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Musculoskeletal 2013
Musculoskeletal 2013 nursing 165
| Question | Answer |
|---|---|
| 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 |
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