Chap 39 Assesment of musculoskeletal function

Which is useful in identifying acute or chronic tears of the joint capsule or supporting ligaments of the knee, shoulder, ankle, hip, or wrist?

Arthrography is useful in identifying acute or chronic tears of the joint capsule or supporting ligaments of the knee, shoulder, ankle, hip, or waist.

A nurse performs a neurovascular assessment on a patient 2 weeks after a wrist cast had been removed. She documents in the patient's chart that there is normal sensation in the ulnar nerve. To reach this conclusion, the nurse performed an assessment test on the fingers that involves pricking the:

Distal fat pad on the small finger.

A client is scheduled to undergo an electromyography. The nurse understands that this test is performed to evaluate which of the following?

Electromyography tests the electric potential of the muscles and nerves leading to the muscles. It is done to evaluate muscle weakness or deterioration, pain, disability, and to differentiate muscle and nerve problems. A bone biopsy is done to identify bone composition. Bone densitometry is done to evaluate bone density. A bone scan would be appropriate to detect metastatic bone lesions.

Which data is most important for the nurse to record while assessing a client with an open wound?

If the client has an open wound, the nurse ascertains when the client last received a tetanus immunization. This vital information helps in assessing the risk of infection in a client with an open wound.

What instructions should the nurse include in the discharge teaching for the client following an arthroscopy?

Mild analgesics are sufficient for pain control. The leg should be elevated with ice applied. The client should be taught the signs and symptoms of infection (such as heat) and neurovascular compromise (such as numbness and tingling) and instructed to contact the physician if they occur.

Which laboratory study indicates the rate of bone turnover?

Serum osteocalcin (bone GLA protein) indicates the rate of bone turnover. Urine calcium concentration increases with bone destruction. Serum calcium concentration is altered in clients with osteomalacia and parathyroid dysfunction. Serum phosphorous concentration is inversely related to calcium concentration and is diminished in osteomalacia associated with malabsorption syndrome.

An instructor is describing the process of bone development. Which of the following would the instructor describe as being responsible for the process of ossification?

Osteoblasts secrete bone matrix (mostly collagen), in which inorganic minerals, such as calcium salts, are deposited. This process of ossification and calcification transforms the blast cells into mature bone cells, called osteocytes, which are involved in maintaining bone tissue. Cortical bone is dense hard bone found in the long shafts; cancellous bone is spongy bone found in the irregular rounded edges of bone.

Which cells are involved in bone resorption?

--Osteoclasts carry out bone resorption by removing unwanted bone while new bone is forming in other areas. -Chondrocytes are responsible for forming new cartilage. -Osteoblasts are bone-forming cells that secrete collagen and other substances. - -Osteocytes, derived from osteoblasts, are the chief cells in bone tissue.

The nurse is performing an assessment for a patient who may have peripheral neurovascular dysfunction. What signs does the patient present with that indicate circulation is impaired? (Select all that apply.)

-Pale, cyanotic, or mottled color -Cool temperature of the extremity -More than 3-second capillary refill

A patient is scheduled for a procedure that will allow the physician to visualize the knee joint in order to diagnose the patient's pain. What procedure will the nurse prepare the patient for?

Arthroscopy is a procedure that allows direct visualization of a joint through the use of a fiberoptic endoscope. Thus, it is a useful adjunct to diagnosing joint disorders.

A client has undergone arthroscopy. After the procedure, the site where the arthroscope was inserted is covered with a bulky dressing. The client's entire leg is also elevated without flexing the knee. What is the appropriate nursing intervention required in caring for a client who has undergone arthroscopy?

after covering the arthroscope insertion site with a bulky dressing and elevating the client's entire leg, the nurse needs to apply a cold pack at the site to minimize any chances of swelling.