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N201: Test III Q

Questions/Vocab

QuestionAnswer
Weight supporting bones Long bones
Largest bone in the body Femur
A fractured pelvis is The biggest risk for damaged organs
The biggest risk for damaged organs is A fractured pelvis
Bones protect the Inner organs
Reservoir for immature blood cells Bands
Because of all of the blood vessels within, bones are Blood rich
Significant factors of a fracture are Loss of blood & hematomia
Bones produce blood cells, this is known as Hematopoesis
Bones facilitate The return of blood to the heart
Synarthrosis joints are Immovable joints
Amphiarthrosis joints Allow limited movement
Diarthrosis joints Are freely movable
Dislocation can occur in Ball and socket joints
Arthritis, hyperextension, tendinitis, and overuse are concerns with Hinge joints
Bone cells that build bones Osteoblasts
Bone cells that destroy bones Osteoclasts
Mature bone cells that maintain the bones Osteocytes
Change in muscle length without using force (extend arm) Isotonic movement
Change in muscle force, not length (push arms against something) Isometric movement
Muscles are attached to bones by Tendons
rocess of bone formation Osteogenesis
The process of formation of the bone matrix and deposition of minerals Ossification
When a bone is broken, WBC's rush to the site bringing blood with them Hematoma & inflammation
New bone formation Calciogenesis
Development of new blood supply (fibroblasts) Angiogenesis
The lungs are a large concern in a pt. with Kyphosisosis
The kidneys are a large concern in a pt. with Lordosis
Involuntary muscle movements Clonus Fasciculation
Fine muscle tremors that keep going when stimulated Clonus
With pelvic fractures, the nurse needs to monitor for Internal bleeding/injury
Bone deformities Joint changes X-ray
Tumors Ligament or tendon changes CT scan
Soft tissue damages (Lumbar issues) MRI
Fast - takes about 2 minutes Dye injected Computed Tomography (CT)
Camera actually enters the body and looks at the joint Arthrography
The leading cause of disability in the United States is Arthritis
The most common musculoskeletal condition that necessitates hospitalization in those over 65 years of age is Hip Fractures
Hip Fractures The most common musculoskeletal condition that necessitates hospitalization in those over 65 years of age is
In the human body, there are ____ bones 206
Approximately ____ mg of calcium daily is essential to maintain adult bone mass. 150
The approximate percentage of total body calcium present in the bones is 98%
___________ is located in the shaft of these four long and flat bones sternum, ileum, vertebrae & ribs. Red bone marrow
The major hormonal regulators of calcium hemostasis are: Parathyroid hormone (PTH) & calcitonin
Ossification for major adult long bone fractures can take up to: 4 months
The term used to describe the grating, crackling sound heard over irregular joint surfaces like the knee is: Crepitus
The fibrous membrane that covers the bone: Periosteum
These connect muscles to muscles: Ligaments
The contractile unit of skeletal muscle: Sarcomere
These attache muscles to bones: Tendons
Loss of bone mass common in postmenopausal women: Osteoporosis
A lateral curving deviation of the spine: Scoliosis
Excessive fluid within a joint capsule: Effusion
Aspiration of a joint to obtain synovial fluid: Arthrocentesis
Dual energy x-ray absorptiometry (DEXA) scan The only way to diagnose osteoporosis
The only way to diagnose osteoporosis Dual energy x-ray absorptiometry (DEXA) scan
Going oin with syringe and removing fluid Centesis
Needles - test that looks for response to sensation Electromyography (EMG)
Test determines structure and composition of bone marrow, bone, muscle, synovium Biopsy
The most prevalent M/S disease in the world is Osteoporosis
A precursor for osteoporosis is Osteopenia
Peak bone mass is achieved between the ages of 18 - 25 y/o
Primary oteoporosis occurs after menopause
Secondary osteo from conditions that affect bone metabolism such as celiac, hypogonadism, corticosteroids and anti-seizure meds
Post menopausal women need _______ Ca+/day 1200 mg
Primary osteoporosis begins in women usually between the ages of 45 and 55, postmenopausal
The primary deficit in osteomalacia is: a deficiency in activated vitamin D (calcitrol), which promotes calcium absorption from the GI tract
The medicines used to treat Paget's Disease are: calcitonin, bisphonates, and plicamycin
The vertebrae can be classified as a type of: irregular bone
The sternum, a bone that is a site for hematopoiesis, is classified as a: flat bone
The basic cells responsible only for the formation of bone matrix are: osteoblasts
About 3 weeks after fracture, an internal bridge of fibrous material. cartilage, and immature bone joins bone fragments so that ossification can occur. The building of a "fracture bridge" occurs during the stage of bone healing known as: callus formation
The hip and the shoulder are examples of diathroses joints that are classified as: ball-and-socket joints
The primary energy source for muscle cells is: adenosine triphosphate (ATP)
Isometric contraction of the vastus lateralis is part of the exercise known as: quadriceps exercises
Pt. understanding for musculoskeletal conditions for the aging is based on the understanding that there is a gradual loss of bone after a peak of bone mass at age: 35 years
By age 75 years, the average woman is susceptible to bone fractures and has lost about what percentage of cancellous bone? 40%
Thr removal of synovial fluid from a joint is called: anthrocentesis
Red bone marrow is located in the shafts of all of the following long and flat bones, EXCEPT: femur
The intervertebral disks that are subject to the greatest mechanical stress and greatest degenerative changes are: L4, L5, and S1
Back pain is classified as "chronic" when the pain lasts without improvement for longer than: 3 months
The best position to ease low back pain is: supine with knees slightly flexed and the head of the bed elevated 30 degrees
When lifting objects, patients with low back pain should be encouraged to maximize the use of the following muscles: quadriceps
The most common symptoms of osteomalacia are: bone pain and tenderness
The accute inflammatory stage of a strain or sprain usually lasts: between 24 to 48 hours
The most serious complication of an open fracture is: infection
Which of the following data is most important for the nurse to record while assessing a patirnt with an open wound? Time when patient last received a tetanus immunization
Which lab study indicates the rate of bone turnover? serum osteocalcin
Skull joints are an example of which type of joint? synarthrosis
After a fracture, the onset of symptoms for fat embolism syndrome occurs: within 1 to 2 days
The femur fracture that commonly leads to avascular necrosis or nonunion because of an abundant supply of blood vessels in the area is a fracture of the: neck
Patients who experience a fracture of the humoral neck are advised that healing will take an average of ____ weeks, with restricted vigorous activity for an additional ____ weeks. 10 / 4
After an arm fracture, pendulum exercises are begun: as soon as tolerated, after a reasonable period of immobilization
The most serious complication of a supracondylar fracture of the humerus is: Volkmann's ischemic contracture
The two most serious complications of pelvic fractures are: hemorrhage and shock
An acetabular fracture of the femur involves the: neck of the femur
The most common complication of a hip fracture in the elderly is: nonunion
A break occurs across the enter section of the bone complete
A fragment of the bone is pulled off by a ligament or tendon avulsion
Bone is splintered into several fragments comminuted
One side of the bone is broken and other side is bent greenstick
A fracture occurs at an angle accross the bone oblique
Fragments are driven inward depressed
The fractured bone is compressed by another bone compressed
The fracture extends through the skin open
Joint dislocations can lead to ____________ if not treated. Avascular necrosis
Avascular necrosis is: tissue death due to anoxia and diminished blood supply
Crepitus, a grating sensation felt when the hands are placed over the extremity, is caused by: the rubbing of the bone fragments against each other
Patients with open fractures are at risk for three major complications: osteomyelitis, tetanus, and gas gangrene
The most common fracture of the distal radius is: Colles' fracture
The most common complication of hip fracture in the elderly is: deep vein thrombosis
Common pulmonary complications, after hip fracture, for the elderly include: atelectasis and pneumonia
Stage 3 of fracture healing is called: Callus formation
Stage 1 of fracture healing is called: Hematoma formation
Stage 2 of fracture healing is called: Fibrocartilage formation
Stage 4 of fracture healing is called: Ossification
greenstick The term _________ fracture has been used to describe the incomplete fractures most commonly seen in children. The bone is splintered on one side but only bent on the other.
stress A ______ fracture is caused by either repeated or prolonged stress.
open, compound In a(n) ______ or a ________ fracture, fragments of the broken bone break through the skin.
pathologic A __________ fracture occurs as a result of a condition in the bone such as a tumor or disease process that causes a spontaneous break.
_________________ is the first sign of a fat embolism, followed by tachycardia, tachypnea, fever, confusion, and decreased level of consciousness. Respiratory distress
Respiratory distress is the first sign of a ____________, followed by tachycardia, tachypnea, fever, confusion, and decreased level of consciousness. fat embolism
______________ checks include assessment of pulse, skin color, capillary refill time, and sensation in the areas distal to the area of concern. Neurovascular
Bile, made in the liver, enters the hepatic ducts and travels the common bile duct to the small intestines to break down food we eat. If we don't need it right away, the bile can be... stored in the gallbladder for later use.
Liver bile is made primarily of bilirubin and cholesterol
Liver functions include: glucose metabolism ammonia conversion drug metabolism
The liver stores glucose as _________. When glucose is needed, the liver can breakdown these stores or produce new glucose. glycogen
The creation of new glucose by the liver is called gluconeogenesis
_________ is turned into urea by the liver and excreted in the urine. If liver fails, there will be a build up of this. ammonia
The liver breaks down RBC's from the body. The bi-product of this is ________ bilirubin
Once the liver has broken down the RBC's, __________ is produced, but the body cannot excrete it in this form. unconjugated bilirubin
Incubation period for Hep A is: 15 - 50 days
Incubation period for Hep B is: 28 - 160 days
Incubation period for Hep C is: 15 - 160 days
Incubation period for Hep D is: 21 - 140 days
Incubation period for Hep E is: 15 - 65 days
Mode of transmission Hep A Water/food borne Poor sanitation Person-to-person contact Fecal to oral route
Mode of transmission Hep B Sexual contact Peri-natal
Health care workers at an increased risk for Hep B & D
Mode of transmission Hep C Sexual contact Blood transfusion
Mode of transmission Hep D Sexual contact Peri-natal (Must have Hep B)
Mode of transmission Hep E Person-to-Person contact Fecal-to-oral
Average immunity for Hep A 30 days Homologous
Average immunity for Hep B 70 - 80 days Homologous
Average immunity for Hep C 50 days
Average immunity for Hep D 35 days Homologous
Average immunity for Hep E 42 days Unknown if it is Homologous
Some people may get Hep A and not know it because the symptoms are similar to the flu. What is one of the key differences? Pt may develop jaundice.
The medical term for excessive hunger is Polyphagia
This means increased red blood cell production Polycythemia
This means excessive thirst Polydipsia
This means increased urine volume. Polyuria
Adequate intake of vitamin ____ is essential for absorption of Ca+ from the GI tract and for bone mineralization. D
Muscle fatigue during strenuous exercise results from the accumulation of _______ acid. lactic
When the nurse assesses a pt's spine, uneven shoulders and iliac crests are signs associated with _______. scoliosis
Pt's receiving long-term steroid therapy are at increased risk for medication-induced ________, which increases their risk for fractures. osteopenia
Flexion of the forearm is an example of an ________ muscle contraction. isotonic
A means of stabilizing or securing a fracture is known as: Traction
_______ traction indicates that there are pins involved. Skeletal
_______ traction involves weights being applied to skin in some manner. (ace bandage, etc.) Skin
When you have ossification, a ______ forms. callus
___________ traction applies pulling force in a straight line with the body part. Straight or running
__________ traction supports the extremity off the bed and allows for some movement. Balanced suspension
movement away from the center or medianline of the body abduction
movement away from the center or medianline of the body adduction
death of tissue due to insufficientblood supply avascular necrosis
a device thatpromotes range of motion, circulation, and healing continuous passive motion (CPM) device:
soft tissue swelling due to fluid accumulation edema
external metal frame attached to bonefragments to stabilize them external fixator
a break in the continuity of the bone fracture
misplaced formation of bone misplaced formation of bone
open surgical procedure to repair and stabilize a fracture open reduction with internal fixation (ORIF)
infection of the bone osteomyelitis
surgical cutting of bone osteotomy
application of a pulling force to a part of the body traction
A drug or medicine given to reduce pain without resulting in loss of consciousness Analgesic
Aspirin, acetaminophen Tylenol
Ibuprofen Motrin, Advil
Naproxen Aleve, Naprosyn
Narcotic analgesics Morphine, oxycodone, and hydrocodone
Hydrocodone Vicodin
without tone; denervated muscle that atrophies atonic
shrinkagelike decrease in the size of a muscle atrophy
fluid-filled sac found in connective tissue, usually inthe area of joints bursa
cartilaginous/fibrous tissue at fracture site callus
latticelike bone structure; trabecularbone cancellous bone
Carpal tunnel syndrome is a neuropathy characterized by: median nerve compression at the wrist
The term for onychocryptosis, a common foot condition, is: ingrown toenail
An overgrowth of the horny layer of epidermis on the foot is called a: corn
The average 75-year-old woman with osteoporosis has lost how much of her cortical bone? 25%
The estimated intake of calcium to prevent bone loss for a postmenopausal woman is ______ mg/day. The actual intake is about _____ mg/day. 1200/400
Most causes of osteomyelitis are caused by: Staphylococcus aureus
The specific treatment for chronic osteomyelitis would probably be: surgical removal of the sequestrum
The most common benign bone tumor is: an osteochondroma
A muscle tear that is microscopic and due to overuse is called a: strain
The accute inflammatory stage of a strain or sprain usually lasts: between 24 to 48 hours
After arthroscopic surgery for a rotator cuff tear, a patient can usually resume full activity in: 6 to 12 months
A patient who has a meniscectomy by arthroscopic surgery needs to know that normal athletic activities can usually be resumed after: 3 weeks
An open fracture with extensive soft tissue damage is classified as a what grade fracture? III
The most serious complication of an open fracture is: infection
Shock, as an immediate complication of fractures, is usually classified as: hypovolemic
Which of the following describes an osteon? a microscopic functional bone unit
Which of the following terms refers to muscle tension being unchanged with muscle shortening and joint motion? isotonic contraction
A patient is exhibiting diminished ROM, loss of flexibility, stiffness, and loss of height. The history and physical findings are associated with age-related changes of which area? Joints
Which of the following data is most important for the nurse to record while assessing a patirnt with an open wound? Time when patient last received a tetanus immunization
Which lab study indicates the rate of bone turnover? serum osteocalcin
Which nerve is assessed when the nurse asks the patient to spread all fingers? ulnar
Skull joints are an example of which type of joint? synarthrosis
The majority of bone infections are caused by which of the following organisms? Staphylococcus aureus
After a fracture, the onset of symptoms for fat embolism syndrome occurs: within 1 to 2 days
The femur fracture that commonly leads to avascular necrosis or nonunion because of an abundant supply of blood vessels in the area is a fracture of the: neck
An immediate nursing concern for a patient who has suffered a femoral shaft fracture is assessment for: hypovolemic shock
The longest immobilization time necessary for fracture union occurs with a fracture of the: tibial shaft
The nurse knows to assess the pt. in an arm cast for possible pressure ulcers in the following area: lateral malleolus.
A common pressure problem are for a long leg cast is the: peroneal nerve.
The nurse is very concerned about the potential debilitating complication of peroneal nerve injury, which is: footdrop
When caring for a pt. with cirrhosis, which of the following symptoms should the nurse report immediately? change in mental status
Using gastric analysis, the nurse would expect that a pt. diagnosed with peptic ulcer would secrete some acid.
Which of the following is a nonmodifiable risk factor for ischemic stroke? gender
Which of the following is an inappropriate use of traction? Decrease space between opposing structures
Half of all spinal cord injuries are related to: substance abuse
Which diagnostic test is more accurate in detecting malignancies than a CT scan? PET scan
Skin traction is limited to a weight between: 4.5 to 8 lbs.
A pt. in pelvic traction needs his/her circulatory status assessed. The nurse should check for a possitive (1) Homans' sign by asking the pt. to: extend each leg and dorsiflex each foot to determine if pain or tenderness is present in the lower leg.
The nurse expects that up to how much weight can be used in skeletal traction? 25 lb
Pts. with a hip and knee replacement begin ambulation with a walker or crutches how long after surgery? 24 hours
The recommended leg position to prevent prosthesis dislocation after a total hip replacement is: abduction
Postoperatively a pt. with a total hip replacement is allowed to turn: 45 degrees onto his/her unoperated side if the affected hip is kept abducted
One of the most dangerous of all postoperative complications is: pulmonary embolism
The nurse caring for a post-op hip-replacement pt knows that the pt should not cross his/her legs, at any time, for how long after surgery? 4 mos.
After a total hip replacement, stair climbing is kept to a minimum for: 3 to 6 mos.
After a total hip replacement, the pt. is usually able to resume daily activities after: 3 mos
A ______ reduces a fracture, corrects a deformity, applies uniform pressure to underlying soft tissue, and supports and stabilizes weakened joints. cast
A wet cast should only be handled with the ______ to prevent indentations. palm of the hand
A wet cast should only be handled with the palm of the hand to prevent _________. indentations
The leading cause of disability in the US is: arthritis
The most common M/S condition that necessitates hospitalization in those over 65 y/o is: hip fractures
The approximate % of total body Ca+ present in the bones is: 98%
The nurse who assesses bone fracture pain expects the patient to describe the pain as: sharp and piercing
The nurse knows to assess the pt. in an arm cast for possible pressure ulcers in the following area: lateral malleolus
A common pressure problem are for a long leg cast is the: peroneal nerve
The nurse is very concerned about the potential debilitating complication of peroneal nerve injury, which is: footdrop
Fracture healing occurs in 4 areas, including the external soft tissue
Which lab study indicates the rate of bone turnover? Serum osteocalcin
Which of the following is useful in identifying acute or chronic tears of the joint capsule or supporting ligaments of the knee, shoulder, ankle, hip or wrist? Arthrography
Which of the following is an indicator of neurovascular compromise? Capillary refill of more than 3 seconds
This is necessary for Ca+ absorption Vitamin D
A site of Ca+ absorption is the Duodenum
This increases bone mass and decreases bone loss by inhibiting osteoclast function Biphosphonates
This directly inhibits osteoclasts, reducing bone loss and increasing BMD Calcitonin
Metabolic bone disease characterized by inadequate mineralization of the bone, weakness of skeleton Osteomalacia
Deficiency of calcitrol (activated vit D) which promotes Ca+ reabsorption from GI Tract; Not Ca+ deficient, just can't absorb it Osteomalacia
What is true about Paget's Disease? Localized rapid bone turnover
What is true about Paget's Disease? Proliferation of osteoclasts
What is true about Paget's Disease? Increased osteoblastic activity
What is true about Paget's Disease? Cause is unknown
Loss of hearing from Paget's Disease is caused by the compression of which cranial nerve? VIII Vestibulocochlear
Fractures, arthritis and hearing loss are complications of: Paget's Disease
Infection of the bone, results in inflammation and necrosis Osteomyelitis
Metabolic bone disease characterized by inadequate mineralization of the bone, weakness of skeleton (malabsorption Ca+) Osteomalasia
__________ causes 50% of cases of Septic Arthritis Staph aureus
Septic Arthritis is common in _________ & diabetes RA
When joints become infected from an infection elsewhere in the body, this is called Septic Arthritis
The most common site for Septic Arthritis is: The Knee
How long does a pt. taking bipohoshonates need to stay upright after administration? 30 minutes
Which nursing diagnosis would the nurse chose as the priority for a pt. with Paget's Disease? Impaired physical mobility
Age related bone loss from Osteoporosis begins in the: 4th Genreation
________, which inhibits bone breakdown, is decreasing in osteoporosis Estrogen
________, promotes bone formation and is decreasing in osteoporosis Calcitonin
________. increases bone turnover & resorption, is increased in osteoporosis Parathyroid Hormone
________ muscles are important in lifting to reduce stress on spine Abdominal
Ligament tears, muscles, tendons and soft tissue problems Ultrasound
Nerve root disorders EMG
Spinal Pathology MRI
One or more vertebrae fused together to stabilize them Spinal fusion
A soft tissue injury caused by blunt force Contusion
A contusion generally lasts: 1 - 2 weeks
What does the T stand for in TNM? Tumor size
What does the N stand for in TNM? lymph Node involvement
What does the M stand for in TNM? distant Metstasis
Responsible for turning on/off cell growth when needed. Cancer - no OFF switch. Oncogenes
Diagnostic test where radioisotope is injected in body - tumor will not pick-up radioisotope. Bone Scan
This med. should be taken first thing in the morn. on an empty stomach w/a full glass of water, and sit upright for 30-60 mins after administration. Bisphosphonates
What hormone stimulates release of Ca+ from the skeleton? PTH
When the spine is fused together, it can be done with bone grafts or metal implants. Where does the bone usually come from? Iliac crest
Which of the 5 Ps of Neurovascular Compromise refer to: numbness or tingling of the extremities? Parasthesia
Which of the 5 Ps of Neurovascular Compromise refer to: the inability to move the extremity? Paralysis
Which of the 5 Ps of Neurovascular Compromise refer to: pale skin, cool to touch? Pallor
Which of the 5 Ps of Neurovascular Compromise refer to: not being relieved by meds & out of proportion to injury? Pain
Which of the 5 Ps of Neurovascular Compromise refer to: diminished or absent distal to injury? Pulses
Norm. value of Alanine aminotransferase (ALT) 5-35 units
Norm. value of Aspirate aminotransferase (AST) 10-40 units
Norm. value of Gamma-glutamyl transferase (GGT) 10-48 IU/L
Norm. value of Ammonia 15-45 ug/dL
What happens to ammonia in the liver? It is turned into urea
If the liver is not functioning, what happens to Ammonia levels? Increased (can't break down urea)
Norm. value of Albumin 1.7-3.3 g/dL
If the liver is not functioning, what happens to Albumin levels? Decreased (can't make enough)
Where is Albumin made? In the liver
Norm. Prothrombin Time (PT) 12-16 seconds
If the liver is not functioning, what happens to Prothrombin Time (PT)? Increased time (longer time for body to clot)
Norm. value of Serum bilirubin, direct 0-0.3 mg/dL
Serum bilirubin, direct measures Conjugated bilirubin
Norm. value of Serum bilirubin, total 0-0.9 mg/dL
Serum bilirubin, total measures Both conjugated & unconjugated bilirubin
Norm. value of Urine urobilinogen 0.05-2.5 mg/24h
0.05-2.5 mg/24h is the normal value of which LFT? Urine urobilinogen
5-35 units is the normal value of which LFT? Alanine aminotransferase (ALT)
10-40 units is the normal value of which LFT? Aspirate aminotransferase (AST)
10-48 IU/L is the normal value of which LFT? Gamma-glutamyl transferase (GGT)
15-45 ug/dL is the normal value of which LFT? Ammonia
1.7-3.3 g/dL is the normal value of which LFT? Albumin
12-16 seconds is the normal value of which LFT? Prothrombin Time (PT)
0-0.3 mg/dL is the normal value of which LFT? Serum bilirubin, direct
0-0.9 mg/dL is the normal value of which LFT? Serum bilirubin, total
emolytic, Hepatocellular & Obstructive are types of: Jaundice
_________ jaundice is caused by Sickel-cell or blood transfusions Hemolytic
_________ jaundice is caused by Cirrhosis or hepatitis: Hepatocellular
_________ jaundice is caused by an obstruction Obstuctive
A large amt. of blood travels from the liver to the GI tract by way of the: Portal vein
Postnecrotic cirrhosis is caused by Pt. having chronic hepatitis
Biliary cirrhosis is caused by Pt. having chronic obstruction
Which type of surgery is being done when lesions that are removed are likely to develop into cancer? Prophylactic
A pt. with newly diagnosed breast cancer is scheduled for a lymph node biopsy and asks the nurse why it is necessary when the diagnosis of cancer is already made. The nurses' best response is based on which of the following? To determine if cancer has metastasized
A new nurse is admitting a severely neutropenic pt. who is receiving radiation therapy. The precepting nurse knows that the nurse understands precautionary measures necessary for the client when he assigns the pt. to which or the following rooms? A private room with protective isolation
The nurse determines that the pt. with Ewing's Sarcoma understands instruction related radiation therapy when the pt. states that the side effects include which of the following? An increased risk for infection
Created by: lost little girl