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Musculoskeletal 2013

Musculoskeletal 2013 nursing 165

QuestionAnswer
Arthroscopy Nursing interventions : after procedure cover wound with compression dressing to control swelling. Monitor neurovascular function. Keep joint extended and elevate to reduce swelling. Give analgesics.
Arthroscopy Nursing implications neurovascular checks pain and swelling control, prevention and monitoring for thrombophlebitis and infection
Bone scan nursing interventions No restricted activity for patient. Encourage patient to drink plenty of fluids after procedure
Erythrocyte sedimentary rate (ESR)test? reflects inflammatory rate, and indirectly the progression of the disease
Rheumatology is The study of any disease or condition that involves the musculoskeletal system
Osteoarthritis is chronic non-inflammatory progressive disorder that causes cartilage deterioration in synovial joints and vertebrae
Osteoarthritis affects mostly what type of joints weight bearing
Risk factors for OA Aging, Obesity, Genetic predisposition, Malalignant of joints, Trauma, Gender and Hormonal factors
Clinical manifestations of OA  Pain and stiffness  Loss of movement function Joint enlargement, Formation of osteophytes, Limitation of joint motion, Joint stiffness in morning or evening, Limited ROM
Heberden’s nodes is bony enlargement of the distal interphalangeal joints of the fingers
Brouchard’s nodes is bony enlargement of the proximal interphalangeal joints of the fingers
management of OA Focuses on, what pain and inflammation, preventing or limiting disability, and maintaining and improving joint function
What are the pharmacologic measures for OA? NSAIDs and COX-2 inhibitors
What is the reconstructive surgery for OA? arthroplasty
What is arthroplasty? replacement of all or part of joint
What are the classic symptoms of Rheumatoid Arthritis Joint pain, swelling, warmth, erythema, and lack of function
What are some to the pharmacologic measures for RA? NSAIDs, COX-2 inhibitors, and disease-modifying antirheumatic drugs (DMARDs)
Diagnostics test for RA Bone scan, MRI, Arthrocentesis, Rheumatoid factor, ANA test, & High sensitivity C reactive protein test
Early symptoms of RA Pain at rest and with movement, Malaise, Depression, Fever, Weight loss, Fatigue, Generalized weakness, Morning stiffness, Edematous, erythematosus
Late symptoms of RA Pallor, color changes of digits, Muscle weakness, atrophy, paresthesias, Decreased joint mobility  Contractures  Dislocation  Increased pain
Gel phenomenon is morning stiffness lasting 45 minutes to several hours after awaking
Sjorgeren’s syndrome is includes dry eyes, dry mouth, dry vagina. Some say their eyes feel gritty
Felty’s syndrome is characterized by RA, hepatosplenomegaly (enlarged liver and spleen), Will usually have decrease WBC’s.
Caplan’s syndrome is characterized by lung nodules and pneumoconiosis. Common in coal miners and asbestos workers
Rheumatoid Factor measures, what? the presence of unusual antibodies of immunoglobulin that develops in connective tissue disease
(ANA) Antinuclear antibody measures, what the titer of unusual antibodies that destroys nuclei of cells & cause tissue death. Results- often negative until the disease progresses. Can be positive without any underlying disease
What class of medications are used to treat RA? anti-inflammatory, antipyretic, analgesic, immunosuppressive
What DMARD's used for the treatment of RA? Methotrexate, Aravia, Leflunomide, Plaquinil & Azulfidine
Plaquenil is a anti-inflammatory and what other type of med? antimalarial drug
What are some things a RA patient should include in their diet? Fish oil, Iron rich foods ( liver, oysters, organ meat whole grains, legumes, green leafy vegetables), Calcium and Vitamin D-
gout is A metabolic disorder marked by the deposition of monosodium urate crystals within joints and other tissues
what are the nursing care priorities of gout? pain management, self care, and lifestyle and dietary modifications
Clinical manifestations of Gout include Articular inflammation; Often appears after 10 years. Gouty nephropathy, metatarsophalangeal joint of the big toe
triggers for acute attack of gout trauma, alcohol ingestion, dieting, medications , surgical stress and illness
Medication management of gout for acute attacks NSAIDS or Colchicine
nursing care for gout patient education, exercise, and cognitive therapy along with the medication regimen
Septic arthritis is Due to infection from other parts of the body or directly from trauma or surgical instrumentation
symptoms of septic arthritis swollen, warm joint with decreased range of motion
How is septic arthritis diagnosised By blood cultures, ESR, C reactive protein, and complete blood count are done, evaluate synovial fluid
Treatment for Septic arthritis Broad spectrum IV antibiotics
Risk factors for Septic arthritis advanced age, diabetes, RA, preexisting joint disease, osteomyelitis, infection of the bone
Osteomyelitis is Infection of the Bone
Risk factors for Osteomyelitis poorly nourished,Elderly, Obese
Osteomyelitis nursing diagnosis acute pain, impaired physically mobility, Risk for extension of infection, Deficient knowledge related to treatment regimen
Contusion is A soft tissue injury produced by blunt force
Strain is An injury to a musculotendinous unit caused by overuse, overstretching, or excessive stress
Sprain is An injury to the ligaments and supporting muscle fibers that surround a joint
Contusions, Strains, and Sprains treatment consist of resting and elevating the affected part, applying cold, and using a compression bandage
Open fracture Grade 1 least severe, skin damage-minimal
Open fracture Grade 2 has skin & muscle contusions
Open fracture Grade 3 has damage to skin, muscle, nerve tissue, and blood vessels (most severe)
Colles fracture a fracture of the distal radius (wrist)
Stress fractures occur with repeated bone trauma from athletic activities; repeated loading of bone and muscle
Compression fractures caused by compression of vertebrae & associated with osteoporosis
Greenstick a fracture in which one side of bone is broken and the other side is bent
Transverse a fracture that is straight across the bone shaft
Oblique a fracture occurring at an angle across the bone(less stable than a transverse fracture)
Spiral a fracture that twist around the shaft of the bone
Comminuted a fracture in which bone has splintered into several fragments
Pathologic fracture a fracture that occurs through an area of diseased bone:can occur without trauma or a fall
avulsion a fracture in which a fragment has been pulled away by a tendon or and its attachment ( assoc. with sprains
Depressed fracture a fracture in which fragments are driven inward
Epiphyseal fracture a fracture through the epiphysis
Impacted fracture a fracture in which a bone fragment is driven into another bone fragment
Clinical manifestations of fractures Pain, tenderness, False motion, loss of motion, Deformity, muscle spasms, numbness, Shortening of the extremity
Crepitus is grating sensation caused by rubbing of the bone fragments against each other, Crepitus, Localized swelling and discoloration
Skin traction done by a weight pulling on velco boot, belt or halter that had been attached to the skin & Limit of weight on extremity: 5-10 pounds
Skeletal traction Pins wires tongs or screws inserted directly into bone distally from fracture 15-30 lbs mostly used to treat fractures to femur ,tibia humorous and cervical spine
Bucks extension traction used for lower leg to provide immobility and comfort after injury to hip- prior to surgery
Russell’s traction may be used for fractures of tibial plateau, supports the flexed knee in a sling
Dunlop’s traction is applied to upper extremity for fractures of elbow and humerous
Acute compartment syndrome involves a sudden & severe decrease in blood flow to the tissue that results in necrosis
Chronic Compartment syndrome involves pain, aching, & tightness in a muscle or muscle group subjected to inordinate stress or exercise.
crush compartment syndrome massive external compression or crushing of a compartment
Treatment of ACS Prevention control edema, elevate extremity to heart level and apply ice after injury. Restrictive dressings and tight cast must be adjusted
Created by: 597389573