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NUR 236 unit 5
| Question | Answer |
|---|---|
| What are the primary structures of the musculoskeletal system? | Bones, joints, cartilage, ligaments, tendons, and muscles. |
| bones store and release | minerals like calcium and phosphorus. |
| What role do blood and lymph vessels play in bones? | They transport nutrients to bone cells and remove waste. |
| What are the three major types of muscles? | Skeletal, smooth, and cardiac. |
| Bones | Provide shape and support to the body, protect internal organs, serve as attachment points for muscles, store minerals (calcium and phosphorus), and contain bone marrow that produces blood cells |
| Joints | Connect bones and allow movement and flexibility; some joints provide stability, while others enable motion. |
| Cartilage | Cushions joints, absorbs shock, and reduces friction between bones during movement; also provides structure in areas like the nose and ears. |
| Ligaments | Tough, fibrous connective tissues that connect bones to other bones; provide joint stability and help prevent excessive movement. |
| Tendons | Strong cords of fibrous tissue that connect muscles to bones; transmit the force of muscle contraction to produce movement. |
| Muscles | Contract to produce movement, maintain posture, stabilize joints, and generate body heat through activity. |
| 50% body weight | Muscles |
| What are common causes of musculoskeletal disorders? | Disease, trauma, malnutrition, and aging. |
| How does poor nutrition affect the musculoskeletal system? | It weakens bones and causes muscle wasting from inadequate protein intake. |
| What role does estrogen play in musculoskeletal health? | Low estrogen levels lead to osteoporosis. |
| How can musculoskeletal disorders be prevented? | Weight-bearing exercise, safety measures, good nutrition, and avoiding smoking. |
| What nutrients are important for bone growth and density? | Calcium, vitamin D, and protein. |
| How does smoking affect musculoskeletal health? | It decreases bone density and delays healing. |
| What labs assess bone and muscle disorders? | Calcium, phosphorus, alkaline phosphatase, creatine phosphokinase (CPK), and uric acid. |
| What is goniometry used for? | Measuring joint range of motion. |
| What is included in a musculoskeletal physical assessment? | Posture, gait, balance, mobility, ROM, muscle strength, spine alignment, joint appearance, and ability to perform ADLs. |
| What age-related changes affect musculoskeletal assessment? | Decreased muscle mass, slower movement, limited joint mobility, and postural changes |
| What are the nurse’s responsibilities when lifting or turning a patient? | Use gentle, firm movements, get sufficient help, and encourage safe participation. |
| What should be explained before lifting or turning a patient? | The procedure and the need to relax completely. |
| What is the purpose of gradual mobilization? | Helps regain mobility and prevent complications like contractures and atrophy. |
| What is a contracture (adaptive shortening)? | Permanent shortening of muscles or tendons due to immobilization. |
| How fast can contractures begin forming? | Within 3–7 days of immobilization. |
| What are common types of contractures? | Foot drop, knee and hip flexion, wrist drop, and finger contractures. |
| What is ankylosis? | Abnormal stiffening and immobility of a joint due to bone fusion. |
| How can ankylosis be prevented? | Gradual mobilization, ROM exercises, and maintaining flexibility. |
| What is the nurse’s role in preventing musculoskeletal disability? | Recognize risks, initiate preventive measures, and encourage safe mobility. |
| What are isometric exercises? | Muscle contractions without joint movement to maintain strength. |
| When are analgesics and anti-inflammatory drugs used? | To relieve pain and allow comfortable participation in therapy. |
| What is the purpose of continuous passive motion (CPM)? | Keeps joints flexible and prevents stiffness after injury or surgery. |
| How does proper positioning help musculoskeletal patients? | Prevents deformities, contractures, and pressure injuries. |
| What are slings and splints used for? | To support and immobilize injured limbs and maintain alignment. |
| What should nurses teach about ambulation with assistive devices? | Safe use of crutches, canes, or walkers to prevent falls. |
| What are key crutch safety tips? | Support weight on hands, not armpits; look ahead; ensure proper crutch length. |
| Foods high in purines that produce uric acid include | cheese, wine, aged meats, chocolates |
| What do radiographs and lab tests help evaluate? | Healing progress, bone health, and treatment effectiveness. |
| Lifting and turning someone with bone cancer | gentle and firm |
| When explaining the structure of the knee to a patient who has knee swelling, which statements are correct | “The meniscus in the joint acts as a cushion.” “The tendons are needed for movement and can be injured.” “Muscles attach to the bones to help provide movement.” |
| Which statement by the patient being taught about musculoskeletal health shows that teaching was effective? | “I will quit smoking.” |
| What action should you perform for postprocedural care of a patient who just had an arthroscopy? | Prepare an ice pack and obtain an elastic bandage. |
| When a 76-year-old female complains of back pain and soreness, what is the first step in assessment? | Family or personal history of osteoporosis or arthritis. |
| Teaching an older adult how to increase musculoskeletal and bone strength—what interventions help? (Select all that apply.) | Walk at least 30 minutes a day, 5–7 days a week. Eat more protein and vitamin C to build muscle. Walk up stairs as often as possible. Perform strength training exercises at least three times a week |
| Which task(s) can be assigned to assistive personnel (AP)? (Select all that apply.) | Assist an older adult with an arm sling to perform ADLs. Report the presence of contractures. Escort a patient in a wheelchair to radiology. Perform passive ROM on a patient during a bed bath. |
| You evaluate a patient’s ability to use a cane. Which action indicates proper use? | The hand grip is at hip level. |
| A 56-year-old with joint pain, poor posture, and uncoordinated gait—what is the priority nursing problem? | Altered physical mobility. |
| When repositioning an immobile patient, what should be done first to prevent injury? | Explain the details of the move. |
| To manage joint discomfort in a patient with severe rheumatoid arthritis, what should you do? | Schedule pain medication administration before exercise. |
| A patient with a splint on the right arm—what finding is most concerning? | Redness indicates possible skin breakdown or pressure injury; warm skin and itching are less concerning. |
| What are the learning objectives for musculoskeletal and connective tissue disorders? | Compare assessment findings of injuries and fractures, understand cast care, identify complications, discuss the six Ps, and outline pre- and postoperative care for joint replacements. |
| What is a sprain? | injury to the ligament |
| What causes a sprain? | Trauma or force that pushes a joint beyond its normal range of motion, such as twisting. |
| What is the treatment for sprains? | RICE: Rest, Ice, Compression, Elevation. |
| What is a strain? | A pulling or tearing of a muscle, tendon, or both due to trauma, overuse, or overextension. |
| What are symptoms of a strain? | Pain, soft tissue swelling, and possible bleeding if muscle fibers are torn. |
| What is the treatment for a strain? | Ice and compression, rest, and limiting movement of the affected part. |
| What safety measure must be taken with compression wraps? | Check distal extremities for sensation and adequate circulation. |
| What is a dislocation? | joint fully pulled apart (one arm longer than other, dangling) |
| What is subluxation? | Partial displacement of a bone in a joint |
| What is the treatment for dislocation or subluxation? | Reduction (realignment) under anesthesia, pain control, rest, and heat or cold applications. |
| What is bursitis? | Inflammation of a bursa, the small saclike structure that cushions joints. |
| What causes bursitis? | Injury, overuse, or infection. |
| How is bursitis treated? | Rest, ice, massage, anti-inflammatory drugs, compression wraps, and possibly cortisone injections. |
| What are other common connective tissue disorders? | Rotator cuff tear, ACL injury, meniscus tear, Achilles tendon rupture, and bunion (hallux valgus) |
| What is carpal tunnel syndrome? | Compression of the median nerve in the wrist, often caused by repetitive hand movements. |
| What are signs and symptoms of carpal tunnel syndrome? | Pain, numbness, and tingling in the hand, especially at night. |
| What treatments are used for carpal tunnel syndrome? | Rest, splinting, steroid injections, or surgery if severe. |
| What is a fracture? | A break or interruption in the continuity of a bone. |
| What causes fractures? | Trauma, osteoporosis, or metabolic bone diseases. |
| What are the main types of fractures? | Complete, incomplete, comminuted, closed (simple), open (compound), and greenstick. |
| What is the emergency care for a fracture? | Prevent shock and hemorrhage, splint as it lies, administer tetanus shot, give antibiotics if open fracture. |
| What is the goal of fracture treatment? | Establish union between bone ends and restore function. |
| What is a closed reduction? | Non-surgical realignment of the bone. (non invasive) |
| What is an open reduction? | Surgical realignment of the bone, often with internal fixation devices. |
| What are internal fixation devices? | Pins, nails, screws, plates, and rods used to stabilize fractures INTERNALLY. |
| What are external fixation devices? | Metal frames with pins that extend OUTSIDE the skin to stabilize severe fractures. |
| What nursing care is needed for internal fixation? | Maintain alignment, prevent infection, and monitor for complications. |
| What nursing care is needed for external fixation? | Keep pin sites clean and dry, monitor for infection, and prevent dislodgment. |
| What are casts used for? | Immobilization of fractures or dislocations while healing occurs. |
| What teaching is important for cast care? | Keep the cast dry, never cover a wet plaster cast, do not stick objects inside, and report pain or swelling. |
| What is traction used for? | To align and stabilize fractures, relieve pain, and prevent muscle spasm. |
| What is skeletal traction? | Uses pins or wires directly through bone with weights ≥10 lbs. |
| What is skin traction? | Uses adhesive or foam bandage and weights ≤10 lbs. |
| What is gait | |
| What is osteomyelitis? | Bacterial infection of the bone, most commonly caused by Staphylococcus aureus. |
| How is osteomyelitis diagnosed? | History, lab work (ESR, WBC), radiographs, and bone biopsy. |
| BKA or AKA? | Below so they can have the knee for mobility |
| What is the treatment for osteomyelitis? | 4–6 weeks of antibiotics, drainage of abscess, debridement, and possible immobilization. |
| What is a fat embolism? | Fat particles released into the bloodstream after a fracture, causing respiratory distress and neurological changes. |
| What are signs of a fat embolism? | Confusion, respiratory distress, tachypnea, fever, and petechiae on chest and neck. |
| What is the nursing care for fat embolism? | Stay with the patient, use high Fowler’s position, administer O₂, IV fluids, and prepare for intubation if needed. |
| What is compartment syndrome? | Pressure within muscle compartments restricts circulation, leading to tissue damage. |
| What are the “six Ps” of compartment syndrome? | Pain, Pallor, Paresthesia, Pulselessness, Paralysis, Poikilothermia (cool skin). |
| What is the treatment for compartment syndrome? | Remove restrictive items, bivalve the cast, and perform fasciotomy if needed. |
| What is Lyme disease? | A tick-borne infection caused by Borrelia burgdorferi. |
| What are symptoms of Lyme disease? | Bull’s-eye rash, flu-like symptoms, joint pain, and neurological or cardiac complications. |
| What is osteoarthritis? | A degenerative joint disease causing breakdown of cartilage in weight-bearing joints. |
| What are risk factors for osteoarthritis? | Aging, obesity, heredity, joint injury, and repetitive use. |
| What are symptoms of osteoarthritis? | Joint pain with movement, stiffness, limited mobility, and possible nodules. |
| How is osteoarthritis treated? | NSAIDs, acetaminophen, weight reduction, exercise, and heat therapy. |
| What is rheumatoid arthritis (RA)? | A chronic autoimmune inflammatory disorder affecting joints symmetrically. |
| What are common RA symptoms? | Morning stiffness >1 hour, joint pain, swelling, warmth, fatigue, and nodules. |
| What medications are used for RA? | NSAIDs, corticosteroids, DMARDs, methotrexate, and biologic TNF inhibitors |
| What nursing interventions are used for RA? | Provide pain relief, assist with ADLs, promote rest, and encourage exercise. |
| ADL | Activities of Daily Living |
| What is gout? | A metabolic disorder caused by elevated uric acid levels leading to joint inflammation. |
| What are common symptoms of gout? | Severe pain, redness, warmth, and swelling—especially in the big toe. |
| How is gout treated? | NSAIDs, colchicine, allopurinol, febuxostat, and increased fluid intake. |
| What foods should gout patients avoid? | Organ meats, shellfish, red meat, alcohol, and high-purine foods. |
| What is osteoporosis? | Loss of bone density leading to fragile bones and increased fracture risk. |
| What are risk factors for osteoporosis? | Aging, female sex, calcium/vitamin D deficiency, smoking, inactivity, and certain medications. |
| What are symptoms of osteoporosis? | Height loss, kyphosis, and compression fractures. |
| How is osteoporosis diagnosed? | Bone density scan (DEXA) with T-score results. |
| What is the treatment for osteoporosis? | Calcium and vitamin D supplements, weight-bearing exercise, bisphosphonates, and estrogen therapy. |
| What is Paget disease? | Abnormal bone remodeling that leads to weak, deformed bones. |
| What are symptoms of Paget disease? | Pain, bone deformity, and fractures. |
| How is Paget disease treated? | Calcitonin, bisphosphonates, supportive care, and fall prevention |
| how do you transport someone with a traction | move the entire bed |
| What are bone tumors? | Can be benign or malignant; primary or secondary cancers that weaken bone. |
| How are bone tumors treated? | Surgery, radiation, chemotherapy, and pain management. |
| What are common causes of amputations? | Peripheral vascular disease, diabetes, trauma, infection, and malignancy. |
| What are key aspects of preoperative care for amputation? | Discuss grief and body image, teach exercises, and prepare the limb. |
| What are key aspects of postoperative care for amputation? | Monitor for hemorrhage, elevate the limb for 24 hours, control pain, and prevent contractures |
| What is phantom limb pain? | Sensation of pain or discomfort in the amputated limb. |
| What patient teaching is essential after amputation? | Proper stump care, activity and weight-bearing guidance, and emotional support. |
| A young male injured his left leg playing football and complains of knee pain. Which data indicate a tibia fracture rather than a connective tissue injury? | Pain, ecchymosis below the knee, and crepitation with any movement of the area. |
| A 24-year-old twisted her ankle while playing soccer. Which immediate measures should be provided? (Select all that apply.) | Apply an elastic bandage. Apply an ice pack. Elevate the ankle. Rest and limit weight bearing. |
| A patient with a plaster cast on the right arm complains of itching. What should you do? | Encourage deep breaths and scratch the other arm. |
| At a roadside emergency, a man has a closed leg deformity and cannot move his leg. What is the most important nursing action? | Immobilize the leg. |
| A patient with a fractured femur, internal fixation, and cast—what complications should you monitor for? (Select all that apply.) | Infection or osteomyelitis. Compartment syndrome. Pulmonary fat embolus. Nonunion of bone. |
| Difference in care between knee and hip replacement patients—what applies to hip replacement? | The patient is allowed to stand at the bedside on the first postoperative day. |
| Which orthopedic patient should be assessed first? | Male with a full leg cast reporting persistent pain despite elevation and pain medication. |
| Teaching joint protection for rheumatoid arthritis: which action requires intervention? | Using palms of the hands to push up and off the bed. |
| A 75-year-old woman with osteoporosis—what discharge teaching is essential? (Select all that apply.) | Denosumab use and side effects. Calcium and vitamin D supplements. Weight-bearing exercises. Smoking cessation. |
| A patient returns from surgery after a below-the-knee amputation and is quiet. What is the priority problem? | Potential for bleeding. |
| A patient with a rotator cuff tear and a sling is taking ibuprofen. Which statement indicates a need for further teaching? | “I need to rest in bed for the next 2 days.” |
| After carpal tunnel surgery, what is the priority assessment? | Color, warmth, and capillary refill. |
| Amputated patient position | (supine) lie on back feet up |
| Red and inflamed (swollen) pin | Signs of infection |
| Never put a fresh cast on plastic Never cover a fresh plaster cast with a blanket | |
| Fractured pelvis and smoker | Priority |
| Total hip replacement discharge teaching | IT IS OK TO LIE ON SIDE |
| 30-45 minutes before therapy administer pain meds | TEST QUESTION |
| Before the therapy, what do you do with the patient 30-45 minutes before therapy/surgery? | Premedicate the patient 30-45 minutes with pain medication before the therapy session or surgery |
| What might be a complication of someone who had an internal fixation and a long leg cast? (they had an open fracture) | Fat embolism might travel |
| Person who has internal fixation and long cast what pulse is most important in regaarding to his condition | Right pedal pulse is most important Always mark pedal pulse on foot |
| Who in the hospital would evaluate if a person needs a home safety evaluation (HSE)? | Social worker |
| What is the purpose of ted hose? | Promote circulation in the lower extremities |
| How to wrap a cast on ankle | Figure 8 |
| What does RICE stand for | |
| A nurse is providing a community education Inservice on how to prevent traumatic Muscoskeletal injuries related to car crashes. What group does the nurse target for this Inservice? | Teens (Adolescents) |
| This person has a cast on right arm what does the need to call the doctor immediately? | PURLENT DRAINAGE |
| A person is in traction how do you change their bed sheets? | |
| Dislocation VS subluxation | TEST QUESTION |
| A person is in traction for right leg fracture how do you change their bed sheets? | Change the bottom of the bed first then the top of the bed |
| What does purines do? | Lead to excessive uric acid which causes gout |
| A student learns that changes that occur to muscuskeletal system occur due to age, which is true with this statement? | |
| muscle tissue atrophy occurs with aging | |
| A trauma nurse cares for clients with several fractures which should she identify as the high risk for DVT? | Pelvic injury and smoking |
| What nerve is responsible for carpal tunnel injury | Median nerve |
| Buffalo hump back | kyphosis |
| A twisting motion around the bone. | spiral (often seen in abuse for children) |
| The bone breaks into multiple fragments. | Comminuted |
| A partial fracture in a young, growing bone | Greenstick |
Created by:
kaimcd