Musculoskeletal 2013 nursing 165
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| 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.
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| Arthroscopy Nursing implications | neurovascular checks pain and swelling control, prevention and monitoring for thrombophlebitis and infection
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| Bone scan nursing interventions | No restricted activity for patient. Encourage patient to drink plenty of fluids after procedure
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| Erythrocyte sedimentary rate (ESR)test? | reflects inflammatory rate, and indirectly the progression of the disease
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| Rheumatology is | The study of any disease or condition that involves the musculoskeletal system
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| Osteoarthritis is | chronic non-inflammatory progressive disorder that causes cartilage deterioration in synovial joints and vertebrae
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| Osteoarthritis affects mostly what type of joints | weight bearing
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| Risk factors for OA | Aging, Obesity, Genetic predisposition, Malalignant of joints, Trauma, Gender and Hormonal factors
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| 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
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| Heberden’s nodes is | bony enlargement of the distal interphalangeal joints of the fingers
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| Brouchard’s nodes is | bony enlargement of the proximal interphalangeal joints of the fingers
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| management of OA Focuses on, what | pain and inflammation, preventing or limiting disability, and maintaining and improving joint function
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| What are the pharmacologic measures for OA? | NSAIDs and COX-2 inhibitors
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| What is the reconstructive surgery for OA? | arthroplasty
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| What is arthroplasty? | replacement of all or part of joint
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| What are the classic symptoms of Rheumatoid Arthritis | Joint pain, swelling, warmth, erythema, and lack of function
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| What are some to the pharmacologic measures for RA? | NSAIDs, COX-2 inhibitors, and disease-modifying antirheumatic drugs (DMARDs)
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| Diagnostics test for RA | Bone scan, MRI, Arthrocentesis, Rheumatoid factor, ANA test, & High sensitivity C reactive protein test
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| Early symptoms of RA | Pain at rest and with movement, Malaise, Depression, Fever, Weight loss, Fatigue, Generalized weakness, Morning stiffness, Edematous, erythematosus
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| Late symptoms of RA | Pallor, color changes of digits, Muscle weakness, atrophy, paresthesias, Decreased joint mobility
Contractures
Dislocation
Increased pain
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| Gel phenomenon is | morning stiffness lasting 45 minutes to several hours after awaking
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| Sjorgeren’s syndrome is | includes dry eyes, dry mouth, dry vagina. Some say their eyes feel gritty
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| Felty’s syndrome is | characterized by RA, hepatosplenomegaly (enlarged liver and spleen), Will usually have decrease WBC’s.
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| Caplan’s syndrome is | characterized by lung nodules and pneumoconiosis. Common in coal miners and asbestos workers
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| Rheumatoid Factor measures, what? | the presence of unusual antibodies of immunoglobulin that develops in connective tissue disease
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| (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
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| What class of medications are used to treat RA? | anti-inflammatory, antipyretic, analgesic, immunosuppressive
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| What DMARD's used for the treatment of RA? | Methotrexate, Aravia, Leflunomide, Plaquinil & Azulfidine
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| Plaquenil is a anti-inflammatory and what other type of med? | antimalarial drug
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| 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-
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| gout is | A metabolic disorder marked by the deposition of monosodium urate crystals within joints and other tissues
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| what are the nursing care priorities of gout? | pain management, self care, and lifestyle and dietary modifications
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| Clinical manifestations of Gout include | Articular inflammation; Often appears after 10 years. Gouty nephropathy, metatarsophalangeal joint of the big toe
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| triggers for acute attack of gout | trauma, alcohol ingestion, dieting, medications , surgical stress and illness
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| Medication management of gout for acute attacks | NSAIDS or Colchicine
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| nursing care for gout | patient education, exercise, and cognitive therapy along with the medication regimen
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| Septic arthritis is | Due to infection from other parts of the body or directly from trauma or surgical instrumentation
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| symptoms of septic arthritis | swollen, warm joint with decreased range of motion
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| How is septic arthritis diagnosised | By blood cultures, ESR, C reactive protein, and complete blood count are done, evaluate synovial fluid
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| Treatment for Septic arthritis | Broad spectrum IV antibiotics
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| Risk factors for Septic arthritis | advanced age, diabetes, RA, preexisting joint disease, osteomyelitis, infection of the bone
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| Osteomyelitis is | Infection of the Bone
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| Risk factors for Osteomyelitis | poorly nourished,Elderly, Obese
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| Osteomyelitis nursing diagnosis | acute pain, impaired physically mobility, Risk for extension of infection, Deficient knowledge related to treatment regimen
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| Contusion is | A soft tissue injury produced by blunt force
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| Strain is | An injury to a musculotendinous unit caused by overuse, overstretching, or excessive stress
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| Sprain is | An injury to the ligaments and supporting muscle fibers that surround a joint
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| Contusions, Strains, and Sprains treatment | consist of resting and elevating the affected part, applying cold, and using a compression bandage
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| Open fracture Grade 1 | least severe, skin damage-minimal
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| Open fracture Grade 2 | has skin & muscle contusions
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| Open fracture Grade 3 | has damage to skin, muscle, nerve tissue, and blood vessels (most severe)
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| Colles fracture | a fracture of the distal radius (wrist)
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| Stress fractures | occur with repeated bone trauma from athletic activities; repeated loading of bone and muscle
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| Compression fractures | caused by compression of vertebrae & associated with osteoporosis
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| Greenstick | a fracture in which one side of bone is broken and the other side is bent
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| Transverse | a fracture that is straight across the bone shaft
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| Oblique | a fracture occurring at an angle across the bone(less stable than a transverse fracture)
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| Spiral | a fracture that twist around the shaft of the bone
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| Comminuted | a fracture in which bone has splintered into several fragments
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| Pathologic fracture | a fracture that occurs through an area of diseased bone:can occur without trauma or a fall
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| avulsion | a fracture in which a fragment has been pulled away by a tendon or and its attachment ( assoc. with sprains
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| Depressed fracture | a fracture in which fragments are driven inward
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| Epiphyseal fracture | a fracture through the epiphysis
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| Impacted fracture | a fracture in which a bone fragment is driven into another bone fragment
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| Clinical manifestations of fractures | Pain, tenderness, False motion, loss of motion, Deformity, muscle spasms, numbness, Shortening of the extremity
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| Crepitus is | grating sensation caused by rubbing of the bone fragments against each other, Crepitus, Localized swelling and discoloration
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| 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
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| 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
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| Bucks extension traction | used for lower leg to provide immobility and comfort after injury to hip- prior to surgery
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| Russell’s traction | may be used for fractures of tibial plateau, supports the flexed knee in a sling
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| Dunlop’s traction | is applied to upper extremity for fractures of elbow and humerous
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| Acute compartment syndrome | involves a sudden & severe decrease in blood flow to the tissue that results in necrosis
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| Chronic Compartment syndrome | involves pain, aching, & tightness in a muscle or muscle group subjected to inordinate stress or exercise.
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| crush compartment syndrome | massive external compression or crushing of a compartment
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| 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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