Musculoskeletal System / Activity Exam 6

What are the risk factors related to Osteoarthritis?

-40 years old and older -Most common in women than men: African American & Hispanic decent is more at risk. -Occupations with heavy labor -Prior injury -OBESITY IS THE MOST PROMINENT MODIFIABLE RISK FOR OSTEOARTHRITIS.

What are the risk factors for osteoporosis?

-Alcohol intake 3 or more drinks daily -Excessive tobacco use -Family history -Inactivity and sedentary lifestyle -Lack of Vitamin D and Calcium intake -Patients on chronic corticoid steroids for longer than 3 months

What are the injuries of the Musculoskeletal System? -Contusion -Strain -Sprain -Dislocation -Subluxation

-Contusion: soft tissue injury produced by blunt force. -Strain: pulled muscle injury to the musculotendinous unit -Sprain: injury to ligaments and supporting muscle fiber around a joint. -Dislocation: articular surfaces of the joint are not in contact -Subluxation: partial or incomplete dislocation

What is the management for Osteoarthritis?

-Diet: foods high in sugar and flour increase inflammatory states in our body. -Weight loss -Exercise

What should we monitor for a patient who has had an amputation?

-POTENTIAL FOR BLEEDING. *make sure additional dressings are at bedside. Phantom pain-pain level is important to monitor.

What is osteoarthritis?

-most common arthritis degenerative joint disease: progressive deterioration and loss of cartilage. more of the "wear and tear" versus rheumatoid arthritis is autoimmune disorder. Result of an injury or occupation.

What are the risk factors for Osteomyelitis?

-older patients -obese -poor immune system -chronic illnesses -autoimmune suppressant agents -post surgical wound infections: tend to occur 30 days after surgery

What are the three techniques for internal fixation?

1. Screws 2. Plates 3. Nails

For total hip surgery, what are the desirable positions?

Abduction and neutral rotation. NOTE: You want to keep their knees apart at all times while turning a patient. You want to place a pillow between their legs when they are sleeping. Never cross their legs when seated, and avoid bending forward while seated because they will be longer than 90 degrees. Might want to get a toilet with a higher seat.

A client is placed in traction for a femur facture. The nurse would document which expected outcomes of traction? Select all that apply. -Realignment of the fracture -Decreased pedal pulse -Reduction of deformity -Minimization of muscle spasms -Increased ability to bear weight -Full range of motion to extremity

Answer: - Realignment of the fracture - Reduction of deformity - Minimization of muscle spasms Rationale: Traction is used to minimize muscle spasms, to reduce, align, and immobilize fractures, and to reduce deformity. Traction does not allow for full range of motion or an increased ability to bear weight. The client is confined to the bed while in traction. A decreased pulse is a sign of circulatory compromise and should be investigated and reported.

The nurse provides teaching to a client with osteoarthritis (OA). Which statement(s) indicate that teaching about pain management and functional ability were effective? Select all that apply. -"I will spend more time resting." -"I will need to lose some weight." -"I will avoid using a cane to walk." -"I will take the pain medication after exercising." -"I will increase the amount of walking I do every day."

Answer: -"I will need to lose some weight." -"I will increase the amount of walking I do every day." Rationale: Pain management and optimal functional ability are the major goals of nursing interventions. With those goals in mind, nursing management of the client with OA includes pharmacologic and nonpharmacologic approaches as well as education. Weight loss is an important approach to lessen pain and disability caused by OA. Exercises such as walking should be begin in moderation and gradually increase. A sedentary lifestyle contributes to the development of OA so resting would not be encouraged. Canes or other assistive devices for ambulation should be considered, and any stigma about the use of these devices should be explored. Clients should plan daily exercise for a time when the pain is least severe or plan to use an analgesic agent before exercising.

During a routine physical examination on an older female client, a nurse notes that the client is 5 feet, 3/8 inches (1.6 m) tall. The client states, "How is that possible? I was always 5 feet and 1/2? (1.7 m) tall." Which statement is the best response by the nurse? -"After age 40, height may show a gradual decrease as a result of spinal compression" -"After menopause, the body's bone density declines, resulting in a gradual loss of height." -"There may be some slight discrepancy between the measuring tools used." -"The posture begins to stoop after middle age."

Answer: "After menopause, the body's bone density declines, resulting in a gradual loss of height." Rationale: The nurse should tell the client that after menopause, the loss of estrogen leads to a loss in bone density, resulting in a loss of height. This client's history doesn't indicate spinal compression. Telling the client that measuring tools used to obtain the client's height may have a discrepancy or that the posture begins to stoop after middle age doesn't address the client's question.

The nurse is providing instructions to the client who is being prepared for skeletal traction. Which statement by the client indicates teaching was effective? -"Metal pins will go through my skin to the bone." -"I will wear a boot with weights attached." -"A belt will go around my pelvis and weights will be attached." -"The traction can be removed once a day so I can shower."

Answer: "Metal pins will go through my skin to the bone" Rationale: In skeletal traction, metal rods or pins are used to apply continuous traction directly to the bone. Weights are used to apply the traction. Casts, external fixators, or splints are used when the traction is discontinued.

A nurse is planning discharge instructions for the client with osteomyelitis. What instructions should the nurse include in the discharge teaching? -"Use your continuous passive motion machine for 2 hours each day." -"You need to perform weight-bearing exercises twice a week." -"You need to limit the amount of protein and calcium in your diet." -"You will receive IV antibiotics for 3 to 6 weeks."

Answer: "You will receive IV antibiotics for 3 to 6 weeks" Rationale: Treatment of osteomyelitis requires IV antibiotics for 3 to 6 weeks. Continuous passive range of motion is used for clients with osteoarthritis. Weight-bearing exercises are used with clients who have osteoporosis. Limiting protein and calcium is not part of the plan of care for clients with osteomyelitis.

Health education for a woman over age 50 includes providing information about the importance of adequate amounts of calcium and vitamin D to prevent osteoporosis. Select the daily dosage of calcium and vitamin D that the nurse should recommend. -1,800 mg; 1,600 IU -1,600 mg; 1,400 IU -1,400 mg; 1,200 IU -1,200 mg; 1,000 IU

Answer: 1,200 mg; 1,000 IU Rationale: The daily recommended dosage is 1,200 mg of calcium and 1,000 IU of vitamin D.

A client is admitted with acute osteomyelitis that developed after an open fracture of the right femur. When planning this client's care, the nurse should anticipate which measure? -Administering large doses of oral antibiotics as ordered -Instructing the client to ambulate twice daily -Withholding all oral intake -Administering large doses of I.V. antibiotics as ordered

Answer: Administering large doses of I.V. antibiotics as ordered. Rationale: Treatment of acute osteomyelitis includes large doses of I.V. antibiotics (after blood cultures identify the infecting organism). Surgical drainage may be indicated, and the affected bone is immobilized. The client usually requires I.V. fluids to maintain hydration, but oral intake isn't necessarily prohibited.

A client's cast is removed. The client is worried because the skin appears mottled and is covered with a yellowish crust. What advice should the nurse give the client to address the skin problem? -Consult a skin specialist. -Scrub the area vigorously to remove the crust. -Apply lotions and take warm baths or soaks. -Avoid exposure to direct sunlight.

Answer: Apply lotions and take warm baths or soaks. Rationale: The client should be advised to apply lotions and take warm baths or soaks. This will help in softening the skin and removing debris. The client usually sheds this residue in a few days so the client need not consult a skin specialist. It is not advisable to scrub the area vigorously. The client need not avoid exposure to direct sunlight because the area is not photosensitive.

A nurse is caring for an elderly female client with osteoporosis. When teaching the client, the nurse should include information about which major complication? -Bone fracture -Loss of estrogen -Negative calcium balance -Dowager's hump

Answer: Bone fracture Rationale: Bone fracture is a major complication of osteoporosis; it results when loss of calcium and phosphate increases the fragility of bones. Estrogen deficiencies result from menopause — not osteoporosis. Calcium and vitamin D supplements may be used to support normal bone metabolism, but a negative calcium balance isn't a complication of osteoporosis. Dowager's hump results from bone fractures. It develops when repeated vertebral fractures increase spinal curvature.

What food can the nurse suggest to the client at risk for osteoporosis? -Carrots -Broccoli -Chicken -Bananas

Answer: Broccoli Rationale: Calcium is important for the prevention of osteoporosis. Broccoli is high in calcium.

Which of the following inhibits bone resorption and promotes bone formation? -Calcitonin -Estrogen -Parathyroid hormone -Corticosteroids

Answer: Calcitonin Rationale: Calcitonin, which inhibits bone resorption and promotes bone formation, is decreased in osteoporosis. Estrogen, which inhibits bone breakdown, decreases with aging. On the other hand, parathyroid hormone (PTH) increases with aging, increasing bone turnover and resorption. The consequence of these changes is net loss of bone mass over time. Corticosteroids place patients as risk for developing osteoporosis.

The nurse is assigned to care for a client who has had an open reduction and internal fixation of a fractured right femur 2 days ago. The nurse is listening to the client's lungs and, when moving the gown, observes petechial hemorrhages on the skin of the chest. What is the first action by the nurse? -Call the physician to inform them of the findings. -Administer pain medication. -Request an antihistamine for the allergic reaction. -Increase the intravenous fluids for hemorrhage.

Answer: Call the physician to inform them of the findings. Rationale: The findings of the nurse indicate that the client may have a fat embolus, and the physician should be informed immediately. Administration of pain medication is not indicated at this time. The rash is not indicative of an allergic reaction. There is no indication that the rash is related to hemorrhage, and there is no need to increase the IV fluids.

While the nurse is performing a physical assessment, the client reports numbness, tingling, and pain when the nurse percusses lightly over the median nerve. What should this assessment indicate to the nurse? -Morton's neuroma -Dupuytren's contracture -Carpal tunnel syndrome -Impingement syndrome

Answer: Carpal tunnel syndrome Rationale: Tinel's sign (numbness, tingling, and pain in response to light percussion over the median nerve) is a positive finding for carpal tunnel syndrome. Morton's neuroma is assessed as a painful condition that affects the ball of the foot. Dupuytren's contracture is when knots of tissue beneath the skin cause one or more fingers stay bent toward the palm. Impingement syndrome is a shoulder condition.

An x-ray demonstrates a fracture in which a bone has splintered into several pieces. Which type of fracture is this? -Compound -Depressed -Impacted -Comminuted

Answer: Comminuted Rationale: A comminuted fracture may require open reduction and internal fixation. A compound fracture is one in which damage also involves the skin or mucous membranes. A depressed fracture is one in which fragments are driven inward. An impacted fracture is one in which a bone fragment is driven into another bone fragment.

A client sustains a fractured right humerus in an automobile accident. The arm is edematous, the client states not being able to move or feel the fingers, and the nurse does not feel a pulse. What condition should the nurse be concerned about that requires emergency measures? -Compartment syndrome -Dislocation -Muscle spasms -Subluxation

Answer: Compartment syndrome Rationale: Separation of adjacent bones from their articulating joint interferes with normal use and produces a distorted appearance. The injury may disrupt local blood supply to structures such as the joint cartilage, causing degeneration, chronic pain, and restricted movement. Compartment syndrome is a condition in which a structure such as a tendon or nerve is constricted in a confined space. The fractured humerus may also be dislocated but is not the result of the impaired circulatory status. Muscle spasms may occur around the fracture site but are not the cause of circulatory impairment. Subluxation is a partial dislocation.

A client is admitted to the emergency room after being hit by a car while riding a bicycle. The client sustained a fracture of the left femur, and the bone is protruding through the skin. What type of fracture does the nurse recognize requires emergency intervention? -Compound -Greenstick -Oblique -Spiral

Answer: Compound Rationale: A compound fracture is a fracture in which damage also involves the skin or mucous membranes with the risk of infection great. A greenstick fracture is where one side of the bone is broken and the other side is bent; it does not protrude through the skin. An oblique fracture occurs at an angle across the bone but does not protrude through the skin. A spiral fracture twists around the shaft of the bone but does not protrude through the skin.

A client comes to the emergency department complaining of pain in the right leg. When obtaining the history, the nurse learns that the client has a history of obesity and hypertension. Based on this information the nurse anticipates the client having which musculoskeletal disorder? -Degenerative joint disease -Muscular dystrophy -Scoliosis -Paget's disease

Answer: Degenerative joint disease Rationale: Obesity predisposes the client to degenerative joint disease. Obesity isn't a predisposing factor for muscular dystrophy, scoliosis, or Paget's disease.

A nurse is planning the care of a client with osteomyelitis that resulted from a diabetic foot ulcer. The client requires a transmetatarsal amputation. When planning the client's postoperative care, which of the following nursing diagnoses should the nurse most likely include in the plan of care? -Ineffective Thermoregulation -Risk-Prone Health Behavior -Disturbed Body Image -Deficient Diversion Activity

Answer: Disturbed Body Image Rationale: Amputations present a serious threat to any client's body image. None of the other listed diagnoses is specifically associated with amputation.

A nurse is caring for a client with a cast on the left arm after sustaining a fracture. Which assessment finding is most significant for this client? -Fingers on the left hand are swollen and cool -Presence of a normal popliteal pulse -Cast edges are rough, with skin irritation present -Minimal pain in the left arm

Answer: Fingers on the left hand are swollen and cool Rationale: Swollen and cool fingers on the left hand are the most significant assessment findings. They represent altered circulation to the hand caused by the cast. A normal radial, not popliteal, pulse should be present in the left arm; the popliteal pulse is found on the leg. Skin irritation is an abnormal assessment finding but it isn't as significant as altered circulation. Minimal pain in the left arm is expected.

The client with a fractured femur is upset and agitated that skeletal traction will be necessary for 6 to 8 weeks. The client states, "How can I stay like this for weeks? I can't even move!" Based on these statements, the nurse would identify which of the following as the most appropriate nursing diagnosis? -Ineffective Coping related to prolonged immobility -Impaired Physical Mobility related to traction -Deficient Diversional Activity related to prolonged hospitalization -Activity Intolerance related to impaired mobility

Answer: Ineffective Coping related to prolonged immobility Rationale: The client is displaying clinical manifestations of anxiety and ineffective coping.

A client experienced an open fracture to the left femur during a horse-riding accident. For which complication is this client at highest risk? -Infection -Malunion -Complex regional pain syndrome -Depression

Answer: Infection Rationale: This client is at the highest risk for infection because of the open fracture that was obtained while horseback riding. Infection that enters the body and affects the bone can lead to osteomyelitis. The treatment may involve long-term antibiotics and may even result in death. The client is still at risk for malunion, but this risk is slight because the bone can be visualized (either through the wound or surgical intervention) and returned to anatomical position. The other options are possible consequences of this type of injury but do not represent the most serious complication.

Which nursing diagnosis takes highest priority for a client with a compound fracture? - Imbalanced nutrition: Less than body requirements related to immobility -Impaired physical mobility related to trauma -Infection related to effects of trauma -Activity intolerance related to weight-bearing limitations

Answer: Infection related to effects of trauma Rationale: A compound fracture involves an opening in the skin at the fracture site. Because the skin is the body's first line of defense against infection, any skin opening places the client at risk for infection. Imbalanced nutrition: Less than body requirements is rarely associated with fractures. Although Impaired physical mobility and Activity intolerance may be associated with any fracture, these nursing diagnoses don't take precedence because they aren't as life-threatening as infection.

A client is seen in the orthopedic clinic for complaints of severe pain in the left hip. After a series of diagnostic tests, the client is diagnosed with severe degenerative joint disease of the left hip and suggested to have the hip reconstructed. What procedure will the nurse schedule the client for? -Left hip arthroplasty -Left hip arthroscopy -Open reduction and internal fixation of the left hip. -Closed reduction of the left hip.

Answer: Left hip arthroplasty Rationale: Clients with arthritis, trauma, hip fracture, or a congenital deformity may have an arthroplasty, or reconstruction of the joint. This procedure uses an artificial joint that restores previously lost function and relieves pain. An arthroscopy is not used to reconstruct a diseased hip. A closed reduction is not an invasive surgical procedure and would not be used to reconstruct the hip. An open reduction and internal fixation is not the treatment for reconstruction of the hip related to a diseased hip.

A nurse is caring for a client who recently underwent a total hip replacement. What is the best action by the nurse for client care? -Ease the client onto a low toilet seat. -Allow the client's legs to be crossed at the knees when out of bed. -Use soft chairs when the client is sitting out of bed. -Limit hip flexion of the client's hip when the client sits up.

Answer: Limit hip flexion of the clients hip when the client sits up. Rationale: The nurse should instruct the client to limit hip flexion to 90 degrees when sitting. The nurse should supply an elevated toilet seat so that the client can sit without having to flex the hip more than 90 degrees. The nurse should instruct the client not to cross legs to avoid dislodging or dislocating the prosthesis. The nurse should caution the client against sitting in chairs that are too low or too soft; these chairs increase flexion, which is undesirable.

A client with a fractured femur is in balanced suspension traction. The client needs to be repositioned toward the head of the bed. During repositioning, what should the nurse do? -Place slight additional tension on the traction cords. -Release the weights and replace them immediately after positioning. -Reposition the bed instead of repositioning the client. -Maintain consistent traction tension while repositioning.

Answer: Maintain consistent traction while repositioning Rationale: Traction is used to reduce the fracture and must be maintained at all times, including during repositioning. It would be inappropriate to add tension or release the weights. Moving the bed instead of the client is not feasible.

A client has undergone an external fixation. Which actions would be the priority for this client? -Maintaining pin care. -Planning the client's diet. -Monitoring the client's urine output. -Monitoring the client's blood pressure.

Answer: Maintaining pin care. Rationale: Pin care is a priority for a client with external fixation, because pin sites are entry points for infection. The nurse should also monitor redness, drainage, and tenderness at the site. Planning the client's diet and monitoring the client's urine output and blood pressure, although necessary, are not as important as maintaining pin care

When caring for a client with a fracture, what assessment would take priority? -Neurovascular compromise -Hormonal imbalances -Cardiac problems -Altered kidney function

Answer: Neurovascular compromise Rationale: When caring for a client with a fracture, the nurse assesses for the neurovascular compromise. A fracture or a treatment for fracture is not known to lead to hormonal imbalances, cardiac problems, or an altered kidney function.

The nurse is caring for a client with an external fixator that requires pin care twice a day. The nurse observes that there is a new purulent drainage around one of the pins. What intervention should the nurse anticipate doing? -Scrubbing the drainage from around the pin site -Obtaining a culture -Applying iodine-based solution -Apply ointment to the pin site.

Answer: Obtaining a culture Rationale: A culture should be obtained if purulent drainage is present. Drainage should be gently removed, not scrubbed. Iodine-based products interfere with tissue healing and are not recommended for cleaning pin sites. Ointment should not be applied to the pin site unless specifically ordered.

Which orthopedic surgery is done to correct and align a fracture after surgical dissection and exposure of the fracture? -Arthrodesis -Joint arthroplasty -Total joint arthroplasty -Open reduction

Answer: Open reduction Rationale: An open reduction is the correction and alignment of the fracture after surgical dissection and exposure of the fracture. Arthrodesis is immobilizing fusion of a joint. A joint arthroplasty or replacement is the replacement of joint surfaces with metal or synthetic materials. A total joint arthroplasty is the replacement of both the articular surfaces within a joint with metal or synthetic materials.

Localized rapid bone turnover, most commonly affecting the skull, femur, tibia, pelvic bones, and vertebrae, is characterized by which bone disorder? -Osteomalacia -Ganglion -Osteomyelitis -Paget disease

Answer: Paget's Disease Paget disease results in bone that is highly vascularized and structurally weak, predisposing the client to pathologic fractures. Osteomalacia is a metabolic bone disease characterized by inadequate mineralization of bone. A ganglion is a collection of neurological gelatinous material. Osteomyelitis is an infection of bone that comes from the extension of a soft-tissue infection, direct bone contamination, or hematogenous spread.

A nurse is caring for a client following foot surgery. Which nursing intervention is most important for the nurse to include in the nursing care plan? -Examine the surgical dressing every hour. -Administer pain medication per client request. -Monitor vital signs every 4 hours. -Perform neuromuscular assessment every hour.

Answer: Perform neuromuscular assessment every hour. Rationale: The priority nursing intervention is to perform a neuromuscular assessment every hour. Early detection of neurological and perfusion problems is important to prevent complications from the surgery. The surgical dressing does not need to be examined hourly. Administering pain medication is important, but assessing the foot color and temperature are most important. Vital sign monitoring is important, but not a priority after foot surgery.

The nurse is caring for a patient who had a total hip replacement. What lethal postoperative complication should the nurse closely monitor for? -Atelectasis -Hypovolemia -Pulmonary embolism -Urinary tract infection

Answer: Pulmonary embolism Rationale: Patients having orthopedic surgery are particularly at risk for venous thromboembolism, including deep vein thrombosis and pulmonary embolism.

A client sustains an injury to the ligaments surrounding a joint. What will the nurse identify this injury as? -Strain -Contusion -Sprain -Fracture

Answer: Sprain Rationale: A sprain is an injury to the ligaments surrounding a joint. A strain is an injury to a muscle when it is stretched or pulled beyond its capacity. A contusion is a soft tissue injury resulting from a blow or blunt trauma. A fracture is a break in the continuity of a bone.

In chronic osteomyelitis, antibiotics are adjunctive therapy in which situation? -Wound packing -Wound irrigation -Vitamin supplements -Surgical debridement

Answer: Surgical debridement Rationale: In chronic osteomyelitis, antibiotics are adjunctive therapy to surgical debridement.

Which is not a guideline for avoiding hip dislocation after replacement surgery. -The hip may be flexed to put on clothing such as pants, stockings, socks, or shoes. -Keep the knees apart at all times. -Put a pillow between the legs when sleeping. -Never cross the legs when seated.

Answer: The hip may be flexed to put on clothing such as pants, stockings, socks, or shoes. Rationale: Guidelines for avoiding hip dislocation after replacement surgery specify that the hip should not be flexed to put on clothing such as pants, stockings, socks, or shoes. Clients should keep the knees apart at all times, put a pillow between the legs when sleeping, and never cross the legs when seated.

The nurse is preparing a client to have his cast cut off after having it for 6 weeks to treat a fractured tibia. What should the nurse inform the client prior to the cast being removed? -The leg will look as it did prior to the cast being applied. -The leg will look moist and will have small bumps that will go away in a few days. -The skin may be covered with a yellowish crust that will shed in a few days. -The leg strength is enforced by the wearing of the cast.

Answer: The skin may be covered with yellowish crust that will shed in a few days. Rationale: Once the cast is off, the skin appears mottled and may be covered with a yellowish crust composed of accumulated body oil and dead skin. The client usually sheds this residue in a few days. The leg will not look as it did prior to the cast but will regain the same shape and status as the other leg. There should be no bumps underneath the cast. The leg may be weak and stiff for some time after the cast is removed, not stronger.

A client has severe osteoarthritis in the left hip and is having surgery to replace both articular surfaces of the hip. What type of surgical procedure will the nurse prepare the client for? -Arthrodesis -Hemiarthroplasty -Total arthroplasty -Osteotomy

Answer: Total arthroplasty Rationale: A total arthroplasty is a replacement of both articular surfaces within one joint. An arthrodesis is a fusion of a joint for stabilization and pain relief and is usually done on a wrist or knee. A hemiarthroplasty is the replacement of one of the articular surfaces in a joint, such as the femoral head but not the acetabulum. An osteotomy is the cutting and removal of a wedge of bone to change the bone's alignment, thereby improving function and relieving pain.

A client with a musculoskeletal injury is instructed to alter the diet. The objective of altering the diet is to facilitate the absorption of calcium from food and supplements. Considering the food intake objective, which food item should the nurse encourage the client to include in the diet? -Red meat -Bananas -Vitamin D-fortified milk -Green vegetables

Answer: Vitamin D-fortified milk Rationale: The nurse should advise the client to include dietary sources of vitamin D, such as fatty fish, vitamin D-fortified milk, and cereals. These foods protect against bone loss and decrease the risk of fracture by facilitating the absorption of calcium from food and supplements. Red meat, bananas, and green vegetables do not facilitate calcium absorption from food and supplements.

The nurse teaches the client with a high risk for osteoporosis about risk-lowering strategies, including which action? -Increase fiber in the diet -Walk or perform weight-bearing exercises outdoors -Reduce stress -Decrease the intake of vitamin A and D

Answer: Walk or perform weight-bearing exercises outdoors Rationale: Risk-lowering strategies for osteoporosis include walking or exercising outdoors, performing a regular weight-bearing exercise regimen, increasing dietary calcium and vitamin D intake, smoking cessation, and consuming alcohol and caffeine in moderation.

A client has been diagnosed with a muscle strain. What does the physician mean by the term "strain"? -stretched or pulled beyond its capacity -injury resulting from a blow or blunt trauma -injuries to ligaments surrounding a joint -subluxation of a joint

Answer: stretched or pulled beyond capacity Rationale: A strain is an injury to a muscle when it is stretched or pulled beyond its capacity.

What is the BMAT tool?

Basic Mobility Assessment Tool To assess what equipment is needed for the patient. Do they have the extremity strength to stand, pivot, or ambulate?

What is Osteoporosis?

Decreasing bone production and loss of bone. Bones become porous, brittle, fragile, and easy to break under stress. Fraction of the spine, neck, and femur.

When should you inspect an external fixation device? (Screws on outside of body)

Every 8 hours ** strict hand hygiene. Chlorhexidine solution.

How would you find the diagnosis for Osteomyelitis?

IV dye bone scan -treatment: IV antibiotics

What should you monitor if a patient is in skeletal traction?

Monitor pin site for care. Assess patient at least 4 hours but can go to 8.

What is isokinetic movement? Examples?

Muscle contraction with resistance Examples: physical therapy, rehabilitation exercises, weight lifting.

What should you never do to a patient who has had an amputation and is healing?

NEVER put the amputated extremity on a pillow because it could result in flexion contraction of the hip.

Can the weights be removed or obstructed when a patient is in traction?

No. It needs to be continuous and the weights are not removed or obstructed in any way.

What are the 5 P's for clinical assessment regarding a patient with a brace, splint, or cast?

Pallor Pain: the earliest signs Pulse Paralysis Parenthesia: numbness and tingling to the area

What group of people are more likely to suffer from Osteoporosis?

Post menopausal women due to loss of estrogen. Loss of height associated with Osteoporosis and aging.

What are the 2 types of osteoarthritis?

Primary: No clear reason for the joint disease (no prior event or related to osteoarthritis) Secondary: Some kind of previous joint injury or form of inflammatory disease.

What happens when a patient is in traction?

Traction is used as a pulling force to promote and maintain alignment of the injured body parent. -Decrease pain, muscle spasm, and realign bone fractures.

What is osteomyelitis?

a severe infection of bone and surrounding soft tissue.

What is a open or compound fracture?

bone protrudes to the outside of the body Grade 1: 1cm long clean wound Grade 2: larger wound without extensive damage Grade 3: highly contaminated, extensive soft tissue injury, may have amputation

What is a intra-articular fracture?

extends into the joint surface of a bone

What is crepitus?

grating sound created by the rubbing of bone fragments

What is Disuse Syndrome for a patient with a brace, splint, or cast?

muscle atrophy and loss of strength Treatment: Isometric exercises, muscle setting exercises

What is isometric movement? Examples?

muscle contraction without shortening. It helps to increase muscle mass, tone, strength, and balance. Examples: Yoga: holding a pose for a time period.

What is isotonic movement? Examples?

muscle shortening and active movement. It helps to increase muscle mass, tone, strength, etc. Examples: -carrying out ADLS -walking -jogging -bicycling -patient being able to perform active ROM activities

What is a closed/simple fracture?

no break in skin

Why is amputation needed?

performed to control pain or disease process, improve function, and improve quality of life.