Med surg musculoskeletal and neuro
the intervertebral discs that are subject to the greatest mechanical stress and degenerative changes
L4, L5, S1
nervous system response from dopamine
affects behavior, attention, and fine movement
classic clinical features of Guillain-Barre syndrome
areflexia and ascending weakness
what is the leading cause of musculoskeletal-related disability in the US
arthritis
the major consequence of osteoporosis
bone fracture
bone formation is enhanced by
calcium intake, muscle activity, and weight baring
brain center responsible for balancing and coordination
cerebellum
three major complications of an extremity that is casted, braced, or splinted
compartment syndrome, pressure ulcers, and disuse syndrome
what is the term that describes the grating, crackling soundheard over irregular joint surfaces like the knee
crepitus
master gland
pituitary
what is an amputation
removal of a body part
what is a fasciotomy
the incision and diversion of the muscle fascia to releive muscle constriction, as in compartment syndrome, or to reduce fascia contracture
primary osteoporosis in women usually begins between what ages
45-55
The nurse is caring for a patient with bone metastasis from a primary bone cancer. The patient complains of muscle weakness and nausea and is voiding large amounts frequently. Cardiac dysrhythmias are observed on telly. What should the nurse suspect based on these clinical manifestations? a. hypercalcemia b. hypocalcemia c. hypokalemia d. kyperkalemia
A
A nurse caring for a patient with head trauma will be monitoring the patient for Cushing's triad. What Will the nurse recognize as the symptoms associated with Cushing's triad? (select all that apply) a. bradycardia b. bradypnea c. HTN d. tachycardia e. pupillary constriction
A, B, C
A patient comes back to the clinic with continues complaint of back pain. What time frame does the nurse understand constitutes chronic pain? a. 4 weeks b. 3 months c. 6 months d. 1 year
B
A patient had a lumbar puncture 3 days ago in the outpatient clinic and calls the nurse with complaints of a throbbing headache. What can the nurse educate the patient to do for relief of the discomfort? (select all that apply) a. limit the amount of fluid to decrease cerebral edema b. force fluids (unless contraindicated) c. get plenty of bedrest d. take some OTC analgesics e. walk around
B, C, D
A patient comes to the ED with severe pain in the face that was stimulated by brushing the teeth. What cranial nerve does the nurse understand can cause this type of pain? a. III b. IV c. V d. VI
C
A patient is admitted to the hospital with an ICP reading of 20 mmHg and a mean arterial pressure of 90. What would the nurse calculate the CPP to be? a. 50 b. 60 c. 70 d. 80
C
A patient is diagnosed with osteogenic sarcoma. What lab studies should the nurse monitor for the presence of elevation? a. magnesium level b. potassium level c. alkaline phosphatase d. troponin levels
C
recommended adequate intake level of calcium for all individuals is
1000-1500
how much weight does the nurse expect can be used for a patient in skeletal traction
20 lbs
A patient arrives to have an MRI done in the outpatient department. What information provided by the patient warrants further assessment to prevent complications related to the MRI? a. I am trying to quit smoking and have a patch on b. I have been trying to get an appointment for so long c. I have not had anything to eat or drink since three hours ago d. My legs go numb sometimes when I sit too long
A
A patient arrives in the ED with a suspected bone fracture of the right arm. How does the nurse expect the patient to describe the pain? a. a dull, deep, boring ache b. sharp and piercing c. similar to muscle cramps d. sore and aching
B
A patient comes to the clinic complaining of low back pain radiating down the left leg. After diagnostic studies rule out any pathology, the physicial orders a SNRI. Which medication does the nurse anticipate the patient about? a. amitriptyline (elavil) b. duloxetine (cymbalta) c. gabapentin (neurontin) d. cyclobenzaprine (flexeril)
B
A patient has a fracture that is being treated with pen rigid compression plate fixation devices. How will the progress of bone healing be monitored? a. remove the plate and determine if the bone is growing back b. serial xrays c. arthroscopy d. the bone will heal on its own without intervention
B
A patient has a long led cast applied. Where does the nurse understand a common pressure problem may occur? a. dorsalis pedis b. peroneal nerve c. popliteal artery d. posterior tibialis
B
A patient has been diagnosed with osteomalacia. What common symptoms does the nurse recognize that correlate with the diagnosis? a. bone fractures and kyphosis b. bone pain and tenderness c. muscle weakness and spasms d. softened and compressed vertebrae
B
A patient has expressive speaking aphasia after having a stroke. Which portion of the brain does the nurse know has been affected? a. temporal lobe b. inferior posterior frontal areas c. posterior frontal area d. parietal-occipital area
B
A patient has had a stroke and is unable to move the right upper and lower extremity. During assessment the nurse picks up the arm and it is limp and without tone. How would the nurse document this finding? a. rigidity b. flaccidity c. atonic d. tetanic
B
A patient is having low back pain. What position can the nurse suggest to relieve this discomfort? a. high-fowler's to allow for max hip flexion b. supine, with the knees slightly flexed and the head of the bed elevated 30 degrees c. prone, with the pillow under the shoulders d. supine, with the bed flat and a firm mattress in place
B
The nurse obtains a Snellen eye chart when assessing cranial nerve functions. Which cranial nerve is the nurse testing with this chart? a. I b. II c. III d. IV
B
The nurse is educating a patient with low back pain about techniques to relieve the back pain and prevent further complications. What statement by the patient shows understanding of the education the nurse provided? a. I will lie prone with my legs slightly elevated b. i will bend at the waist when i am lifting objects from the floor c. I will avoid prolonged sitting or walking d. Instead of turning around to grasp an object, I will twist at the waist
C
The nurse is educating the patient with low back pain about the proper way to lift objects. What muscle should the nurse encourage the patient to maximize? a. gastrocnemius b. latissimus dorsi c. quadriceps d. rectus abdominus
C
A nurse is assessing a patient's urinary output as an indicator of diabetes insipidus. The nurse knows that an hourly output of what volume over 2 hours may be a positive indicator? a. 50-100 b. 100-150 c. 150-200 d more than 200
D
A patient had hand surgery to correct a Duputren's contracture. What nursing intervention is a priority postoperatively? a. changing the dressing b. applying a cock-up splint and immobilization c. having the patient exercise the fingers to avoid future contractures d. performing hourly neurovascular assessments for the first 24 hours
D
A patient stepped on an acorm while walking barefoot in the backyard and developed an infection progressing to osteomyelitis. What microorganisms does the nurse understand is most often the cause of the development of osteomyelitis? a. proteus b. pseudomonas c. salmonella d. staphylococcus aureus
D
A patient who has suffered a stroke is unable to maintain respiration and so is intubated and placed on mechanical ventilator support. What portion of the brain is most likely responsible for the inability to breath? a. frontal lobe b. parietal lobe c. occipital lobe d. brain stem
D
The nurse is caring for a patient with an altered LOC. What is the first priority of treatment for this patient? a. assessment of pupillary light reflexes b. determination of the cause c. positioning to prevent complications d. maintenance of the patient airway
D
what are the major hormonal regulators of calcium homeostasis
PTH and calcitonin
an artificial joint for total hip replacement involves an implant that consists of
a femoral component, spherical ball, and acetabular socket
The nurse completes a neurovascular assessment of either the fingers or toes of a casted extremity to determine circulatory status. What expected outcomes does the nurse anticipate will occur
able to move fingers and sensations are intact
the parasympathetic division of the ANS yeilds impulses that are medication by the secretion of _________________, the dominant neurotransmitter in parasympathetic nervois system function
acetylcholine
meds of choice for herpes simplex
acyclovir and grancyclovir
If a patient with an altered LOC requires suctioning, what intervention is a priority for the nurse to provide
adequately ventilate before and after suctioning to prevent hypoxia
what are the differences in the function of osteoblasts, osteoclasts, and osteocytes
blasts build bone up, clasts break bone down, and cytes are the units of bone
primary, lethal complication of ICP
brain herniation
three complications of increased ICP
brain-stem herniation, diabetic insipidus, syndrome of inappropriate ADH
difference between bursitis and tendinitis
bursitis is a fluid-filled sac, tendinitis is inflammed tendons
the three medications used to treat paget's disease
calcitonin, biphosphonates, and plicomyocin
nursing postoperative management includes detecting and reducing ____________, releiving _________________, preventing _____________, and monitoring ______________ and __________________.
cerebral edema, pain, seizures, ICP increase, neuro status
leading cause of seizures in the elderly
cerebrovascular disease
earliest sign of an increase in ICP
change in LOC
what is the most effective cleansing solution for care of a pin site
chlorhexidine
what is the primary deficit in osteomalacia that promotes calcium absorption from the GI tract
deficiency in the deactivated vitamin D
how does vitamin D regulate the balance between bone formation and bone resirption
deficiency results in bone mineralization deficit, deformity, and fracture
osteomylitis with vascular insufficiency, with most commonly affects the feet, is seen most often in patient with
diabetes and PVD
parkinson's disease is caused by an imbalance in what neurotransmitter
dopamine
list the danger signs of possible circulatory constriction that the nurse should assess for in a casted extremity
dusky pale appearance, cool skin, inability to move fingers and toes
what are the roles of the sex hormones testosterone and estrogen on bone remodeling
estrogen enhances bone formation and inhibits reabsorption; testosterone is used in skeletal growth
what is a meniscectomy
excision of damaged joint fibrocartilage
advantages of a fiberglass cast to those of a plaster cast
fiberglass is lighter, stronger, more durable, and water-resistant; plaster is cheaper and forms a better mold
What are the five P's that should be assessed as part of the neurovascular check?
pain, pallor, pulselesssness, parasthesia, and paralysis
neurotransmitter that helps control mood and sleep
serotonin
what is an arthroplasty
the repair of joint problems through the operating arthroscope ( an instrument that allows the surgeon to operate within a joint without a surgical incision) or through open joint surgery
what is a MRI scan
used to evaluate spinal nerve root sidorders
what is an ultrasound
useful in detecting tears in ligaments, muscles, tendons, and soft tissues in the back
what is a CT scan
useful in identifying underlying problems, such as obscure soft tissue lesions adjacent to the vertebral column and problems of vertebral discs
A patient has a cast removed after bone healing takes place. What should the nurse instruct the patient to do after the removal? (select all that apply) a. apply an emollient lotion to soften the skin b. control swelling with elastic bandages, as directed c. gradually resume activities and exercise d. use friction to remove dead surface skin by rubbing the area with a towel e. use a razor to shave the dead skin off
A, B, C
after a total hip replacement, the patient is able to resume daily activities after how long
3 months
after a total hip replacement, stair climbing is kept to a minimum for how long
3-6 weeks
the nurse caring for a postoperative hip replacement patient known that the patient should not cross his or her legs at any times for hour long after surgery
4 months
what is the approximate percentage of total body calcium present in the bones
98%
A nurse assesses the patient's LOC using the GCS. What score indicates severe impairment of neurologic functions? a. 3 b. 6 c. 9 d. 12
A
A patient had a total hip replacement. What recommended leg position should the nurse ensure is maintained to prevent prostesis dislocation? a. abduction b. adduction c. flexion d. internal rotation
A
A patient sustained a head injury during a fall and has changes in personality and affect. What fart of the brain does the nurse recognize has been affected in this injury? a. frontal lobe b. occipital lobe c. parietal lobe d. temporal lobe
A
The nurse is caring for a patient with a total hip replacement. How should the nurse allow the patient to turn? a. 45 degrees onto the unoperated side if the affected hip is kept abducted b. from the prone to the supine position only, and the patient must keep the affected hip extended and abducted c. to any comfortable position as long as the affected leg is extended d. to the operative side if the affected hip remains extended
A
The nurse is performing an assessment of cranial nerve function and asks the patient to cover one nostril at a time to see if the patient can smell coffee, alcohol, and mint. The patient is unable to smell any of the odors. The nurse is aware that the patient has a dysfunction of what cranial nerve a.I b. II c. III d. IV
A
The nurse suspects compartment syndrome for a casted extremity. What characteristic symptoms would the nurse assess that would confirm this suspicion? (select all that apply) a. decreased sensory function b. excrutiating pain c. loss of motion d. capillary refill of less than 3 seconds e. 2+ peripheral pulses in the affected distal pulse
A,B,C
what is the approximate amount of calcium daily that is essential to maintain adult bone mass
1,000-1,2000 mg
how much CSFis produced daily by a normal adult
150 mL
how many bones are there in the human body
206
A patient comes to the clinic and informs the nurse of numbness, tingling, and aburning sensation in the arm from the elbow down to the fingers. What type of symptoms would this be documented as? a. paresthesia b. flaccidity c. atonia d. effusion
A
An older adult patient had a hip replacement. When should the patient begin with assisted ambulation with a walker? a. 24 hours b. 72 hours c. 1 week d. 2-3 weeks
A
A patient is having a lumbar puncture and the physician has removed 20 mL of CSF. What nursing intervention is the priority after the procedure? a. early ambulation b. have the patient lie flat for 6 hours c. have the patient lie flat for 1 hour and then sit for 1 hour before ambulating d. have the patient lie in the semi-fowler's position with the head of the bed at 30 degrees
B
A patient is pelvic traction needs circulatory status assessed. How should the nurse assess for a positive Homan's sign? a. have the patient extend both hands while the nurse compares the volume of both radial pulses b. have the patient extend each led and dorsiflex each foot to determine if pain or tenderness is present in the lower lef c. have the patient plantar flex both feet while the nurse performs the blacnh test on all of the patient's toes d. have the patient squeeze the nurse's hands with his or her hands to evaluate any difference in strength
B
The nurse is caring for a patient who had a total hip replacement. What lethal postoperative complication should the nurse closely monitor for? a. atelectasis b. hypovolemia c. PE d. UTI
C
The nurse is caring for a patient with increased ICP. As the pressure rises, what osmotic diuretic does the nurse prepare to administer? a. glycerine b. isosorbide c. mannitol d. urea
C
The nurse is educating a client with a seizure disorder. What nutritional approach for seizure managment would be beneficial for the patient a. low in fat b. restricts protein to 10% of daily caloric intake c. high in protein and low in carbs d. at least 50% carbs
C
The nurse is performing a neurologic assessment and requests that the patient stand with eyes open and then closed for 20 seconds to assess balance. What type of test is the nurse performing? a. weber test b. rinne test c. romberg test d. watch-tick test
C
When educating a patient about the use of antiseizure medication, what should the nurse inform the patient is a result of long-term use of the medication in women? a. anemia b. osteoarthritis c. osteoporosis d. obesity
C
A patient shows the nurse a round, firm nodule on the wrist. The pain is described as aching, with some weakness in the fingers. What treatment does the nurse anticipate assisting with? (select all that apply) a. educating the patient on the use of gabapentin b. active ROM exercises c. corticosteroid injection d. surgical excision e. aspiration of the cyst
C,D,E
After a bone density test, an older adult female patient tells the nurse, "I dont understand why i have osteoporosis because I ead well and take my calcium." what does the nurse understand is the reason that the patient may have osteoporosis? a. everyone gets osteoporosis and there is nothing you can do to prevent it b. men lose more bone mass than women but women still lose some c. in order to prevent bone loss, women have to take hormons d. the loss is from withdrawal of estrogen and decrease in activity levels
D
The nurse is performing an assessment on an older adult patient and observes the patient has an increased forward curvature of the thoracic spine. What does the nurse understand this common finding is known as? a. lordosis b. scoliosis c. osteoporosis d. kyphosis
D
The nurse suspects that a patient with an arm cast has developed a pressure ulcer. Where should the nurse assess for the presence of the ulcer? a. lateral malleolus b. olecranon c. radial styloid d. ulna styloid
D
What does the nurse recognize as the earliest sign of serious impairment of brain circulation related to increaseing ICP? a. a bounding pulse b. bradycardia c. HTN d. lethargy and stupor
D
what is a volkmann's contracture
permanent flexion of the hand at the wrist
major potential complication of epilepsy
status epilepticus
The hospice nurse is assigned to care for a patient with metastatic bone cancer who wants to remain at home. What is the therapeutic foal in the care of this patient? a. prevent the patient from having to go to the hospital for care b. releive pain and discomfort while promoting quaility of life c. increase the activity level of the patient to prevent complications related to immobility d. ensure that the family accepts the patient's imminent death
B
The nurse assesses a patient after total right hip arthroplasty and observes a shortening of the extremity, and the patient complains of severe pain in the right side of the groin. What is the primary action of the nurse? a. apply buck's traction b. notify the physician c. externally rotate the extremity d. bend the knee and rotate the knee internally
B
The nurse caring for a patient with bacterial meningitis is administering decamethasone that has been ordered as an adjunct to antibiotic therapy. When does the nurse know is the appropriate time to administer this med a. 1 hour after the antibiotic has infused and daily for 7 days b. 15-20 minutes before the first dose of antibiotic and every 6 hours for the next 4 days c. 2 hours prior to the administration of antibiotics for 7 days d. it can be administered every hours for 10 days
B
The nurse is assessing the pupils of a patient who has had a head injury. What does the nurse recognize as a parasympathetic effect? a. dilated pupils b. constricted pupils c. one pupil is dilated and the opposite pupil is normal d. roth's spots
B
The nurse is caring for a patient in the neurologic ICU who sustained head trauma in a physical altercation. What would the nurse know is an optimal range of ICP for this patient? a. 8-15 mmHg b. 0-10 mmHg c. 20-30 mmHg d. 25-40 mmHg
B
The nurse is caring for a patient who was involved in a motor vehicle agent and sustained a head injury. When assessing DTRs, the nurse observes diminished or hypoactive reflexes. How will the nurse document this finding? a. 0 b. 1+ c. 2+ d. 3+
B
The nurse is caring for a pregnant patient with pregnancy-indiced hypertension. When assessing the reflexes in the ankle, the nurse observes rhythmic contractions of the muscle when dorsiflexing the foot. What would the nurse document this finding as? a. positive babinski reflex b. clonus c. hypertrophy d. ankle reflex
B
The nurse is very concerned about the potential debilitating complication of peroneal nerve injury. What symptoms does the nurse recognize as a result of this complication? a. permanent paresthesias b. footdrop c. DVT d. infection
B
A patient diagnosed with carpal tunnel syndromen (CTS) asks the nurse about numbness in the fingers and pain in the wrist. In responding to the patient, how would the nurse best respond CTS? a. CTS is a neuropathy that is characterized by bursitis and tendinitis b. CTS is a neuropathy that is characterized by flexion contracture of the 4th and 5th fingers c. CTS is a neuropathy that is characterized by compression of the median nerve at the wrist d. CTS is a neuropathy that is characterized by pannus formation in the shoulder
C
preganglionic fibers of the sympathetic neurons are located in what segments of the spinal cord
C8 and L3
layman's term for onychocryptosis
ingrown toe nail
what is a tendon transfer
insertion of a tendon to improve function
primary pathology of MS is damage to the
myelin sheeth
what is a hemiarthroplasty
replacement of one of the articular surfaces
lobe of the cerebral cortex that is responsible for the understanding of language and music
temporal lobe
what is a bone graft
the placement of tobe tissue to promote healing, to stabilize, or to replace diseased bone
A patient had a total left hip arthroplast. What clinical manifestation would indicate to the nurse that the prosthesis is dislocated? a. the left leg is internally rotated b. the leg length is the same as the right leg c. the patient has discomfort when moving in the bed d. diminished peripehral pulses on the affected extremity
A
A patient has been diagnosed with meningococcal meningitis at a community living home. When should prophylactic therapy begin for those who have had close contact witht the patient a. within 24 hours after exposure b. within 48 hours after exposure c. within 72 hours after exposure d. therapy is not necesary
A
A patient is diagnosed with osteomyelitis of the right leg. What signs and symptoms does the nurse recognize that are associated with this diagnosis? (select all that apply) a. pain b. erythema c. fever d. leukopenia e. purulent drainage
A, B, C
A patient is having repeated tears of the joint capsule in the shoulder, and the physician orders an arthrogram. What intervention should the nurse provide after the procedure is completed? (select all that apply) a. apply a compression bandage to the area b. apply heat to the area for 48 hours c. administer a mild analgesic d. inform the patient that a clicking or crackling noise in the joint may persist for a couple of days e. actively exercise the area immediately after the procedure
A, C, D
The nurse is performing an assessment for a patient who may have peripheral nerovascular dysfunction. What signs does the patient present with that indicate circulation is impaired? (select all that apply) a. pale, cyanotic, or mottled color b. cool temperature of the extremity c. more than 3-second capillary refill d. tenting skin tugor e. limited range of motion
A,B,C
A patient has a severe neurologic impairment from a head trauma. What does the nurse recognize is the type of posturing that occurs with the most severe neurologic impairment? a. decerebrate b. decorticate c. flaccid d. rigid
C
A patient is scheduled for an EEG in the morning. What food on the patient's tray should the nurse remove prior to the test? a. orange juice b. toast c. coffee d. eggs
C
The nurse is caring for a patient postoperatively following orthopedic surgery. The nurse assesses an oxygen saturation of 89%, confusion, and a rash on the upper torso. What does the nurse suspect is occuring with this patient? a. polyethylene-induced infection b. pneumonia c. fat emboli syndrome d. DIC
C
A patient has a fracture of the right femur sustained in an automobine accident. What process of fracture healing does the nurse understand will occur with this patient? a. reactive phase, reparative phase, remodeling phase b. primary phase, secondary phase, third phase c. first intention, secondary intention, third intention d. active phase, dormant phase, restructure phase
a
nervous system response from norepinephrine
excitatory response, mostly affecting moods
four reasons for a patient to have traction application
promote alignment, decrease muscle spasms, correct deformities, and increase space between joints
what is meant by an "altered level of consciousness"
pt is not oriented, doesn't follow commands, needs persistant stimuli to acheive a state of alertness
what is the optimal way to determine the level of a patient's alertness
pts ability to open the eyes spontaneously or in response to vocal or noxious stimuli
what is the process of fracture healing, including the three stages of progression
reactive --> reparative --> remodeling
role and function of autonomic nervous system
regulates the activities of internal organs such as heart, lungs, blood vessels, digestive organs and glands; maintenance and restoration of internal homeostasis
potential collaborative problems for a patient with an altered LOC
respiratory depression or failure, pneumonia, aspiration, pressure ulcer, DVT, contractures
function of the blood-brain barrier
restrict movement of substances, allows transfer proteins with required materials in
The nurse is assisting with a lumbar puncture and observes that when the physician obtains CSF, it is clear and colorless. What does this finding indicate? a. a subarachnoid hemorrhage b. an overwhelming infection c. a normal finding d. local trauma from the insertion of the needle
C
A patient is being tested for a gag reflex. When the nurse places the tongue blade to the back of the thriat, there is no response elicited. What dysfunction does the nurse determine the patient has? a. dysfunction of the spinal accessory nerve b. dysfunction of the acoustic nerve c. dysfunction of the facial nerve d. dysfunction of the vagus nerve
D
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? a. arthrocentesis b. bone scan c. electromyography d. arthroscopy
D
nervous system response from enkephalin
excitatory; inhibits pain transmission
principle signs of lower motor neuron disease
flaccid paralysis, atrophy of affected muscles
voluntary muscle control is governed by a vertival band of "motor cortex" located where
frontal lobe
what test is used to test radial peripheral nerve function
prick the skin midway between the thumb and second finger
what are the age-related changes of the musculoskeletal system specific to bones, muscles, joints, and ligaments
progressive loss of bone and muscle, less elastic tendons, deterioration of cartilage, lax ligaments
what bones contain red bone marrow in thier shaft
sternum, ileum, vertebrae, and ribs
The nurse is caring for a patient admitted to the hospital with a brain abscess that developed from an untreated case of otitis media. What assessment data is priority to alert the nurse to changes in ICP? a. LOC b. peripheral pulses c. sensory perception d. crackles bilateraly
A
The nurse is caring for a patient postoperative after intracranial surgery for the treatment of a subdural hematoma. The nurse observes an increase in the patient's blood pressure from the baseline and a decrease in the heart rate from 86 to 54. The patient has crackles in the base of the lungs. What does the nurse suspect is occuring? a. increased ICP b. exacerbation of uncontrolled HTN c. infection d. increase in cerebral perfusion pressure
A
A patient tells the nurse "I was working out and lifting weights and now that I have stopped, I am flabby and my muscles have gone!" What is the best response by the nurse? a. while you are lifting weights, endorphins are released, creating increase in muscle mass, but if the muscles are not used they will atrophy b. the muscle mass has decreased from the lack of calcium in the cells c. your muscles were in a state of hypertrophy from the weight lifting but it will persist only if the exercise is continued d. once you stop exercising, the conractions of the muscle does not regain its strength
C
nervous system response from gamma-aminobutyric acid
muscle and nerve inhibitory transmissions
clinical manifestations that occur when there is destruction or dysfunction in the basal ganglia
muscle rigidity, disturbance of posture, difficulty intitiating or changing movement
unrelieved pain for a patient in a cast must be immediately reported to avoid
necrosis, pressure ulcers, impaired perfusion, and possible paralysis
the nurse assesses for perineal nerve injury by checking the patient's casted leg for the primary symptoms of
numbness, tingling, and burning
most common benign bone tumor
osteocondrome
a nursing goal for a patient with skeletal traction is to avoid infection and the development of what at the site of pin insertion
osteomyelitis
clinical manifestations associated with septic arthritis
painful joints, decreased ROm
assessment technique used for tinel's sign
percuss over median nerve, if tingling=carpal tunnel
what is a myelogram
permits visualization of segments of the spinal cord that may have herniated or may be compressed
three potential complications in a patient with a depressed LOC
pneumonia, aspiration, respiratory failure
what potential immobility-related complications may develop when a patient is in skeletal traction
pressure ulcers, pneumonia, PE
what test is used to test ulnar peripheral nerve function
prick the distal fat pad of the small finger
what test is used to test tibial peripheral nerve function
prick the medial and lateral surface of the sole
what test is used to test peroneal nerve function sensation
prick the skin midway between the great and second toe
what test is used to test median peripheral nerve function
prick the top or distal surface of the index finger
nervous system response from acetylcholine
primarily excitatory; can produce vagal stimulation of heart
A patient tells the physician about shoulder pain that is present even without any strenuous movement. The physician identifies a sac filled with synovial fluid. What condition should the nurse educate the patient about? a. a fracture of the clavicle b. osteoarthritis of the shoulder c. bursitis d. ankylosing spondylitis
C
The nurse assesses soft subcutaneous nodules along the line of the tendons in a patient's hand and wrist. What does this finding indicate to the nurse? a. the patient has osteoarthritis b. the patient has lupus erythematosus c. the patient has rheumatoid arthritis d. the patient has neurofibromatosis
C
The nurse is assessing the feet of a patient and observes an overgrowth of the horny layer of the epidermis. What does the nurse recognize this condition as a. bunion b. clawfoot c. corn d. hammer toe
C
what area of the brain controls a person's personality and judgement
frontal lobe
risk factors associated with osteoporosis
genetics, age, nutritions, exercise, meds
most common cause of acute encephalitis is the US
herpes simplex
sleep-wake cycle regulator and the site of the hunger center
hypothalamus
four purposes for having a cast application
immobilizing a fracture, correct a deformity, apply uniform pressure, support weakened joints
three diagnostic tests used to support diagnosis of creutzfield jakob's
immunological assessment, EEG, MRI
disease-modifying therapies that are available to treat MS
immunomodulating therapies and immunosuppressive therapies
what is impingement syndrome and what measures are necessary to promote shoulder healing
impaired movment of rotaror cuff, therapeutic exercise program
nervous system response from serotonin
inhibits pain pathways and can control sleep
what is the difference between isotonic and isometric contractions
isometric=length of muscle remains constant, but the force is increased isotonic=shortening of muscle with an increase in tension within muscle
what is the different between kyphosis, lordosis, and scoliosis
kyphosis-increased forward curvature lordosis-exaggerated curvature of lumbar scoliosis-lateral curving deviation
describe compartment syndrome
large pressure in muscle compartment due to bleeding or pressure
A patient has a lesion affecting the pons, resulting in parlysis and the inability to speek, but has vertical eye movements and lid elevation. What is the patient suffering from
locked-in syndrome
musculoskeletal problems that can cause acute low back pain
lumbral-sacral strain, stress, obesity
what is a bone scan
may disclose infections, tumors, and bone marrow abnormalities
when the nurse performs a neurologic exam, what should be included
mental status, LOC, cranial nerve function, cerebellar function, reflexes, motor and sensory funtion
infectious disorders of the nervous system
mningitis, brain abscesses, various types of encephalitus, creutzfield-jackob's syndrome, variant creutzfield jakob's
what is an internal fixation
stabilization of the reduced fracture by the use of metal screws, plates, wires, nails, and pins
what methods for preventing hip prosthesis dislocation would the nurse teach the patient
supine, head slightly elevated, pillows between legs, keep knees apart at all times, dont cross legs, dont bend forward, use high seated chair
what are the general functions of the musculoskeletal system
support and protect the body and foster movement of the extremities
the nurse knows to assess a patient for DVT by assessing the lower extremities for
tenderness, warmth, redness, and swelling
major receiving and communication center for afferent sensory nerves
thalamus
what is an open reduction
the correction and alignment of the fracture after surgical dissection and exposure of the fracture
A patient with an arm cast complains of pain. What nursing interventions should the nurse provide in order to reduce the incidence of complications? (select all that apply) a. assess the fingers for color and temperature b. administer a prescribed analgesic to promote comfort and allay anxiety c. assess for a pressure sore d. determine the exact site of the pain e. cut the cast with a cast saw
A, C, D
The nurse is called to attend a patient having a seizure in the waiting area. What nursing care is provided for a patient who is experiencing a convulsive seizure? (select all that apply) a. loosening constrictive clothing b. opening the patient's jaw and inserting a mouth gag c. positioning the patient on his or her side with head flexed forward d. providing for privacy e. restraining the patient to avoid self-injury
A, C, D
