PrepU Chapter 35: Assessment of Musculoskeletal Function

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.

A client undergoes an arthroscopy at the outpatient clinic. After the procedure, the nurse provides discharge teaching. Which response by the client indicates the need for further teaching?

"I should use my heating pad this evening to reduce some of the pain in my knee." -The client requires additional teaching if he states that he'll use a heating pad to reduce pain the evening of the procedure. The client shouldn't use heat at the procedure site during the first 24 hours because doing so may increase localized swelling. Ice is indicated during this time. Elevating the extremity helps reduce swelling. The client may experience some discomfort after the procedure for which the physician may order medication. Bruising and swelling are common after an arthroscopy.

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.

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.

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 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 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?

"Your muscles were in a state of hypertrophy from the weight lifting but it will persist only if the exercise is continued."

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?"

A client is having repeated tears of the joint capsule in the shoulder, and the health care provider orders an arthrogram. What intervention should the nurse provide after the procedure is completed? Select all that apply.

- Apply a compression bandage to the area. - Administer a mild analgesic. - Inform the client that a clicking or crackling noise in the joint may persist for a couple of days.

The nurse is preparing to assess the spine of an older adult. Which actions will the nurse take during this assessment? Select all that apply.

- Measure height - Ask the client to bend backward - Ask the client to bend forward at the waist

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

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

- Platelets - White blood cells (WBCs) - Red blood cells (RBCs)

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

What areas of the body may be examined when bone densitometry is done? Select all that apply.

- hip - spine - wrist

Which term refers to moving away from midline?

Abduction -Abduction is moving away from the midline. Adduction is moving toward the midline. Inversion is turning inward. Eversion is turning outward.

Which statement describes paresthesia?

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 arrives at the orthopedic physician's office stating knee pain sustained while playing soccer. A history and physical assessment is completed. The knee appears reddened with edema. Which other diagnostic testing would the nurse anticipate?

An arthroscopy -An arthroscopy is the internal inspection of the joint using an arthroscope. The physician can inspect the joint for injury or deterioration and can also complete therapeutic procedures such as removing bit of torn or floating cartilage. A bone densitometry estimates bone density. A bone scan is used to detect metastatic bone lesions, fractures, or inflammatory disorders. An arthrocentesis is the aspiration of synovial fluid. An arthrocentesis may be completed during an arthroscopy.

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.

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.

Which nursing action is most important in caring for the client following an arthrogram?

Apply ice to the joint. -Ice is applied to minimize edema and provide analgesia to the joint. The joint is elevated to minimize edema. Mild analgesics are sufficient to control pain. The joint is usually rested for 12 hours post-procedure.

A client has had an electromyography. What is an appropriate nursing intervention following this diagnostic procedure?

Apply warm compresses. -Electromyography involves the insertion of needles into select muscles. The nurse applies warm compresses to the insertion sites to relieve discomfort following the procedure.

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 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.

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 nurse is performing a neurological assessment. What will this assessment include?

Ask the client to plantar flex the toes. -A neurological assessment evaluates sensation and motion. Assessing plantar flexion of the toes would be included in a neurological assessment. Capillary refill, palpation of pulses, and inspecting for edema would be included in a vascular assessment.

Which hormone inhibits bone reabsorption and increases calcium deposit in the bone?

Calcitonin -Calcitonin, secreted by the thyroid gland in response to elevated blood calcium concentration, inhibits bone reabsorption and increases the deposit of calcium in the bone. The other answers do not apply.

Which hormone inhibits bone resorption and increases the deposit of calcium in the bone?

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 orthopedic nurse is caring for a client diagnosed with a fracture of the radius. In which type of bone tissue does the nurse anticipate the fracture being?

Cancellous -Cancellous bone or spongy bone is light and contains many spaces making it a less solid bone than the cortical or compact bone. Collagen and cartilage are not types of bone.

Which is an indicator of neurovascular compromise?

Capillary refill of more than 3 seconds -Capillary refill of more than 3 seconds is an indicator of neurovascular compromise. Other indicators include cool skin temperature, pale or cyanotic color, weakness, paralysis, paresthesia, unrelenting pain, pain upon passive stretch, and absence of feeling. Cool skin temperature is an indicator of neurovascular compromise. Unrelenting pain is an indicator of neurovascular compromise. Pain upon passive stretch is an indicator of neurovascular compromise.

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.

Choose the correct statement about the endosteum, a significant component of the skeletal system:

Covers the marrow cavity of long bones -The endosteum is a thin vascular membrane that covers the marrow cavity of long bones and the spaces in cancellous bone. Osteoclasts are located near the endosteum.

Which term refers to a grating or crackling sound or sensation?

Crepitus

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.

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 - Assessment of peripheral nerve function has two key elements: evaluation of sensation and evaluation of motion. To assess motion of the peroneal nerve, the client should be asked to dorsiflex the foot and extend the toes. Pricking the skin along the top of the index finger assesses sensation of the median nerve. Having the client stretch the thumb away from the wrist assesses motion of the radial nerve. Pricking the skin between the medial and lateral surface of the sole will assess tibial nerve sensation.

The nurse is performing a neurovascular assessment of a client's injured extremity. Which would the nurse report?

Dusky or mottled skin color -Normally, skin color would be similar to the color in other body areas. Pale or dusky skin color indicates an abnormality that needs to be reported. Presence of pulses, capillary refill of 3 seconds, and warm skin are normal findings.

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

Elbow

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.

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

Which of the following describes a muscle that is limp and without tone?

Flaccid -A muscle that is limp and without tone is described as flaccid. A muscle with greater-than-normal tone is described as spastic. In conditions characterized by lower neuron destruction, denervated muscle becomes atonic (soft and flabby) and atrophies. A person with muscle paralysis has a loss of movement and possibly nerve damage.

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?

Flaccidity -A muscle that is limp and without tone is described as flaccid; a muscle with greater-than-normal tone is described as spastic. Conditions characterized by lower motor neuron destruction (e.g., muscular dystrophy), denervated muscle becomes atonic (soft and flabby) and atrophies.

The nurse is preparing to perform a musculoskeletal assessment for a client with chronic muscle pain. Which assessment technique would be an appropriate tool to evaluate this type of pain?

Flex the bicep against resistance. - Evaluating muscle strength is a part of the musculoskeletal system. Strength of the bicep muscles can be tested by having the client flex the bicep against resistance. Palpating for the balloon sign assesses for fluid around the knee joint. Measuring the girth of the thigh evaluates for muscle size. Cracking with movement may indicate a ligament slipping over a bony prominence.

The nurse is reporting on the results of client blood work to the oncoming nurse. Upon reviewing the data, it is noted that the client has an elevated uric acid level. Which inflammatory process would the nurse screen for on shift rounds?

Gout -Gout is a medical condition with symptoms of acute inflammatory arthritis that is caused by high levels of uric acid in the blood. The client has uric acid crystal deposits in the joint. The nurse would assess joint areas for pain, redness, and swelling. Rheumatoid arthritis is a chronic disease of joint inflammation and pain. Lupus erythematous is a chronic tissue disorder of the connective tissue and is known to have an elevated antinuclear antibody level. Osteoporosis has a deficiency in the serum calcium level.

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.

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 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.

Which term refers to mature compact bone structures that form concentric rings of bone matrix?

Lamellae -Lamellae are mineralized bone matrices. Endosteum refers to the marrow cavity lining of hollow bone. Trabecula refers to latticelike bone structure. Cancellous bone refers to spongy, latticelike bone structure.

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.

The nurse would expect which of the following age-related change of the musculoskeletal system?

Loss of bone mass

Which description refers to an osteon?

Microscopic functional bone unit -The center of an osteon contains a capillary, a microscopic functional bone unit. An osteoblast is a bone-forming cell. An osteoclast is a bone resorption cell. An osteocyte is a mature bone cell.

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 -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.

After a person experiences a closure of the epiphyses, which statement is true?

No further increase in bone length occurs. -After closure of the epiphyses, no further increase in bone length can occur. The other options are inappropriate and not related to closure of the epiphyses.

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

Obtain a blood specimen.

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.

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 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.

A group of students are reviewing information about bones in preparation for a quiz. Which of the following indicates that the students have understood the material?

Osteoclasts are involved in the destruction and remodeling of bone. -Osteoclasts are the cells involved in the destruction, resorption, and remodeling of bone. Red bone marrow is responsible for manufacturing red blood cells. Long bones contain yellow bone marrow; the sternum, ileum, vertebrae, and ribs contain red bone marrow. Osteoblasts are transformed into osteocytes, mature bone cells.

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.

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.

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.

Which nursing instruction is most important to stress when teaching on calcium intake?

Provide age-related calcium intake recommendations.

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.

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 phase, reparative phase, 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.

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.

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.

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

Risk for infection

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.

A client undergoes an invasive joint examination of the knee. What will the nurse closely monitor the client for?

Serous drainage - When the client undergoes an invasive knee joint examination, the nurse should inspect the knee area for swelling, bleeding, and serous drainage. An invasive joint examination does not cause lack of sleep or appetite, depression, or shock. The client may be in shock due to the injury itself.

Which laboratory study indicates the rate of bone turnover?

Serum osteocalcin

A group of students are studying for an examination on joints. The students demonstrate understanding of the material when they identify which of the following as an example of a synarthrodial joint?

Skull at the temporal and occipital bones

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 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.

A nurse practitioner assesses a patient's movement in his left hand after a cast is removed. The nurse asks the patient to turn his wrist so the palm of his hand is facing up. This movement is known as:

Supination

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.

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.

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?

The patient has rheumatoid arthritis. - The subcutaneous nodules of rheumatoid arthritis are soft and occur within and along tendons that provide extensor function to the joints. Osteoarthritic nodules are hard and painless and represent bony overgrowth that has resulted from destruction of the cartilaginous surface of bone within the joint capsule. Lupus and neurofibromatosis are not associated with the production of nodules.

A client visits the health care provider for a routine checkup. The history reveals that the client was diagnosed with a spinal curvature. Which region of the spine should the nurse assess for complications?

Thoracic -The nurse should assess the thoracic region of the spine because a progressive curvature of more than 65 degrees in this region may lead to cardiopulmonary failure as well as less serious signs and symptoms, such as fatigue, back pain, decreased height, and cosmetic deformity. Although a curvature may affect any part of the spine, life-threatening complications aren't associated with curvature of the cervical, lumbar, or sacral regions.

Which nerve is assessed when the nurse asks the client to spread all fingers?

Ulnar -Asking the client to spread all fingers allows the nurse to assess motor function affected by ulnar innervation, while pricking the fat pad at the top of the small finger allows assessment of the sensory function affected by the ulnar nerve. The peroneal nerve is assessed by asking the client to dorsiflex the ankle and to extend the toes. 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.

The nurse is teaching a client about a vitamin that supports calcium's absorption. What vitamin is the nurse teaching the client about?

Vitamin D -To support the absorption of calcium from the gastrointestinal tract and increase the amount of calcium in the blood, there needs to be sufficient active vitamin D. Vitamin A is for eye health. Vitamin B12 is for anemia prevention. Vitamin C is used for skin and immune health.

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.

The vertebral joints and symphysis pubis are

amphiarthrosis joints that have limited motion.

Serial x-rays are used to monitor the progress of

bone healing.

A client tells the health care provider about shoulder pain that is present even without any strenuous movement. The health care provider identifies a sac filled with synovial fluid. What condition will the nurse educate the client about?

bursitis -A bursa is a small sac filled with synovial fluid. Bursae reduce friction between areas, such as tendon and bone and tendon and ligament. Inflammation of these sacs is called bursitis. A fracture of the clavicle is a bone break. Osteoarthritis is an inflammatory disease. Ankylosing spondylitis is a form of arthritis affecting the spine.

Lordosis is an excessive

concave curvature of the lumbar spine.

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.

Fracture healing occurs in four areas, including the

external soft tissue. -Fracture healing occurs in four areas, including the bone marrow, bone cortex, periosteum, and the external soft tissue, where a bridging callus (fibrous tissue) stabilizes the fracture. Cartilage is special tissue at the ends of bone. The bursae are fluid-filled sacs found in connective tissue, usually in the area of joints. Fascia is fibrous tissue that covers, supports, and separates muscles.

Callus is fibrous tissue that forms at the

fracture site.

A diarthrosis joint, like the elbow, is

freely movable.

The skull is an example of an

immovable joint.

Fasciculation refers to the

involuntary twitch of muscle fibers.

The vertebra is an

irregular bone.

A client has an exaggerated convex curvature of the thoracic spine. What is this condition called?

kyphosis -Kyphosis is an exaggerated convex curvature of the thoracic spine.

Scoliosis is a

lateral curvature of the spine.

The femur is a

long bone.

Diaphyses are the

long shafts of bones in the arms and legs.

A short bone is a

metacarpal.

Crepitus may occur with

movement of the ends of a broken bone or irregular joint surface.

Clonus refers to

rhythmic contraction of muscle.

A client reports being consistently tired, with no energy. The client's CBC indicates low hemoglobin. Where is hemoglobin manufactured?

ribs -Red bone marrow, found primarily in the sternum, ileum, vertebrae, and ribs, manufactures blood cells and hemoglobin.

An example of a flat bone is the

sternum.

An arthroscopy is used to

visualize joints.