Musculoskeletal definitions
A nurse is providing teaching about disease management to a client who has rheumatoid arthritis, which of the following responses by the client indicates an understanding of the teaching
"I will have handrails installed in my bathroom and hall."
How to go up and down stairs with a cane and crutches
"up with the good, down with the bad"
4 point gait
1: 1 crutch 2: opposite foot 3: other crutch 4: other foot nothing moves together
3 point gait
1: move two crutches and bad leg together 2: move good foot
Proper fit for crutches
2-3 fingers (1-1.5 inches) in between armpit and resting pod. Elbows flexed 30 degrees
Fat embolism
A blockage in a blood vessel made up of one or more particles of fat Petechiae, cyanosis, O2 sat decreased, altered mental status
The nurse is preparing to administer subcutaneous enoxaparin. Which intervention should the nurse implement?
Administer in the anterolateral abdomen
A nurse is caring for a client who is 72 hr postoperative following an above the knee amputation which of the following actions should the nurse take
Assist the client to a prone position every 4 hr.
Juvenile Idiopathic Arthritis
Autoimmune inflammatory disease with no known cause Younger than 16 5 major types
Osteoporosis
Chronic metabolic bone disorder resulting in low bone density. The rate of bone resorption exceeds the rate of bone formation which results in fragile bone tissue and can lead to fractures
A 24-year-old female is seen at the clinic and reports a low-grade fever, arthralgias, fatigue, and a facial rash. Which diagnostic studies would the nurse expect the HCP to order to see if she has systemic lupus erythematosus
Complete blood count and antinuclear antibody tests
nurse is caring for a client who has a fractured hip and was placed in Buck's traction 4 hr ago. Which of the following actions should the nurse take?
Encourage the client to perform dorsiflexion of the affected extremity every 2 hr
Which intervention should the nurse implement for a patient with a fractured hip in Buck's traction?
Ensure amount of traction weight is accurate
Strain
Excessive stretching or pulling of a muscle or tendon
Which intervention should the nurse implement for the patient diagnosed with an open fracture of the left ankle? Select all that apply
Extremity elevated Tetanus shot Pedal pulses Iv antibiotics Monitor bleeding
Walker fitting
Hand grips even with wrist crease. 15-30 degree angle bend in elbows
60-year-old patient is being assessed for osteoporosis. Which data should the nurse assess? SATA
History of osteoporosis Estrogen deficit Type and amount of exercise Alcohol intake
cane fitting
In line with the greater trochanter Elbows flexed 15-30 degrees
The nurse is providing care for a client with systemic lupus erythematous. What assessment finding is indicative of an exacerbation of the disease?
Inflamed joints with fever
Bursitis
Inflammation of bursa affects shoulder, hip, leg, and shoulder
A nurse is providing teaching for a client following a below-the-knee amputation. Which of the following pieces of information should the nurse include in the teaching?
Instruct the client to lie prone while in bed
Right knee Arthroplasty the nurse should expect which of the following findings
Joint crepitus Limited mobility Pain when bearing weight Swelling of the affected joint
skeletal traction(balanced suspension)
Long-term pull to maintain alignment Pin or screws inserted into bone Complications of immobility
Lupus LESS
Lower stress Exercise Sleep Sun protection
The nurse recognizes that which of the following is a risk factor for osteoporosis?
Medical history of menopause
A nurse is caring for a client who has chronic phantom limb pain following an above-knee amputation. Which of the following medication prescriptions should the nurse verify with the provider?
Meperidine
Walker instructions
Move Walker forward Then Move weak leg And lastly Move strong leg
2 point gait crutches
Move right crutch and left leg Move left crutch and right leg
systemic lupus erythematosus (SLE)
Multi system chronic inflammatory, rheumatic, autoimmune disease characterized by remissions and exacerbations . Most often occurs in African American women Pericardial rub and crackles in the lungs
nurse is preparing to care for a client who is in balanced skeletal traction to stabilize a femur fracture. Which of the following actions should the nurse include in the client's plan of care?
Offering the client a diet high in fluid and fiber.
Internal fixation devices/ open reduction
Open reduction refers to visualization of a fracture through an incision in the skin, and internal fixation with plates, screws, pins, rods, and prosthetics as needed.
P's of compartment syndrome
Pain (early sign) Paresthesia Pallor Poikilothermic Paralysis Pulselessness (late sign)
nurse is planning care for a client following a total hip arthroplasty. Which of the following interventions should the nurse include in the plan?
Place a pillow between the client's legs
Which patients are at risk for developing osteoarthritis? Select all that apply
Played college football BMI of 37 Female grocery cashier
nurse is caring for a client following a hip arthroplasty. The nurse places an abduction pillow on the client for which of the following purposes?
Preventing dislocation of the hip during position changes or movement
Nurse is caring for a client who is 3 days postoperative following a below the knee amputation which of the following actions should the nurse take
Rewrap the residual limb with a bandage 3 times per day
Straight or running traction
Skin traction used to decrease muscle spasms and immobilize extremity before surgery . Short term ex. Bucks traction
cane use
Stand on patients weak side Hold cane on strong side of the body Move cane while moving weak leg
Care of Client in Traction (TRACTION)
T- Temperature (Extremity, Infection) R - Ropes hang freely A - Alignment C - Circulation Check (5 P's) T- Type & Location of fracture I - Increase fluide intake O - Overhead trapeze N - No weights on bed or floor
The nurse is preparing to administer morning medications. Which medication should the nurse administer first?
The diuretic medication to the patient diagnosed with systemic lupus erythematous
The patient diagnosed with rheumatoid arthritis is prescribed infliximab. Which education should the nurse provide in education about the medication?
The patient should monitor for symptoms of infection
Gout
Type of arthritis that causes inflammation of joints due to excess uric acid usually in the big toe
compartment syndrome
Usually affects extremities and occurs when pressure within one or more of the muscle compartments compromises circulation.
A nurse is caring for a client with the hip fracture who has bucks extension traction in place which of the following pieces of information should the nurse give the client about this type of traction?
You'll have considerably less pain with the traction in place The traction will help decrease muscle spasms The weight act as a pulling force to keep your leg and hip still
rhematoid arthritis
a chronic autoimmune disorder in which the joints and some organs of other body systems are attacked. Have exacerbations mainly seen in females . WORSE IN THE MORNING Labs- ANA, C reactive protein, ESR, WBC
Fibromyalgia
a chronic pain syndrome that involves stiffness, sleep disturbance, generalized muscle weakness, and chronic fatigue.
Osteoarthritis
a degenerative joint disease. Characterized by progressive deterioration of the articular cartilage. Noninflammatory (unless localized) nonsytemic disease Mainly In hands finger joints are affected
fasciotomy
a surgical incision through the fascia to relieve tension or pressure
Open compound fracture(compound/complex)
bone fragments break through skin concerned about infection and bleeding
Fractures
disruption or break in the continuity of bone
Osteomyelitis
infection of the bone would see redness, edema, fever ELEVATED WBC give antibiotics
external fixation
involves fracture immobilization using percutaneous pins and wires that are attached to a rigid external frame.Assess for infection, prevent DVT, and observe for fat and pulmonary embolism
Sprain
stretching or tearing of ligaments
Arthroplasty
surgical reconstruction or replacement of a joint to relieve pain, maintain or improve ROM, and correct deformities Knee and hip can treat osteoarthritis and rheumatoid arthritis