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Musculoskeletal lvn
notes part 2 of 3 Alison M.
Question | Answer |
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Progressive Systemic Sclerosis is also called: | Scleroderma; takes name from characteristic of "hardening of the skin" |
Progressive Systemic Sclerosis is what type of disease? | chronic MULTISYSTEM autoimmune disease |
Other organs affected with Progressive Systemic Sclerosis? | blood vessels, gastrointestinal tract, lungs, heart, and kidneys |
Signs and Symptoms of Progressive Systemic Sclerosis? | Raynaud's phenomenon, symmetric painless swelling or thickening of skin, taut and shiny skin, morning stiffness, frequent reflux of gastric acid, difficulty swallowing, weight loss, dypsnea, pericarditis, renal insufficiency |
Medical diagnosis of Progressive Systemic Sclerosis? | positive ANA, elevated ESR, increased serum muscle enzyme levels |
Medical treatment of Progressive Systemic Sclerosis? | NO CURE; treatment includes high doses of steroids or other immunosuppressants; medical management of symptoms to prevent complications |
Raynaud's Phenomenon: | spasm of the digital arteries with blanching and numbness or pain in the fingers; fingers become variably red, white and blue |
Positive ANA means: | autoimmune disease |
Elevated ESR means: | inflammation |
Bursitis is: | inflammation of the bursa, a fluid filled sac that cushions bone ends to enhance a gliding movement |
Common sites for Bursitis: | elbow, shoulder, and knee |
Bursitis is most often the result of: | trauma |
Other causes of Bursitis: | infection, secondary effects of gout and RA (causes pain and swelling with compromised function) |
Assessment of Bursitis: | lump seen on x-ray; aspiration reveals what fluid composed of |
Treatment of Bursitis: | joint rest, Salicylates or NSAIDs, Corticosteroid may be injected into the joint, ROM exercises |
Ankylosing Spondylitis: | also called Marie-Strumpell disease |
Ankylosing Spondylitis is what type of disorder: | chronic connective tissue disorder of the spine and surrounding cartilaginous joints |
Characteristics of Ankylosing Spondylitis: | stiffening and fusion of the vertebrae (effects spine and eventually hips) |
Ankylosing Spondylitis is what type of disease? | may be autoimmune and has hereditary tendencies; causes progressive immobility and fixation of the joints in hips and ascends the vertebrae |
Ankylosis: | fixation of the joints |
Spondylitis: | stiffening |
Signs and symptoms of Ankylosing Spondylitis: | spine and hip become immobile, lumbar curve may be flattened, neck may become permanently flexed, lung sounds may be reduced--especially in the apical areas, aortic regurg, or AV node conduction problems |
MOST COMMON symptoms of Ankylosing Spondylitis: | low back pain and stiffness |
Ankylosing Spondylitis diagnosed by: | elevated ESR (indicating inflammation), negative cultre of synovial fluid, elevated alkaline phosphatase and creatine phosphokinase; X-rays and CT scans show erosion, ossification and fusion of the joints in the spine and hip |
Ankylosing Spondylitis treated by: | administer prescribed meds (antiinflammatory meds such as indomethacin and NSAIDs), steroids, mild exercises to reduce stiffness and pain, back brace, hip replacement....goal is to maintain functional posture |
Lyme Disease: | contracted from ticks |
Lyme disease--what happens when the affected tick bites humans? | they transmit the bacteria Borrelia burgdorferi, which results in a chronic inflammatory process and multi-system disease |
EARLY STAGE ONE: Signs and symptoms of Lyme Disease | red macule or papule at the site (may not appear for 20-30 days), headache, neck stiffness, fever, chills, malaise...some may have nausea, vomiting and sore throat, and pain |
Characteristic of Lyme Disease: | bulls-eye rash |
Later symptoms of Lyme Disease | 4 weeks after t(he bite): arthritis and other musculoskeletal problems; joints, particularly the knees, become warm, swollen and painful; joint erosion may result from the inflammatory process |
MID STAGE: signs and symptoms of Lyme Disease | CARDIAC: involves dysrhythmias and heartblock; NEUROLOGIC: involves facial palsy, meningitis and encephalitis; May also have weakness, pain, and parethesia (numbness or tingling) |
DIAGNOSIS of Lyme Disease: | symptoms are vague; IgG antibodies for Borrelia (detected 6 wks after bite) |
Medical Management of Lyme Disease: | treatment involves antibiotics and supportive measures; if treated early, prognosis is favorable; permanent MULTISYSTEM problems may occur if treatment is delayed |
Osteomyelitis | infection in the bone |
characteristics of Osteomyelitis: | limited blood supply, inflammation of and pressure on tissue and formation of new bone around devitalized bone tissue; challenging to treat; decreased blood supply, decreased ability of meds to reach the sites |
Causes of Osteomyelitis: | STAPHYLOCOCCUS AUREUS causes 70% to 80% of bone infections |
Acute osteomyelitis results from: | bacteria reaching the bone through the blood stream (is systemic) |
other complications of osteomyelitis: | septicemia (systemic infection), thrombophlebitis (inflammation of blood bessels), muscle contractures and non-union (non-healing) fractures |
signs and symptoms of osteomyelitis: | high fever, chills, rapid pulse, tenderness or pain over affected area, redness and swelling, exposed bone, drainage from wounds |