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espn brenda b LSII
Immobility test b benton
Question | Answer |
---|---|
Fracture coils around the bone; results form a twisting force | Spiral fracture |
Fracture line runs directly across the bone; 90 degree angle | Transverse Fracture |
Fracture in alignment, incomplete, common in children | Greenstick Fracture |
Bone broken splintered into 3 or more pieces | Cominuted Fracture |
Bone collapses into small pieces; common in the vertebrae | Compression fracture |
Wrist fracture at the distal radius; happens when a person tries to break a fall | Colle's fracture |
One end of bone is telescoped into the adjacent bone | Impacted Fracture |
Results from a weakness in the bone due to structural changes, such as, a tumor or osteoporosis - can occur spontaneously | Pathologic Fracture |
Sodium urate deposits around joints, seen with gout | Tophi |
Partial or incomplete dislocation | Subluxation |
Traction applied directly to the bone | Skeletal |
Abnormal joint flexion caused by permanent atrophy and shortening of muscle fibers | Volkman's Contracture |
List the 7 P's | Pain, pallor, pulse, puffiness, polar temp, paralysis, parasteshia |
Your patient has a fractured hip, but won't go to sugery till tomorrow. What type of traction is used | Buck's traction |
What precautions must be taken prior to sending a patient for an MRI? | Remove metal objects, Determine if pt. has metal implants, vascular clips, can't have MRI. If claustrophobic - give meds eg. xanax, valieum, ativan |
Rheumatoid arthritis is a systemic or non systemic disease | Systemic |
Rheumatoid arthritis is a inflammatory/non inflamatory disease | Inflammatory |
Subcutaneous nodules that are associated with R.A. can form in what areas of the body? | fingers, wrists, boney proominences, pressure places, joints, lungs |
What are the systemic effects of R.A. | Marked fatigue, depression, malaise, anorexia, low grade fever,fe deficient anemia |
What diagnostic tests will be abnormal in RA | ESR, cloudy synovial fluid analysis, RA latex, CBC, Note RBC count, RF rheumatoid factor, x-ray, anemic |
What medications are used to treat R.A. | Aspirin, NSAIDS, motrin,, naproxin, COX2 inhibitors, celebrex, viox, adrenocarticosteroids, prednisone, immune suppressants, remicase, |
What is another name for ostoarthritis? | degenerative joint disease |
What are some causes of secondary osteoarthritis? | trauma, infections, obesity, injury, occupational stress, previous fracture, rheumatoid arthritis |
O.A. is systemic or non systemic | systemic |
O.A. is inflammatory or non inflammatory | non inflammatory |
What joints are most commonly affected with O.A. | hips, knees, hands, cervical and lumbar vertabrae, top of spine. |
Waht causes the pain in O.A | Articular cartlige deteriorates bones and joints degenerating with aging process, (wt. bearing & movement) |
What medications are used to treat O.A? | Analagesics, acetaminophen - Tylenol, aspirin, or NSAIDS (Motrin) steroids, cortisone into joints, glucosteroids |
Why is it important to keep the hip adbucted following an arthroplasty | To keep hip joint in proper alignment |
How often should neuro - vascular checks be done following arthroplasty surgery and why? | qH for 24 hours, Q2h for 24 hours, q4h for 24 To make sure circulation is not impaired and nervous system is intact.Color of extremities check cap refill, can you feel this check pulse |
What can you do to prevent the patient from over flexing their hips postoperatively | Use of the abductor pillows between raised toilet seats, don't bend over too much |
An elevated uric acid level is diagnositc of gout | False it is a indicator or symptom but not diagnostic |
List some of the foods that are high in purines. How does avoiding these foods help keep the uric acid levels lower? | Organ meats, cheese, beer, wine, anchovies, yeast herring mackeral, scallops, because they are very high in protein and high protein increase uric acid levels |
How can gout contribute to the development of kidney failure | Uric acid crystals in tubules, lead to blockage, tophi can form in kidneys and alter kidney function |
What joint is most commonly affected by gout? | Big or great toe |
When does the pain associated with gout most commonly occur? | Night time |
Describe what the joint will look like | Edema, heat, discolored erythemetous or purple, limited movement of joint |
What are common sites for tophi formation | great toe joints, heart valve, kidney, rim of ear and other joints of body |
How is gout diagnosed | Serum & urinary acid levels increased, increased ESR levelsm cbc, x ray, leukocytosis and anemia, synovial fluid |
What medication is o ften used for acute attacks of gout? | colchine pain with acute attack |
What medications are used as a preventitive for recurrent attacks of gout | allopurinol - makes uric acid slow down production xyleoprin |
How can you relieve your patients discomfort other than using medications? | Bedreset, support foot in alignment, bed cradle over fot, cold packs, intake to pomote excretion of uric acid, elevated on pillow. |
What medication should not be used to relieve inflammation/pain with gout? Why? | Aspirin - slows down uric acid excretion from kidney |
Describe the appearance of the bone in persons with osteoporosis? | Bone looks thin, not dense, spider web |
What bones are frequently affected with osteoporosis | vertabrae, neck or femur, pelvis, hands, wrists |
Why do pts. with osteoporpsos frequently develop a shortened stature | Compression of vertabrae |
How is osteoporosis diagnosed? | X-ray, porous bones, compression of fractues, bone density testm losts of bone mass density. |
What are the goals of treatment in OA | Stop bone loss, increase bone formation, prevent fractures |
What do you need to teach your patient about takng fosomax | Take 1st thing in Am with 6 - 8 oz. of water, at least 30 minutes before meds, beverages & food, remain upright for 30 minutes |
Qhy is osteomyelitis difficult to treat | stimulation causes surrounding bone to develop new bone growth around infected site - "walling it off" |
What are some long term complications that can occur as the result of osteomyelitis? | Chronic long term infection, joints may be infected which can affect future growth in child, sinus can develop in soft tissue and spread infection to adjacent tissue, contractures, prone to spontaneous fractures. |
How is ostemyelitis diagnosed | Xray, bone scan, cbc, eser, leukocytosis, blood culture & wound drainage |
What can worsen the signs/symptoms of fibromyalgia | Humid & cold weather, physical or mental fatigue, ecess physical activity, anxiety, stress |
What lab abnormalities will be seen with fibromyalgia | none |
What is the most common type of soft tissue injury | contusion |
Whiplash is a type of? contusion, sprain, strain | Sprain |
What are the effects of heat and ice of the injuries in whiplash | ice=vasoconstriciton and reduces swelling, heat = vasodiliation to increase blood flow to promote healing |
Define closed reduction | Manual manipulation |
Define open reduction | involves surgery, possible internal fixation device |
What nerve is involveed in carpal tunnel syndrome | median |
What is Tinnel's sign | Increase tinglingand gentle tap over tendon sheath or ventral surface of wrist |
What is a Phalen test | Hold wrist together in forced palmar flexion for 1 minute sensory of numbness tingling |
What will EMG & MI results showin a pt. with carpal tunnel syndrome | EMG = weakened muscle response, MRI = compression, flattness of median |
What are some causes of herniated disc | lefting, twisting, trauma |
Where do most of these ruptures occur? | Between L4 & L5 and L5 & S1, cervical, lumbar |
Describe the pain associated with a herniated disc | pain, stiffness, paresthesisa, numbness, bowel and bladder, sciatic nerve |
What diagnostic measures are utilized when a herniated disc is suspected? | Xray, CT, emg, MRI |
Primary bone tumors originate in the ? and can be malignant or benign | Long bone |
Primary cancer site that often metastasize to the bone include | prostate, lung, breast, kidney, thyroid |
What i the malignant tumor found in long bones | Osteogenic sarcoma |
Bone cancers are diagnosed by | Pet Scan, xray, bone scan, bopsy, labs, cbc, platelets |
What is the most common cause of fractures | trauma motorcycle |
How are most fractures diagnosed | x-ray |
What causes a pathological fracture | weak bone structure d/t osteoporosis or tumor, neoplasia, ostemalacia, spontaneous fracture |
What is a "torsion" injury | twisting |
Why is a hematoma formation at the fracture site important | Stop bleeding, start healing, osteoclaasts destroy necrotic tissue and it serves as a basis into which granulation tissue grows |
What are 1st aid measrues that should be initiated immediately after a fracture | Immediate spliinting and immobilization, elevate, ice, analagesice, observe for shock |
With what type of fractures is tetanus toxoid indicated | Open compound |
Why are isometric exercises important for someone with an immobilized extremity | to keep muscle tone prevent muscle atrophy |
what condition need to be monitored for fat embolism? What are some s/s | Within 48 hours following injury to clients with a long bone fracture at greatest risk, s/s mental status change, restlessness, tachycardia, tachypnea, dyspnea, hypotension, petichae, rash over upper chest back |
When a pt is in Bucks traction what produces the counter traction | wts. & elevation of foot of bed using persons own body wt. |
What complications do you need to monitor for whe a patient is in traction | Maintain proper body alignment weight hanging greelly and pulleys not obstructed, 7 p's |
How does traction relieve pain associated with a fracture | Provide proper bone alignment and reduces muscle spasm, immobile |
What should you do if your pt. in Buck's traction develops cold, blue distal extremity with numbness and tingling | See if boot is too tight, monitor tightness of wrap |
Describe the skin care for a pt with an external fixation device | watch for any skin rubbing frictiion, pin care, neosporin, infection |
What part of body does a spica cast immobilize | leg, hip, shoulder, trunk |
What should you tell your patient prior to a cast application | sudden movement during procedure could cause injury, plaster will feel warm as it dries, explain extent of immobilization, don't varnish, don't insert objects under cast |
Describe the nursing care immediately after a cast application | handle with a flat of hands or on pillows, inspect skin at edges of cast and remove plaster rumbs from skin. Use creams and lotions sparringly |
Define muscle atrophy | decrease in size of muscle or an organ |
What is neoplasia | •the pathological process that results in the formation and growth of a tumor |
what is osteomalacia | •abnormal softening of bones caused by deficiencies of phosphorus or calcium or vitamin D |
what is a spontaneous fracture | the breaking of a part, especially a bone. 2. a break or rupture in a bone. avulsion fracture separation of a small fragment of bone cortex at the site ... |
What is an osteoclasts | Osteoclasts are large multinucleate cells (cells with more than one ... In women, osteoclast activity is increased because of decreased estrogen after the ... |
What are 3 complications of fractures | infection, edema, comparment syndrome, fat embolus |
The type of osteoarthritis that is brought on by trauma infections, obestity or other factors is referred to as | Secondary |
Treatment for osteomylitis includes all of the following except a. aggressive long term antibiotic b. Hormone replaement therapy c. Bedrest, abslute rest of bone d. Surgical debridement of bone | Hormone replacement therapy |
What is fibrous connective tissue enclosing a joint | joint capsule |
Post op care for a patient with a laminectobmy includes all of following exvept a. log rolling' b. reposition q2h c. absolute bedrest for 72 hours d.monitor bleeding and leakage of cerebral fluid | absolute bedrest for 72 hours |
the diagnostic test in which needle electrodes are inserted into a muscle so electrical activity can be measured is called | electrolyogram EMG |
What is a compression fracture | crushd bone, as seen in vertebral fractures |
what is an oblique fracture | fracture lines runs a slant across the bone at 45 degree angle |
What is a comminuted fracture | Broken into 3 or more pieces |
What is a transverse fracture | Fracture line runs directly across the bone 90 degree angle |
What is an impacted fracture | fragmented pieces wedged together may not need repair |
What is a spiral fracture | fracture coils around the bone results from twisting force |
What work is associated with Carpel tunnel syndrome | repetitive |
What nerve is effected in carpal tunnel syndrome | median |
S/S of a hip fracture include all of the following except a. pain that increases w movenment b. external rotation c. internal rotation d. shortening of the leg e. inability to move leg or bear weight f. creptius | internal rotation |
A potentially fatal complication that can occur after a fracture of a long bone or pelvis is | fat embolism |
Carpal tunnel syndrom involves compression of what nerve | median |
Which drug puts a person at a higher risk for developing osteoporosis | steroids |
the joint surface of each of the bones is lined with | articular cartilage |
Deficiency of which hormone is associated with an increase in bone resorption with out an increase in bone formation | estrogen |
the type of arthritis that is a systemic disease is | rheumatoid |