Q

what should we not do : other than do not elevate their legs ( fasciotomy )

A

no cold compresses ( vasoconstrictor )
if it was just a tenser ( losen )
if its a cast ( call the doctors and ortho and get them to deal with it )

156
Q

fasciotomy : true or false. this wound needs to heal from inside out, packing dressings, likely need a skin graft or some other method of slow/constant closure

A

true

157
Q

black sterile sponge in the wound bed ( largest clear tape all over it ) and attach the tubing to it and make a hole sterile scissors and attach it to eh machine so it suctions fluids
: what does this undergo to?

A

fasciotomy

158
Q

Hip
what undergoes the charactersitics

A

elderly ( significant of death, osteoporosis increases risk )

159
Q

pain management/multimodal approach, geriatric dosing, regional nerve block

when it comes to hip

A

this is true

160
Q

ng quality care for hip

A

timing of surgery, mobility, nutrition, foley fr uti, delirium

161
Q

recall : that these timing of surgery, mobility, nutrition, foley fr uti, delirium undergoes ng quality care , what else?

A

pneumonia, constipation, vte, pressure injury, discharge plan, bone health

162
Q

hip : traction - alignment/turning

A

true

163
Q

people with hip issues typically may need what ?

A

may need pinning or replacement a replacement is reffered to as prosthesis - risk for hip dislocation

164
Q

activity orders for hip is what ?

A

char, ambulate, weight bear

165
Q

use of abduction pillow to prevent hip dislocation after toal hip replacement , what are we doing

A

1) affected leg should not cross the center of the body

2) hip should not bend more than 90 degrees

3) affected leg should not turn inward

166
Q

what do u have to think about when it comes to the pelvic

A

think abt internal organs ( bowel, bladder, urethra ) what we worry abt is bone fracture could actually damage organs
could cause irrigate the vessels
stops doing tis thing

167
Q

pelvic is not life threatening ?

A

it is life threatening - high mortality rte

168
Q

what can cause a serious intra abdominal injury

A

pelvic
- lacerate an organ ( urethra , bladder, colon )
-lacerate a vessel ( hemorrhage )
-paralytic ileus

169
Q

pain medication, stool softeners are utilized in pelvic

A

yes this is true

170
Q

Non-weight baring#(bedrest, painful; heal in 2
months – may need rehab/PT after)

for pelvic

A

true

171
Q

Weight baring # - need OR (external fixation, ORIF or both: severity of injury/potential need for traction determines when pt can weight bare

is this true in terms of pelvic

A

yes this is true

172
Q

surgery ( they get hardware put in ) depending on where it is broken
non weight bearing ( heals on its own ) need some things such as rehab and physio

A

true in terms of pelvic

173
Q

in pelvic , they have these hardware that stay in there forever

A

this is true

173
Q

spinal cord injury : is what ?
what are the diagnostics we are looking at

A

injury to a vertebrae that impacts the cord
dx: xray, mri

174
Q

what is the level of injury of spinal cord injury

A

C,T, L , vertebrae
vertebra #
complete or incomplete ( more common )

175
Q

bone like a vertebrae you will have problems ( and fractures or elg fractures ) your cord has sensory and motor neurons. Is this true or false.

A

this is true

176
Q

if u have a vertebra #
what happens

A

never breathe on their own again ( spinal cord injury )
elbow crunches
level of injury is huge (tells us what the future will tell us for the patient )

177
Q

level of injury could be complete or incomplete ( more common )

A

this is true

178
Q

impact on the bod systems : loss of or decreased mobility, sensory perception and bowel and bladder control often result for an sci

A

this is true

179
Q

the higher the injury the more the effect on the body

A

this is true ( spinal cord injury )

180
Q

cross messages right through cord or incomplete
damage part of the cord ( usually right where the bone came off )

A

yes this is true

181
Q

what happens if there is a c4 injury
c6 injury

A

c4- tetraplegia
c6- tetraplegia

182
Q

what happens if there is a t6 injury
or L1 injury

A

t6- paraplegia
L1- paraplegia

183
Q

where is cervical located close to ?

A

right by the neck

184
Q

sacral : complete right through the cord cannot move it cannot feel it. true or false.

A

true

185
Q

what is this describing : that area of spinal nerve is involve with

A

dermatomes

186
Q

this is a good image of what an injury or part of the body infected on the level : what is this describing

A

dermatones

187
Q

c6
t4

A

thumb
nipple line

188
Q

level of injury will tell us what will be the impact on the patients functioning ?

A

tells us what that patient functioning will be and will be focusing on our care

( when we think abt the injury the primary injury right when the accident happens )

189
Q

injury : what is the initial/primary injry

A

actual physical disruption of axons

190
Q

what is secondary inury

A

ongoing, progressive damage that occurs after the
initial injury

191
Q

the damage from the primary
make the injury itself a bit worse
what is this describing ?

A

secondary injury

192
Q

what is the goal for injury ?

A

prevent further cord damage/extension of injury

193
Q

____ or ____ because of that secondary injury

A

t4 or t3

194
Q

what is the whole goal for injury

A

to prevent more poor damage

195
Q

we do not want the secondary injury to happen ( we immobilize them ) and think abt collars
is this true or false.

A

this is true

196
Q

how can we prevent further cord damage/extension of injury

A

immobilize and methylprednisolone

197
Q

IV a big dose
( for 24 to 48 hours )
all that to prevent more swelling or secondary injury
true or false.

A

true

198
Q

spinal shock
true or false. it does affect vital signs , not only spinal cord

A

false. it does not affect your vital signs

199
Q

spinal shock
what happens in the body ?

A

that is not permanent
this is temporary - it depresses all the cord function

decrease reflexes, and we also have lose sensation

200
Q

true or false. spinal shock also causes flaccid paralysis , below the level of injury , this is a bit of a shock

A

true

201
Q

true or false. spinal cord injury are at risk for spinal shock happening but only 50 percent o them get it

A

true

202
Q

spinal shock may mask what

A

post injury neurologic function
when we get this patient ( never gonna move their arms again ) but once this spinal shock wears off then they move there arms

203
Q

what is the treatment for spinal shock ?

A

last from days to months
there is none
we dont have to wait to get to patient

204
Q

is there an active rehab in spinal shock

A

no treatment or active rehab right away

resolves overtime

once it resolves
we might see that the functioning is actually better than we initially thought

205
Q

complete sci assessment
( spinal cord injury )

A

effects depend on the level of injury

resp c1-3 ( these injuries are fatal , these people have apnea ( cannot breathe in ) they cannot cough

if these people do live, they will need 24 hour help for the rest of their life

206
Q

if someone has c4 injury what happens

A

if someone is injured a bit lower c4 - may be able to breathe without a ventilator ( but they have a poor cough )

diaphragmatic breathing or hypoventilation ( they do not take big breaths )

207
Q

what happens if someone has c5-t6 injury ( complete sci )

A

c5-t6 they have decrease resp reserve ( decrease resp reserve means u and i can get cold and feel crap and feel okay ) that cold can turn into horible pneumonia and can be fatal ( if they get sick )

muscle weakness - cannot talk very loud ( cannot get air to get through vocal chords )

maybe even a weak voice

208
Q

below t6 , what is the injury

A

no problem with resp system

209
Q

phrenic nerve

A

the cervical plexus ( make your diaphragm move )

210
Q

CVS : above T6 complete sci assesment

A

absence of vaso motor tone - they also have postural hypotension

they also have lower heart rate, low blood pressure

( abdominal binder ) something that helps these people

211
Q

complete sci assesment
GI : above T5

A

they cannot control bowel movement or sometimes cannot they need to go

no bowel sounds

212
Q

people with gi problems above 75 what type of problem do they often have ?

A

have often have problems with paralytic ileus
also problems with abdominal distension,constipation, and fecla incontinence

213
Q

complete sci assesment : GU T1-L2

A

they cannot control when they void

urinary this is retention

urine is flaccid , kidneys will make urine and sit there

214
Q

gu. true or false doesnt get the urge to move away, there bladder can reflex empty

A

true

215
Q

in the photo describe how the man is ( try to recall the picture )

A

tracheostomy
got an iv
pump probably tube feed pump

216
Q

in the photo ( try recalling the photo )
why bother wearing sneakers ?

A

runners and when u are not walking runner helps keep their foot protected, and keep their heels flat

keep tendons from wanting to shorten

217
Q

s

A
217
Q

sci : effect on pt and ng care ncp

A

manage airway and improve breathing , resp chest physio ( pulmonary toileting )

218
Q

SCI: Effect on Pt & Ng Care NCP
* Manage airway & improve breathing p881 Respiratory “chest physio” “pulmonary toileting”

what undergoes this

A

effort ( work of breathing )
abg ( po2 and c02 levels )
air entry ( atlectasis ) , asuculate breath sounds
adequate cough ( pneumonia )
cough assist

219
Q

what undergoes cvs : sci : effect on pt and ng care ncp

A

rics neurogenic shock
adequate hydration, dec CO
DVT, PE
muscle spasm, neuropathic pain

220
Q

DV, PE ( because they are immobile )
what type of intervention are we utilizing for muscle spasm and neurpathic pain

A

baclofen , sometimes necrotic

221
Q

effort of breathing and how strong their heart is
cough assist is take a deep breaths and say cough and move in their upper abdomen to help them cough

A

yes

222
Q

cough as hard as u can ( not hard at all )
cvs thinking risk for neurogenic shock

A

true

223
Q

neurogenic shock : what is it ?

A

loss of sympathetic innervation

224
Q

neurogenic shock
what does this do ?

A

vital signs
neuro genic shock happens because they have losee their sympathetic innevration

225
Q

what type of vasodilation do neurogenic shock get ?

A

they get peripheral vasodilation
also get venous pooling
and decrease in cardiac output

226
Q

who is at risk for neurogenic shock ?

A

low blood pressure and low heart rate these patients are warm and dry

they do not feel cold and calmy which they should since low bp and low he

227
Q

people who are at risk is injured from t5-or above what is this describing ?

A

neurogenic shock

228
Q

what are the s & S for neurogenic shock ?

A

low blood pressure and low heart rate

( treat this blood pressure )

229
Q

true or false. neurogenic shock is always a problem ( life long )

A

this is true may have to put medarine meds that brings up blood pressure

230
Q

what are the s and s resolution

A

systolic of 60-75 if we do nothing
it may not go up and this is trouble and can lead to hear attack ( keep an eye on this )

231
Q

when is this goingaway ?

A

when vital signs become more normal

232
Q

bowel and bladder retraing

GI neurogenic bowel

A

hypotomotility and management ( bowel routine ) –> bowel routine this is usual colace everyday , doing this suppersitory, every second day

233
Q

bowel and baldder retraing , what do we have to make sure ?

A

getting enough nutriton and fibre

234
Q

bowel and bladder retraing
GU neurogenic bladder
what undergoes it

A

urgency, frequnrecy, incontinence
management
decreasing the risk of UTIs

235
Q

getting enough nutrition and fibre
for gu ( neuro genic bladder ) problem with what ?

A

urgency , frequency, incontinence

236
Q

these people may need to ct staright of then is always better than stragiht cath than indwelling foley
GU ( neurogenic bladder ) . tru or false.

A

true

237
Q

if patient cannot straight cath, they may given indwelling foley

A

true

238
Q

nutrition/GI : bowel and bladder retraing

A

nutrional intake
metabolism
ulcer protection

239
Q

first 6 months are hypermetabollic meaning they are not moving they are burning calories a lof of calories, make sure they have enough calories and proteina dn metbaplism is the high at the start because of what ?

A

muscle wasting

240
Q

ulcer protecting — what type of medication are we doing ?

A

PPI h2 we want to make sure they are getting enough nutrition and not a bleeding ulcer

241
Q

bowel and bladder retraing :what else?

A

thermoregulation ( poikilothermia )

skin inspection : skin care, comfort, mattress; roho cushion for wheelchair

242
Q

these pts are a high level of injury ( be careful of body temp )
will take on the environment temperature
los the ability tor regulate it

A

true or false.

243
Q

bowel and bladder retraing : sexuality , rehab process, emotional/mental health

A

sexuality
-sensation
-fertility

rehab process
- expectations regarding recovery ( related to level of injury )

emotional/mental health
-greif/loss, depression
-goal is pyschosocial adjustment

244
Q

stabilization and alignment : harcd vercial collar
other than that what else

A

crutchfield tongs
- weight/bed angle
-turning/logroll
-washing skin and pin site care

245
Q

stabilization and alignment : harcd vercial collar
other than that what else

recall : crutchfield tongs
- weight/bed angle
-turning/logroll
-washing skin and pin site care

what else ?

A

halo vest
- patient and family education
alters patient’s balance
-skin and pin site assessment and care
-washing skin under vest liner

  • emergency wrench
246
Q

is traction and stabilization short or long term

A

this is short term

247
Q

what is the situation for the patient like during traction and stabilization

A

just to get them stable enough

patient is npo

turn him ( had to make sure )

foley and clean him and clean the bed again

turn a tiny bit ( shift to the weight is okay )

248
Q

summary of sci management in acute care
give a run down of the meds
and surgery

A

meds :
methylprednisone
dopamine
atropine

surgery : ( stabilize, realign, spinal column )
- laminectomy, fusion

249
Q

blood pressure up, for dopamine and get heart rate up with atropine is this true or false.

A

this is true

250
Q

how does lainectomy work ?

A

dr will go in or prone ( faced down ) and make an incision, in that area clean out bone fragments, and clean up any blood and out in hardware

251
Q

how is the patient going to recover furing laminectomy ?

A

back on the unit, and rule is discontinued to get the pt to move around and get up in the wheelchair

and then move on to rehab

252
Q

what is non surgical intervention for sci management n acute care

A

spinal immobilization and stabilization

253
Q

what do they wear in sci management in acute care

A

wear hard cervical collar , halo fixation device with jacket

254
Q

recall : what do they wear in sci management in acute care
wear hard cervical collar , halo fixation device with jacket

then when physcially stable the focus move to what ?

A

physio ( stretching, stregtening, balance 0
braces/canes/wheelchair/mobility
rehab and hospital leaving unit on day passes
adl and mobility training

255
Q

autonomic dysreflexia whcih sci pts are at risk ?why does it occur ?

A

injured at t6 , or above high level injury problem
why does this ocur ? because of a reflex neuro sympathetic response of vasoconstriction

256
Q

autonomic dysreflexia

why does it occur ?

A

slower imbounded pulse
high blood pressure is one

heart rate could be in the 0s or 40s the patient feels terrible, bad headache, blurred vision, and even flushed above the level of injury

257
Q

autonomic dysreflexia what is it ?

A

a massive uncompensated cvs reaction mediated by the sns

258
Q

recall that : a massive uncompensated cvs reaction mediated by the sns

autonomic dysreflexia

A

sns response to stimuli > reflex vasococntriction below injury and vasodilation above injury

  • the return of reflexes ( after spinal shock has resovled) means that hse pts may develop autonmic dysflexia
259
Q

what are the s and s for autonomic dysreflexia

A

systlloc 180-200
slower imbounded pulse
( high blood rpessure is one )
heart rate could be in the 0s or 40s the patient feels terrible , bad headache , blured voison
and even flushed above the level of oiijiry

260
Q

ng care and tc for autonomic dysrefelxia

A

vasodilator
- we want their blood pressure to be down
first thing we do is nursing care , et their head of bed head up

  • figure out what is the cause and idea with that
261
Q

fixed whatver cased this happen : autonomic dysreflexia , is this true or false

A

this is true

262
Q

possible causes of autonomic dysreflexia ?

A

full bladder, things like a full bowel ( alot of stool in their rectum ) and even like shoes on too tight when was the last time u catherized ur self ? staight cath would solve the problem

263
Q

true or false. it is important ot eh tach the pt an family

A

true what can happen person can have stroke or seizure if not contorlled of blood pressure

teach patient and fmailt identify signs and tratments tis can happen in t6 or above

264
Q

amputation
what undergoes this ?

A

H & Illness 4: A & C illness (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions