chapter 35

A client scheduled to undergo an electromyography asks the nurse what this test will evaluate. What is the correct response from the nurse?

muscle weakness

Which serum level indicates the rate of bone turnover?

osteocalcin Serum osteocalcin (bone GLA protein) indicates the rate of bone turnover. Serum myoglobin is assessed to evaluate muscle trauma. Serum enzyme levels of creatinine kinase and aspartate aminotransferase become elevated with muscle damage.

Which elements of assessment of a traumatic musculoskeletal injury should be included when a client is evaluated. Select all that apply.

Observing for swelling, external bleeding, or bruising; palpating the peripheral pulses; and checking the sensation of the injured part should all be included.

The nurse is preparing the client with a right neck mass for magnetic resonance imaging (MRI). Which question should the nurse ask? Select all that apply.

"Are you wearing any jewelry?" "Have you removed your hearing aid?" "Do you have a pacemaker?" Magnetic resonance imaging (MRI) is a noninvasive imaging technique that uses magnetic fields, radio waves, and computers to demonstrate abnormalities of soft tissue. Individuals with any metal implants, clips, or pacemakers are not candidates for MRI. Individuals do not need to be NPO and can take usual medications.

Which statement by the client preparing for a bone scan indicates further teaching by the nurse is needed?

"I will need to limit my fluid intake so as not to interfere with the isotope." The client needs to increase fluid intake to help distribute the isotope and to promote its excretion.

A client with a sports injury undergoes a diagnostic arthroscopy of the left knee. What comment by the client following the procedure will the nurse address first?

"My toes are numb" Numbness would indicate neurological compromise of the extremity and requires immediate intervention to prevent permanent damage. An aching knee is expected after the procedure. Cold or swollen feet are not priority assessments.

A client is diagnosed with a bone tumor. What result would the nurse expect the blood tests to reveal?

Decreased serum calcium level Decreased serum calcium level may indicate osteomalacia, osteoporosis, and bone tumors. With bone tumors, the alkaline phosphatase and serum phosphorus levels would be increased. Decreased red blood cell count may reflect anemia.

Which term refers to the shaft of the long bone?

Diaphysis The diaphysis is primarily cortical bone. An epiphysis is an end of a long bone. Lordosis refers to an increase in lumbar curvature of spine. Scoliosis refers to lateral curving of the spine.

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?

Diaphysis pg. 1088

The nurse is educating a group of students about peroneal nerve damage. The nurse knows that which assessment will show this type of nerve damage?

Dorsiflexion of the foot and extension of the toes

Which diagnostic test would the nurse expect to be ordered for a client with lower extremity muscle weakness?

Electromyograph (EMG) The EMG provides information about the electrical potential of the muscles and the nerves leading to them. The test is performed to evaluate muscle weakness, pain, and disability. An arthrocentesis, bone scan, and biopsy does not measure muscle weakness.

A nurse understands the influence of hormones on bone maintenance. Therefore, the nurse knows that a patient on long-term cortisol may experience:

Increased bone resorption. Increased levels of cortisol result in increased bone resorption and decreased bone formation. These patients are at increased risk for steroid-induced osteopenia and fractures.

The client presents with an exaggeration of the lumbar spine curve. How does the nurse interpret this finding?

Lordosis Lordosis is an exaggeration of the lumbar spine curve.

A nurse knows that a person with a 3-week-old femur fracture is at the stage where angiogenesis is occurring. What are the characteristics of this stage?

New capillaries producing a bridge between the fractured bones. Angiogenesis and cartilage formation begin when fibroblasts from the periosteum produce a bridge between the fractured bones. This is known as a callus.

A nurse performs a neurovascular assessment on a client 2 weeks after a wrist cast had been removed. The nurse documents in the client's chart that there is normal sensation in the ulnar nerve. What finger assessment test will the nurse perform on this client?

Prick the distal fat pad on the small finger. See Table 40-2 in the text. The ulnar nerve runs near the ulnar bone and enters the palm of the hand. It branches to the fifth finger (small finger) and the ulnar side of the fourth finger.

A client has just undergone arthrography. What is the most important instruction for the nurse to include in the teaching plan?

Report joint crackling or clicking noises occurring after the second day. After undergoing arthrography, the client must be informed that he or she may hear crackling or clicking noises in the joints for up to 2 days, but if noises occur beyond this time, they should be reported. These noises may indicate the presence of a complication, and therefore should not be ignored or treated by the client. Massage is not indicated. The client need not be asked to avoid sunlight or dairy products.

A client has a fracture that is being treated with open rigid compression plate fixation devices. What teaching will the nurse reinforce to the client about how the progress of bone healing will be monitored?

Serial x-rays will be taken. Serial x-rays are used to monitor the progress of bone healing. The plate need not be disturbed. An arthroscopy is used to visualize joints. While the bone will heal without interference, monitoring of bone healing is needed to ensure further adjustments are not necessary.

Which laboratory study indicates the rate of bone turnover?

Serum osteocalcin 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.

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 Arthrography is useful in identifying acute or chronic tears of the joint capsule or supporting ligaments of the knee, shoulder, ankle, hip, or waist. Meniscography is a distractor for this question. Bone densitometry is used to estimate bone mineral density. An EMG provides information about the electrical potential of the muscles and nerves leading to them.

Weight-bearing exercises maintain bone mass. Weight-resistance exercises maintain and strengthen muscles. Cardio training is important for heart health and weight maintenance/reduction. Range-of-motion exercises are essential for joint mobility.

calcitonin Calcitonin, secreted by the thyroid gland in response to elevated blood calcium levels, inhibits bone reabsorption and increases the deposit of calcium in the bone.

The nurse working in the emergency department receives a call from the x-ray department communicating that the client the nurse is caring for has a fracture in the shaft of the tibia. The nurse tells the physician that the client's fracture is in the

diaphysis The diaphysis is primarily cortical bone. An epiphysis is an end of a long bone. Lordosis refers to an increase in lumbar curvature of spine. Scoliosis refers to lateral curving of the spine.

A client is diagnosed with a fracture of a diarthrosis joint. What is an example of this type of joint?

elbow A diarthrosis joint, like the elbow, is freely movable. The skull is an example of an immovable joint. The vertebral joints and symphysis pubis are amphiarthrosis joints that have limited motion.

The nurse is performing a musculoskeletal assessment for a client whose right leg muscles exhibit no tone and are limp. Which descriptor should the nurse use to document this condition?

flaccid The term flaccid describes muscles that have no tone or are limp. Spastic describes muscles that have greater-than-normal tone. Atonic describes muscles that are not enervated and become soft and flabby. Atrophic describes muscles deterioration that occurs with lack of use and exercise.

An osteocalcin (bone GLA protein) level has been ordered. How will the nurse prepare for this order?

obtain a blood specimen An osteocalcin level is determined from a blood sample. It is used to assess the rate of bone turnover.

Which nerve is being assessed when the nurses asks the client to dorsiflex the ankle and extend the toes?

peroneal The motor function of the peroneal nerve is assessed by asking the client to dorsiflex the ankle and to extend the toes, while pricking the skin between the great toe and center toe assesses sensory function. The radial nerve is assessed by asking the client to stretch out the thumb, then the wrist, and then the fingers at the metacarpal joints. The median nerve is assessed by asking the client to touch the thumb to the little finger. Asking the client to spread all fingers allows the nurse to assess motor function affected by ulnar innervation.

Which of the following is the final stage of fracture repair?

remodeling The final stage of fracture repair consists of remodeling the new bone into its former structural arrangement. During cartilage calcification, enzymes within the matrix vesicles prepare the cartilage for calcium release and deposit. Cartilage removal occurs when the calcified cartilage is invaded by blood vessels and becomes reabsorbed by chondroblasts and osteoclasts. Angiogenesis occurs when new capillaries infiltrate the hematoma, and fibroblasts from the periosteum, endosteum, and bone marrow produce a bridge between the fractured bones.

The nurse is conducting the admission assessment for a client who is to undergo an arthrogram. What is the priority question the nurse should ask?

"Do you have any allergies?" Many contrast dyes contain iodine. Therefore, it is essential for the nurse to determine whether the client has any allergies, especially to iodine, shellfish, and other seafood. Asking about eating or urinating is important but not priority. The claustrophobia is not a concern for the arthrogram.

The nurse is preparing the client for computed tomography. Which information should be given by the nurse?

"You must remain very still during the procedure." In computed tomography, a series of detailed x-rays are taken. The client must lie very still during the procedure. A contrast agent, not a radioisotope, may or may not be injected. Arthrocentesis involves the removal of fluid from a joint. A small bit of tissue is removed with a biopsy.

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?

Apply a cold pack at the insertion site. 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.

The nurse is conducting a musculoskeletal assessment on a client documented to have rheumatoid arthritis. Which would the nurse anticipate finding when inspecting the client's fingers?

Soft, subcutaneous nodules along the tendons The subcutaneous nodules of rheumatoid arthritis are soft and occur within and along tendons that provide extensor function to the joints. The nodules of gout are hard and lie within and immediately adjacent to the joint capsule itself. Osteoarthritic nodules are hard and painless and represent bony overgrowth that results from destruction of the cartilaginous surface of bone within the joint capsule.

The nurse working in the orthopedic surgeon's office is asked to schedule a shoulder arthrography. The nurse determines that the surgeon suspects which finding?

Tear in the joint capsule Arthrography is useful in identifying acute or chronic tears of the joint capsule or supporting ligaments of the knee, shoulder, ankle, hip, or waist. X-rays are used to diagnose bone fractures. Bone densitometry is used to estimate bone mineral density. An electromyogram (EMG) provides information about the electrical potential of the muscles and nerves leading to them.

The nurse is preparing an education program on risk factors for musculoskeletal disorders. Which risk factors are appropriate for the nurse to include in the teaching program? Select all that apply.

age menopause bed rest current cigarette smoking Increasing age, menopause, immobility (such as bed rest), and current cigarette smoking increase the risk for musculoskeletal disorders. A diet rich in calcium is beneficial in maintaining bone and muscle.

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 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.

The primary functions of cartilage are to reduce friction between articular surfaces, absorb shocks, and reduce stress on joint surfaces. Where in the human body is cartilage found?

between the ribs covering elbow joints between the vertebrae Types of cartilage include costal cartilage, which connects the ribs and sternum; semilunar cartilage, which is one of the cartilages of the knee joint; fibrous cartilage, found between the vertebrae (intervertebral disks); and elastic cartilage, found in the larynx, epiglottis, and outer ear.

The nurse is conducting a medication reconciliation with a client admitted with a fracture. What medication predisposes a client for a risk for fractures?

prednisone Prednisone, a corticosteroid, causes increased bone resorption and decreased bone formation, resulting in increased risk for fractures. Furosemide, digoxin, and metoprolol do not interfere with bone resorption or predispose clients to fractures.

The nurse observes a client with a shuffling gait. What disease is commonly associated with a shuffling gait?

Parkinson's disease Client with Parkinson's disease may have a shuffling gait. Clients with a lower motor disease will have steppage gait. Clients with scoliosis may have a limp. Clients with Paget's disease may have bone fractures.q

Which of the following diagnostic studies are done to relieve joint pain due to effusion?

arthrocentesis Arthrocentesis (joint aspiration) is carried out to obtain synovial fluid for purpose of examination or to relieve pain due to effusion. EMG provides information about the electrical potential of the muscles and the nerves leading to them. A bone scan is performed to detect metastatic and primary bone tumors, osteomyelitis, certain fractures, and aseptic necrosis. A biopsy may be performed to determine the structure and composition of bone marrow, bone, muscle, or synovium to help diagnose specific diseases.

Which of the following is the most common site of joint effusion?

knee The most common site for joint effusion is the knee. If inflammation or fluid is suspected in a joint, consultation with a provider is indicated. The elbow, hip, and shoulder are not the most common site of joint effusion.

The nurse is performing a musculoskeletal assessment of a client in a nursing home who had a stroke 2 years ago and who has right-sided hemiplegia. The nurse notes that the girth of the client's right calf is 2 inches less in diameter than the left calf. The nurse attributes the decreased girth to

atrophy of right calf muscle Girth of an extremity may increase as a result of exercise, edema, or bleeding into the muscle. However, a client with right-sided hemiplegia is unable to use the right lower extremity. This client may experience atrophy of the muscles from lack of use, which results in a subsequent decrease in the girth of the calf muscle.

An example of a flat bone is the

sternum An example of a flat bone is the sternum. A short bone is a metacarpal. The femur is a long bone. The vertebra is an irregular bone.

A client experiences a musculoskeletal injury that involves the structure that connects a muscle to the bone. The nurse understands that this injury involves which structure?

tendon Tendons are cordlike structures that attach muscles to the periosteum of the bone. Ligaments consisting of fibrous tissue connect two adjacent, freely movable bones. Cartilage is a firm dense type of connective tissue that reduces friction between articular surfaces, absorbs shock, and reduces the stress on joint surfaces. A joint is the junction between 2 or more bones.

Which of the following is an example of a hinge joint?

knee Hinge joints permit bending in one direction only and include the knee and elbow. The hip is a ball-and-socket joint. The joint at the base of the thumb is a saddle joint. Gliding joints allow for limited movement in all directions and are represented by the joints of the carpal bones in the wrist.

Which cells are involved in bone resorption?

osteoclasts 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.

Skull sutures are an example of which type of joint?

synarthrosis Skull sutures are considered synarthrosis joints and are immovable. Amphiarthrosis joints allow limited movement, such as a vertebral joint. Diarthrosis joints are freely movable joints such as the hip and shoulder. Aponeuroses are broad, flat sheets of connective tissue.

The older client asks the nurse how best to maintain strong bones. What is the nurse's best response?

"Weight-bearing exercises can strengthen bones." Weight-bearing exercises maintain bone mass. Weight-resistance exercises maintain and strengthen muscles. Cardio training is important for heart health and weight maintenance/reduction. Range-of-motion exercises are essential for joint mobility.

The older client asks the nurse how best to maintain strong muscles. What is the nurse's best response?

"Weight-resistance exercises can strengthen muscles." Weight-resistance exercises maintain and strengthen muscles. Cardio-training is important for heart health and weight maintenance/reduction. Rest is good if you get exercise but doesn't build muscle on its own. Range of motion exercises are essential for joint mobility.

A nurse is caring for a client with an undiagnosed bone disease. When instructing on the normal process to maintain bone tissue, which process transforms osteoblasts into mature bone cells?

Ossification and calcification Ossification and calcifications the body's process to transform osteoblasts into mature bone cells called osteocytes. Osteocytes are involved in maintaining bone tissue. Resorption and remodeling are involved in bone destruction. Epiphyses and diaphyses are bone tissues that provide strength and support to the human skeleton.

After bone fracture, fibrocartilaginous callus formation normally occurs at the same time as which process?

fibroblast migration Fibrocartilaginous callus formation occurs as fibroblasts and osteoblasts migrate into the fracture site, where they begin to reconstruct the bone; the bone is not yet able to bear weight at the end of this phase. Next, mature bone replaces the fibrocartilaginous callus. Together these processes are sometimes referred to as the reparative stage. Inflammation and hematoma formation occur in the days immediately after the fracture, as macrophages invade and debride the fracture area. Remodeling is the final stage of fracture repair, during which the new bone is reorganized into the bone's former structural arrangement.

The nurse is assigned to a client admitted with advanced Parkinson's disease. What type of gait correlates with Parkinson's disease?

shuffling gait A variety of neurologic conditions are associated with abnormal gaits, such as spastic hemiparesis gait (stroke), steppage gait (lower motor neuron disease), and shuffling gait (Parkinson's disease). Scissors gait is seen in cerebral palsy.

Which assessment finding would cause the nurse to suspect compartment syndrome in the client following a bone biopsy?

increased diameter of the calf Increasing diameter of the calf can be indicative of bleeding into the muscle. The other findings are within normal limits.

After a fracture, during which stage or phase of bone healing is devitalized tissue removed and new bone reorganized into its former structural arrangement?

remodeling Remodeling is the final stage of fracture repair. During inflammation, macrophages invade and debride the fracture area. Revascularization occurs within about 5 days after a fracture. Callus forms during the reparative stage but is disrupted by excessive motion at the fracture site.

The nurse is assessing the client for scoliosis. What will the nurse have the client do to perform the assessment?

Stand behind the client and ask the client to bend forward at the waist. Scoliosis is characterized by a lateral curvature of the spine. The nurse stands behind the client and asks the client to bend forward at the waist for the nurse to examine the spine curvature. The nurse cannot see the spine by standing beside the client or in front of the client. The spinal curve cannot be seen by watching the client walk.

Which is a circulatory indicator of peripheral neurovascular dysfunction?

cool skin Indicators of peripheral neurovascular dysfunction related to circulation include pale, cyanotic, or mottled skin with a cool temperature. The capillary refill is more than 3 seconds. Weakness and paralysis are related to motion. Paresthesia is related to sensation.

The nurse is caring for a client who has a deficiency in the formation of cartilage in joints. Which essential substance is absent?

matrix Cartilage is a firm, dense type of connective tissue that consists of cells embedded in a substance called matrix. The matrix is firm and compact. Cartilage is essential in reducing friction between articular surfaces and absorbs shock. Osteoblasts build bone. Sarcomeres assist in contracting muscle. Skeletal muscles are composed of myofibrils.

The nurse is caring for a client who experienced a crushing injury of the lower extremities. Which of the following symptoms is essential to be reported to the physician?

pulselessness Neurovascular checks (circulation, sensation, motion) are essential with a crushing injury. The absence of a pulse is a critical assessment finding to report to the physician. The other options are symptoms that need regular assessment.

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?

kyphosis Common deformities of the spine include kyphosis, which is an increased forward curvature of the thoracic spine that causes a bowing or rounding of the back, leading to a hunchback or slouching posture. The second deformity of the spine is referred to as lordosis, or swayback, an exaggerated curvature of the lumbar spine. A third deformity is scoliosis, which is a lateral curving deviation of the spine (Fig. 40-4). Osteoporosis is abnormal excessive bone loss.

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 Indicators of peripheral neurovascular dysfunction include pale, cyanotic, or mottled skin color; cool temperature of the extremities; and a capillary refill of more than 3 seconds.

During the interview an older adult client reports joint pain with movement. The client states, "But if I rest it, the pain gets better." What is the most likely cause of client's pain?

relaxation of teh ligaments The client's pain is most likely due to the relaxation of the ligaments resulting in postural changes and joint pain with movement that improves with rest. Deterioration of the cartilage results stiffness and reduce flexibility as evidenced by stiffness, decreased flexibility, and decreased range of motion. Increased collagen and decreased muscle mass would result in loss of strength and flexibility, weakness and fatigue, stumbling and falls.

The nurse is working on an orthopedic floor caring for a client injured in a football game. The nurse is reviewing the client's chart noting that the client has previously had an injured tendon. The nurse anticipates an injury between the periosteum of the bone and which of the following?

muscle Tendons attach muscles to the periosteum of bone. Joints are a junction between two or more bones. Ligaments connect two freely movable bones. Cartilage is a dense connective tissue used to reduce friction between two structures.

A patient has a fracture of the right femur sustained in an automobile accident. What process of fracture healing does the nurse understand will occur with this patient?

reactive, reparative, remodeling phase The process of fracture healing occurs over three phases. These include the following: Phase I: Reactive phase; Phase II: Reparative phase; and Phase III: Remodeling phase.

The nurse is assessing a client with a musculoskeletal system condition. Which statement indicates to the nurse that the client is experiencing bone pain?

"The pain feels deep in my legs and keeps me awake at night." Bone pain is typically described as a dull, deep ache that is "boring" in nature. This pain is not typically related to movement and may interfere with sleep. Muscular pain is described as soreness or aching and is referred to as "muscle cramps." Joint pain is felt around or in the joint and typically worsens with movement. Fracture pain is sharp and piercing and is relieved by immobilization. Sharp pain may also result from bone infection with muscle spasm or pressure on a sensory nerve.

Red bone marrow produces which of the following? Select all that apply.

Platelets White blood cells (WBCs) Red blood cells (RBCs) The red bone marrow located within the bone cavities produces RBC, WBCs, and platelets through the process of hematopoiesis. The red bone marrow does not produce estrogen or corticosteroids.

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 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 of the following is an appropriate priority nursing diagnosis for the client following an arthrocentesis?

risk for infection The priority nursing diagnosis following an arthrocentesis is risk for infection. The client may experience acute pain. The client needs adequate information before experiencing the procedure. Activity intolerance would not be an expected nursing diagnosis.

A client is seen in the emergency room for a knee injury that happened during a basketball game. Diagnostic tests reveal torn cords of fibrous connective tissue that connect muscles to bones. What type of tear has this client sustained?

tendon Tendons are broad, flat sheets of connective tissue that attach muscles to bones, soft tissue, and other muscles. Ligaments bind bones together. A bursa is a synovial-filled sac, and fascia surround muscle cells.

A client is recovering from a fractured hip. What would the nurse suggest that the client increase intake of to facilitate calcium absorption from food and supplements?

vitamin d The nurse must advise a client recovering from a fractured hip to increase the intake of vitamin D, because vitamin D protects against bone loss and decreases the risk of recurring fracture by facilitating calcium absorption from food and supplements. Amino acids and vitamin B6, though important, do not facilitate the absorption of calcium. Dairy products also do not facilitate the absorption of calcium; however, the exception to this is vitamin D-fortified milk.

The client who is about to undergo arthroscopy of the knee begins to describe the procedure to the nurse. What statement(s) indicate to the nurse that the client understands the procedure? Select all that apply.

"A needle will be inserted into the joint space." "A special scan may be done to verify the placement of the needle." "Fluid is taken from the joint for laboratory analysis." If the client describes the procedure as one in which a needle is inserted into the joint space, with a special scan possibly being done to verify needle placement, to take fluid from the joint for laboratory analysis, the nurse can confirm that the client understands the arthroscopy procedure. Before the procedure, the provider first injects a local anesthetic. The client should expect the crackling or clicking noises to resolve after 2 days. Noises beyond this time are abnormal; the client should report them.

A client is scheduled for a bone scan. A bone scan may be ordered to detect metastatic bone lesions, fractures, and certain types of inflammatory disorders. Which nursing considerations are correct in preparing a client for a bone scan? Select all that apply.

Inform the client that the radiopaque isotope will be administered intravenously. Ensure that the client does not have any allergies to the isotope. Encourage the client to drink fluids to help distribute and eliminate the isotope. Informing the client that the radiopaque isotope will be administered intravenously, ensuring that the client does not have any allergies to the isotope, and encouraging the client to drink fluids to help distribute and eliminate the isotope are all considered in preparing a client for a bone scan. The client does not need to be NPO for 12 hours before the test.

A patient comes to the clinic and informs the nurse of numbness, tingling, and a burning sensation in the arm from the elbow down to the fingers. What type of symptom would this be documented as?

Paresthesia Sensory disturbances are frequently associated with musculoskeletal problems. The patient may describe paresthesias, which are sensations of burning, tingling, or numbness. These sensations may be caused by pressure on nerves or by circulatory impairment.

While reading a client's chart, the nurse notices that the client is documented to have paresthesia. The nurse plans care for a client with

abnormal sensations. Abnormal sensations, such as burning, tingling, and numbness, are referred to as paresthesias. The absence of muscle tone suggesting nerve damage is referred to as paralysis. A fasciculation is the involuntary twitch of muscle fibers. A muscle that holds no tone is referred to as flaccid.

A client is experiencing muscle weakness in the upper extremities. The client raises an arm above the head but then loses the ability to maintain the position. Muscular dystrophy is suspected. Which diagnostic test would evaluate muscle weakness or deterioration?

an electromyography An electromyography tests the electrical potential of muscles and nerves leading to the muscles. It is done to evaluate muscle weakness or deterioration. A serum calcium test evaluates the calcium in the blood. An arthroscopy assesses changes in the joint. An MRI identifies abnormalities in the targeted area.

Which medication taken by the client in the previous 24 hours would be of greatest concern to the nurse caring for a client undergoing a bone biopsy?

aspirin Aspirin has anti-clotting properties, and bone is a very vascular tissue. The client taking aspirin in close proximity to a bone biopsy is at increased risk for excessive bleeding.