NUR 102 - UNIT 11 & 12 EXAM

To prevent fat embolism

-Cautious movement - Minimal manipulation of the bone fragments - Provide immediate immobilization of that long bone or whatever bone it is.

signs and symptoms of fractures

-Pain* -swelling -tenderness -Deformity -loss of function -Crepitus or grating sound -Spasm (muscles near fracture involuntary contracts) -false motion

Diarthrodial (synovial) joints

-freely movable -joint cavities contain lubricating synovial fluid -include plane (gliding) joints, ball-and-socket joints, and hinge joints

Providing Pin Site Care

-the nurse inspects the pin sites q 8 hrs for reaction -After the first 48 to 72 hours following skeletal pin placement, pin site care should be performed daily or weekly. -Chlorhexidine 2 mg/mL solution, if contraindicated (due to known sensitivity or skin reaction), saline solution should be used for cleansing -Strict handwashing before and after -IV antibiotics

What is a skin traction?

-used short term to relieve muscle spasms and immobilize until surgery -This is when tape or some type of material is stuck to the skin and the weights pull against it. The skin is NOT penetrated

When should client avoid salicylates?

1 week prior to surgery to reduce risk of bleeding.

Opioid withdrawal Stage 11

8-24 hours: sxs are Anxiety, insomnia, diaphoresis, mydriasis, GI disturbances, Rhinorrhea

Cartilage

A connective tissue that is more flexible than bone and that protects the ends of bones and keeps them from rubbing together.

Ligaments

A fibrous tissue that connects bone to bone.

Skeletal muscle

A muscle that is attached to the bones of the skeleton and provides the force that moves the bones. They are voluntary muscles.

The nurse is caring for a 14-year-old boy in Buck traction for a slipped capital femoral epiphysis (SCFE). What information would the nurse include when completing a neurovascular assessment of the affected leg? Select all that apply.

A neurovascular assessment includes assessing for color, movement, sensation, edema, and quality of pulses.

Who should not take NSAIDs?

A patient with hypotension, heart failure, or renal failure.

Tolerance

A progressive decrease in a person's responsiveness to a drug.

What is traction?

A pulling force used to maintain body alignment, maintain fracture alignment, and relieve pain and muscle spasm.

What is a skeletal traction?

A traction applied directly to the bone with pins and wires. Used when prolonged traction is needed. Must monitor pin site and do skin care: Prevent foot drop skin irritation and thrombophlebitis

Physical dependence

A type of addiction in which the body itself feels a direct need for a drug.

Synarthrodial joints

A type of joint in which bones are held together by tough connective tissue, making the joint essentially immovable. Example: at suture line of the skull between the temporal and occipital bones.

What are example of a non-salicylate ?

Acetaminophen

The nurse is caring for a client who has been prescribed a nonopioid analgesic in addition to a narcotic analgesic. What effect will the nurse expect?

Acetaminophen is added to narcotic analgesics for additive effects of pain relief without the addition of narcotic adverse effects.

What is the antidote for Acetaminophen?

Acetylcysteine (Mucomyst)

A client admitted with a history of peptic ulcers and well-controlled diabetes mellitus who was treated for a lower gastrointestinal bleed is preparing for discharge. The nurse recognizes which statement indicates this client needs additional teaching?

Acetylsalicylic acid is contraindicated in a client with a history of gastrointestinal bleeding. This statement indicates the client needs additional teaching.

How should the administration of analgesics be scheduled to provide a uniform level of pain relief to a client?

Administering the analgesics on a regular basis

A client undergoes open reduction with internal fixation to treat an intertrochanteric fracture of the right hip. The nurse should include which intervention in the postoperative care plan?

After open reduction with internal fixation, the client must keep the affected leg abducted at all times; placing a pillow between the legs reminds the client not to cross the legs and to keep the leg abducted.

A child was in a motor vehicle accident and sustained fractures. The lower leg was placed in an external fixation device. What will be the focus when performing care for this child? Select all that apply.

An external fixation device is connected to the leg with pins through the skin into the bones to hold the bones in place while healing. The pins require daily care and assessment. The pins through the skin provide a portal for infection. They must be kept very clean with products according to the hospital facility protocols. As with all fractures, there is a risk for neurovascular compromise. The nurse will instruct the family to assess the extremity for pain, pressure, and paresthesia. The child and family must be educated to avoid activities in which the fixator might be hit or bumped causing further injury to the child. Weights are used for traction, not external fixation devices.

What are the retardants that affect bone formation?

Androgen/estrogen deficiency, diabetes, excess parathyroid hormone, heparin, inactivity and immobility, starvation, steroids, vitamin deficiency

The client states that aspirin is no longer working for the joint pain. To best determine the ineffectiveness of the aspirin therapy, the nurse assesses for the possible co-use of which drug classification?

Antacids decrease the effectiveness of salicylates.

A home health nurse is visiting a client who has been taking the same dose of acetaminophen/hydrocodone for 2 months. To monitor for the presence of expected side effects of this medication, what should the nurse include in the assessment of the client?

Ask about the client's bowel pattern.

What are examples of salicylate?

Aspirin, Diflunisal, magnesium salicylate

How do we provide pin care?

Assess for redness, swelling or drainage ensure pins aren't damage or bend clean with soap and water and apply antibiotic ointment Obtain culture if purulent drainage is present.

A nurse is caring for a 10-year-old who is in skeletal traction following injuries sustained in a car accident. Which statement accurately describes a recommended nursing measure for this type of traction?

At sites with mechanically stable bone-pin interfaces, pin-site care should be done on a daily or weekly basis (after the first 48 to 72 hours)

Formation of new bone

Bleeding, hematoma, fibrin mesh, inflammatory reaction, granulation tissue, callus (healing mass; it can hold the end of the bone together but it cannot endure strain), ossification.

A client has experienced a fracture. Place in the correct order the steps in bone healing that the nurse will explain to the client to prepare her for what to expect.

Blood seeps into the area and a hematoma forms. Osteoblasts form as the clot retracts. A procallus forms and stabilizes the fracture. A callus with bone cells forms. Osteoblasts begin to remodel the fracture site.

Open fracture (compound fracture)

Broken bone has come through the skin

What are bone formation facilitators?

Calcium, calcitonin, estrogen, exercise, growth hormone, insulin, phosphorous, testosterone, vitamin A,C,D

Treatment of foot drop

Casting, arthoplasty to help, open reduction internal fixation (ORIF)

Osteoblasts

Cells that build bones.

Osteocytes

Cells that mature into bone and maintain the bone matrix

The nurse receives report about a newly admitted client diagnosed with fibromyalgia. The report describes the client as withdrawn, refusing visitors, and with labile emotions. Which does the nurse identify as a plausible explanation of the client's behavior? Select all that apply.

Chronic pain can cause intense emotional responses. Anxiety is often associated with anger triggered by chronic pain. (Pain that lasts for an extended period can result in depression, anger, or emotional withdrawal)

A client who has undergone a lower limb amputation is preparing to be discharged home. What outcome is necessary prior to discharge?

Client can demonstrate safe use of assistive devices.

A client diagnosed with impaired renal function has been prescribed morphine. How will the client's underlying condition affect the pharmacokinetics of the drug?

Clients with renal impairment should take minimal doses of morphine for the shortest effective time because usual doses may produce profound sedation and a prolonged duration of action.

A 15-year-old boy with a history of asthma is admitted to the hospital for repair of a compound fracture of the left wrist. The physician prescribes codeine to manage his pain. The client's respiratory status must be monitored closely while taking codeine because of which?

Codeine will decrease the clients cough reflex.

What is motor neuropathy?

Damage to the nerves that control movement. When affected the muscle weaken and atrophy will eventually affect the bone causing AMPUTATION.

A 14-year-old adolescent is suspected of having scoliosis. When doing scoliosis screening, what observation would be important for the nurse to note?

Diagnosis of scoliosis is best made with inspection and observation. When inspecting the back with the child in a standing position, the nurse should note asymmetries such as shoulder elevation, the prominence of one scapula, an uneven curve at the waistline, or a rib hump on one side. A lateral curvature of the spine is best revealed when the child bends forward. The child should bend forward with the arms hanging freely. The curve and asymmetry of the back can be observed.

What is the mechanism of action of naloxone (Narcan), an opioid antagonist?

Displaces opioids by more effectively binding to opioid receptor sites.

What are some questions to ask for pain assessment?

Does the pain keep you awake? Can you describe the pain? Are you taking any OTC drug or herbal supplements? Does anything help you to obtain relief from the pain?

A client asks the nurse why his residual limb cannot be elevated on a pillow. What is the best response by the nurse?

Elevating the residual limb on a pillow may lead to a flexion contracture; this could jeopardize the client's ability to use a prosthesis.

What do we do to treat compartment syndrome?

Fasciotomy (surgical incision of fascia & separation of muscles)

What are some common opioids and side effects?

Fentanyl is sweating, headache, vertigo Hydrocodone is sedation, confusion, lightheadedness Morphine is constipation, hypotension, dry mouth Tramadol is constipation, hypotension, dry mouth ALL cause respiratory depression and N/V

Foot drop

Foot permanently fixed in plantar flexion. weakness of muscles in the feet and ankles that causes difficulty with the ability to flex the ankles and walk normally. Shortening of the peroneal nerve (the nerve in your calf)

Fat embolism

Freely floating fat globules in the bloodstream can obstruct blood circulation to vital organs (e.g., heart, brain). Usually caused by injury to subcutaneous tissue or a bone fracture that allows fat release. Onset is rapid. Sxs usually occur within 48-72 hours. More common in young adults w/ multiple crushing injuries. Can be FATAL.

What do we need to worry about if client states the have used acetaminophen long term?

Hepatoxicity, and/or liver failure

What are some common NSAIDs?

Ibuprofen (Advil, motrin), Naproxen (aleve), Meloxicam, (All may experience nausea, dizziness, GI bleeding, rash) except Celecoxib (celebrex) - doesn't affect stomach lining.

The nurse is caring for a child who has just received a cast for a broken wrist. The parents ask, "Why do we need to keep the arm up on a pillow?" Which response by the nurse is appropriate?

If an extremity has been casted, the client should keep it elevated with a pillow to prevent edema in the fractured area.

What is Buck's traction?

Immobilizes the hip fractures before surgery. A boot or traction tape is applied to the affected extremity and a prescribed weight pulls the limb into traction. The client is typically placed in a supine position with the foot of the bed raised to maintain a COUNTER-TRACTION.

A client who has fallen and injured a hip cannot place weight on the leg and is in significant pain. After radiographs indicate intact but malpositioned bones, what would the physician diagnose?

In joint dislocation, radiographic films show intact yet malpositioned bones.

About which issue should the nurse inform clients who use pain medications on a regular basis?

Inform the primary health care provider about the use of salicylates before any procedure, and avoid over-the-counter analgesics consistently without consulting a physician.

What is salicylates anti-inflammatory action

Inhibits prostaglandins

Arthroscopy

Insertion of fiber optic scope into a joint to visualize it, perform biopsies or remove loose bodies 2. Performed in OR under sterile technique 3. Nursing care: pressure dressing for 24 hours Patient must limit activities for several days.

Diabetic foot care

Inspect your feet daily, Bathe feet in lukewarm, never hot, water; Be gentle when bathing your feet; Moisturize your feet but not between your toes. Cut them straight across and file the edges; Never treat corns or calluses yourself. Consider using an antiperspirant on the soles of your feet.

A client is involved in a motorcycle accident and injures an arm. The health care provider diagnoses the man with an intra-articular fracture and splints the injury. The nurse implements the teaching plan developed for this client. What sequela of intra-articular fractures should the nurse describe regarding this client?

Intra-articular fractures often lead to posttraumatic arthritis.

The nurse applies a transdermal patch of fentanyl for a client with pain due to cancer of the pancreas. The client puts the call light on 1 hour later and tells the nurse that it has not helped. What is the best response by the nurse?

It will take approximately 12 to 18 hours for the medication to begin to work, so I will give you something else now to relieve the pain."

What are two basic measures needed for pain assessment?

Location and intensity

What are some side effects of NSAIDs?

N/V, photosensitivity, rash, stomatitis, acute renal failure, diarrhea, constipation, dry mouth, anxiety, decrease appetite, visual disturbances

What are diagnostics we can run for peripheral neuropathy?

Neuro exam: tuning fork ( diminished vibration sense), sensation test (sharp or dull); evaluate diabetes status; EMG, nerve biopsy, skin biopsy

What two assessment are priority for clients with musculoskeletal disorder?

Neurovascular and pain

What kind of support can we offer our clients with fibromyalgia?

OT, PT, support group, self care, and counseling.

After administering an opioid antagonist, what should the nurse do?

Once response is show, monitor patient vitals every 5-15 minutes until effect of opioid wear off?

A new graduate nurse lists which of the following as uses for opioid antagonists? (Check all that apply.)

Opioid antagonists are used for the treatment of postoperative acute respiratory depression, opioid adverse effects (reversal), and suspected acute opioid overdosage.

The nurse is explaining to a client about the analgesic and its possible adverse effects. The client is receiving an opioid analgesic. What would be important to teach this client is a possible adverse effect of this drug?

Orthostatic hypotension is commonly seen with some narcotics.

Compartment Syndrome S/S

Pain Pallor Paresthesia Paralysis Pulselessness (ominous sign)

Describe signs and symptoms for peripheral neuropathy.

Pain (leading sx), weakness, and numbness from nerve damage, usually in hands and feet. Skeletal muscles are smaller, insensitive to temperature/tactile stimuli, digestive /urinary /or sexual dysfunction

breakthrough pain

Pain that occurs between doses of pain medication

What may parethesias put client at risk for with different types of pain?

Permanent damage, chronic pain, loss of function and sensation.

What is red marrow and where is it found?

Produces blood cells and is found within cavities of spongy bone (sternum,ilium, vertebrae, ribs)

A client who has had an amputation is being cared for by a multidisciplinary rehabilitation team. What is the primary goal of this multidisciplinary team?

Promote the client's highest possible level of function.

A client is scheduled to undergo craniofacial surgery, a procedure that will necessitate the use of propofol. The operating room nurse should be aware that alternative medications will be absolutely necessary in order to produce what effect in the client?

Propofol produces amnesia, euphoria, and hypnosis. It therefore blocks the perception of pain.

Which nursing intervention is essential in caring for a client with compartment syndrome?

Removing all clothing, jewelry, and external forms of pressure (such as dressings or casts) to prevent constriction and additional tissue compromise. The extremity should be maintained at heart level.

A new surgical patient has been prescribed an opioid analgesic intravenously for pain control. The nurse should be aware of which most serious adverse effect of this medication?

Respiratory depression is the most serious adverse effect of opioid analgesic agents administered by IV, subcutaneous, or epidural routes.

The nurse is providing care to a child with a long-leg hip spica cast. What is the priority nursing diagnosis?

Risk for impaired skin integrity due to cast and location

The nurse is reconciling medications for a client who brought their home medications to the primary care clinic. The client states they have not used a single pill from an over-the-counter bottle of magnesium salicylate and states they "should just drink apple-cider vinegar because it smells the same." What is the best response from the nurse?

Salicylates deteriorate more rapidly than other drugs. A vinegar smell indicates they should be properly discarded.

Which adverse reactions may occur as a result of administering an opioid antagonist?

Side effects of opioid antagonists include nausea and vomiting, sweating, increased blood pressure, and tremors.

A client is brought to the emergency department by ambulance after falling. While assessing the client, the nurse notes that their right leg is shorter than the left leg; the right hip is noticeably deformed and they are in acute pain. Imaging does not reveal a fracture. Which of the following is the most plausible explanation for this client's signs and symptoms?

Signs and symptoms of a traumatic dislocation include acute pain, change in positioning of the joint, shortening of the extremity, deformity, and decreased mobility.

What is Russell traction?

Similar to bucks extension, a sling is positioned under the knee, which suspends the distal thigh above the bed. Skin traction is applied to the lower extremity. The pull is in two directions, vertically from the knee sling, and longitudinally from footplate. -Use for fracture of the femur Vertical pull as well as horizontal pull Pressure is on the popliteal area Check for circulation

The nurse is caring for a child in the postanesthesia care unit following a surgical procedure to place pins in the child's fractured femur. This pin placement is an example of which type of traction?

Skeletal.....There are three types of traction: manual, skin, and skeletal. Skeletal traction involves adding pull through the use of pins, wires, screws, or tongs. Skin traction involves directly applying pull to the skin, and manual traction involves direct pulling by the physician or nurse. Counter-traction uses weights, sandbags, or body weight to accomplish pulling..

A child is admitted to the pediatric unit with osteomyelitis. The child is to be placed on antibiotics. The nurse expects antibiotic coverage to include which of the following as the most common cause of osteomyelitis?

Staphylococcus aureus is the most common cause of osteomyelitis; therefore, the nurse would expect the antibiotics to cover that bacteria.

What is lordosis?

Swayback in the lumbar region (Lumbar, Lordosis)

What are some side effects after administering opioid antagonist?

Tachycardia, N/V, sweating, tremors

The nurse reviews a client's medication administration record before giving a new medication. For which medication would the nurse question giving the client a dose of tapentadol?

Tapentadol is an opioid agonist used to relieve moderate to severe neuropathic pain. There is a risk of serotonin syndrome if it is combined with St. John's wort. Tapentadol can be safely taken with metformin and other vitamin supplements such as vitamin D3 and vitamin B complex.

The nurse teaches the client to avoid which when taking aspirin products?

Tea, paprika, licorice, prunes, and curry powder

How do we care for a client in traction?

Temperature Ropes hang freely Alignment Circulation check (5 p's) Type and location of fracture Increase fluid intake Overhead trapeze No weight on bed/floor freely hanging

After administration of an opioid antagonist, the nurse should perform which action?

The client's vital signs should be assessed every five minutes until the client responds to the antagonist, and then every five to 15 minutes once they have responded.

When teaching a group of parents about the skeletal development in children, what information will the nurse provide?

The infant and a young child's bones are more flexible and more porous with a lower mineral count than adults. The structural differences of a young child's bone allow for greater shock absorption thus, bones will often bend rather than break when an injury occurs. Growth plates are growing tissue found near the ends of long bones. The infant's skeleton is not fully ossified at birth. Children's bones have a thick periosteum and an abundant blood supply.

A client with a traumatic amputation of the right lower leg is refusing to look at the leg. Which action by the nurse is most appropriate?

The nurse should encourage the client to look at, and assist with, care of the residual limb. Providing feedback on the client's strengths and resources may allow the client to start to adapt to the body image and lifestyle change. The nurse should also allow time for the client to discuss their feelings related to the amputation.

A client has had surgical repair of a hip injury after joint manipulation was unsuccessful. In addition to the regular postoperative assessments prescribed by policy, what assessment does the nurse complete every 30 minutes for several hours?

The nurse should perform neurovascular assessments every 30 minutes for several hours, and then at least every 2 to 4 hours for the next 1 or 2 days to detect complications.

What is the treatment for fibromyalgia?

The overall goal is to get the client to feel better, decrease pain, and improve sleep. Can be prescribed antidepressants, antiseizure, analgesics, and muscle relaxants. Complementary and alternative medicine. (Cymbalta, Elavil, Flexeril, and Lyrica )

A client with osteoarthritis of the hip for a number of years reports a dull, aching pain with ambulation and pain shooting down the leg at night while sleeping. The nurse recognizes that the client is experiencing which type of pain?

The pain from osteoarthritis is a chronic pain that persists over a period of time due to the degeneration of the hip joint.

How do prostaglandins influence pain?

The sensitize pain receptors.

The nurse is caring for a client who lives with chronic pain. The client states, "I have heard meditation can help me relieve my pain. Is that true?" How should the nurse respond?

This is true. It can help with reducing high blood pressure associated with pain."

What are some side effect of aspirin?

Tinnitus, GI upset, N&V, anorexia, GI bleeding, allergy to salicylates.

Symptoms of a client experiencing salicylism?

Tinnitus, dizziness, mental confusion

A client with back pain is prescribed a transcutaneous electrical nerve stimulation (TENS) unit. Which information will the nurse provide to educate the client about the use of this device?

To treat painful areas, the client will place one electrode from each channel on either side of the painful area. The TENS unit may be applied intermittently throughout the day or worn for extended periods of time, depending on the provider's order. TENS is a noninvasive alternative technique that involves electrical stimulation of large-diameter fibers to inhibit transmission of painful impulses carried over small-diameter fibers.

The nurse is observing a child walk down stairs using a swing-through gait. What action by the child is correct?

To walk downstairs using a swing-through gait, the child places the crutches on the lower step, and then the good foot is placed on the step between the crutches. Both crutches should be moved at the same time. The good foot should not be placed on a lower step than the crutches when going down stairs.

Opioid withdrawal Stage 111

Up to 3 days: Sxs are tachycardia, nausea &vomiting, diarrhea, chills, tremors, hypertension, fever, seizures, muscle spasms

In which case it is most likely that pain management may not be readily forthcoming to an adult client who is in pain?

When the client's expressions of pain are incongruent with the nurse's expectations.

What are the signs and symptoms of fibromyalgia?

Widespread and chronic pain is the most common; fatigue and waking unrefreshed, sleep disturbances, IBS, chronic headache & TMJ, cognitive memory impairment (fibro fog); heightened sensitivity to noise, lights, and touch, depression/anxiety

How do we treat and diagnose a fracture?

X-RAY

What is yellow bone marrow?

Yellow Bone Marrow is Red Bone Marrow that has changed to fat. Found in long bones.

Spiral fracture

a fracture in which the bone has been twisted apart; a common sports injury

Neuropathic pain

abnormal processing of pain message; burning, shooting in nature: often chronic

What is the antidote for aspirin?

activated charcoal

What is autonomic neuropathy?

affects all body systems and lead to hypoglycemic unawareness, bowel incontinence, diarrhea, and urinary retention, erectile dysfunction, cardiovascular dysfunction (orthostatic hypotension), gastroparesis (atony of the stomach, which interrupts peristalsis)

Who should not take aspirin?

anyone under 19- could get reye's syndrome

What is a skeletal traction?

applied directly to the skeletal structure by a pin, wire, or tongs inserted into or through the diameter of the bone distal to the fracture

Osteoclast

are cells involved in the destruction, reabsorption, and remodeling of bones.

Tendons

attach muscle to periosteum of the bone.

Greenstick fracture

bending and incomplete break of a bone; most often seen in children

Simple fracture (closed)

bone is broken but there is no open wound in the skin

Depressed fracture

broken bone portion is pressed inward, typical of skull fracture or facial bone.

What is fibromyalgia?

chronic, widespread musculoskeletal pain, mood disorder, and sleep disturbances. unknown cause and affect women more than men.

Treatment of fracture

closed reduction, open reduction, traction, internal and external fixation, cast application

What do you include in a neurovascular assessment?

color, temperature ( to the touch), edema, sensation, pulse

What is sensory neuropathy?

damage to nerves that mediate sensation that leads to paresthesia's, abnormal sensations, such as tingling, prickling and burning or needlelike pain in the feet, legs and sometimes in the hand

What are some nursing managements for a client with peripheral neuropathy?

diabetic management, foot care, exercise, avoiding alcohol, orthostatic hypotension precaution, TED Hose instruction, diet and fluid intake, and medication compliance.

How do we treat peripheral neuropathy?

diet, exercise, control blood sugar, pain management ( NSAIDS, OPIOIDS, Anti-seizure meds, topical (Voltaren gel), anti-depressants, tens unit, TED HOSE.

Cast care

don't cover until dry, handle with palms of hands, don't rest on hard surfaces, keep above level of heart, check pulses, color , sensation. Complication of cast is numbness, tingling, no pulses, bluish color of the skin

analgesic

drug that relieves pain.

What is kyphosis?

exaggerated thoracic curvature (humpback)

Impacted fracture

fracture in which one bone fragment is pushed into another

Comminuted fracture

fracture in which the bone is splintered or crushed

Treatment of fractures: closed reduction

fragments are aligned with manipulation and casted. Doesn't require surgery.

Treatment of fracture: open reduction

involves surgical exposure of the bone and the use of plates, screws, or pins to realign the fragments

Compartment syndrome

involves the compression of nerves and blood vessels due to swelling within the enclosed space created by the fascia that separates groups of muscles.

Addiction

is a behavioral pattern of substance use characterized by a compulsion to take the substance primarily to experience its psychic effects.

Placebo effect

is analgesia that results from the expectation that a substance will work, not from the actual substance itself.

Pain Tolerance

is the amount of pain a person can endure once the pain threshold has been reached.

Acute pain

last less than 3-6 months for example postoperative pain, procedural pain, and traumatic pain

Chronic pain

last more than 6 months and is often associated with specific diseases, such as cancer, osteoarthritis, RA, headache and sickle cell.

What is scoliosis?

lateral curvature of the spine

nocioceptive pain

normal process, sensing a noxious stimuli, perceiving as pain

Pulmonary embolism (PE)

occlusion in the pulmonary circulation, most often caused by a blood clot. Thromboembolism may occur after a fracture or surgery to repair fractures. These leads to pulmonary emboli in some clients and can be FATAL.

Tolerance

occurs when a client who has been taking opioids becomes less sensitive to their analgesic properties.

Dependence

occurs when a client who has been taking opioids experiences a withdrawal syndrome when the opioids are discontinued.

Which of the following is a physiologic response to pain?

pallor, tachycardia, diaphoresis, and hypertension.

What are two types of cast?

plaster and fiberglass

Pain threshold

point at which a stimulus is perceived as pain

Potential complications of ortho clients

pulmonary embolism fat embolism Osteomyelitis Contractures Compartment syndrome

When should you give pain medications for chronic pain?

round the clock scheduled drugs, not PRN.

intractable pain

severe pain that is extremely resistant to relief measures

What are some side effects of acetaminophen?

side effects are rare, can develop hemolytic anemia, hepatoxicity if used long term.

Amphiarthrodial joints

slightly movable joints. Example between vertebrae

withdrawal symptoms

symptoms that occur after chronic use of a drug is reduced or stopped

An adolescent with scoliosis is refusing to wear the prescribed body brace. Which instruction is best to progress the adolescent to the treatment goals?

t is important to have the adolescent understand the treatment and how the treatment will benefit him or her. Body bracing helps to hold the spine in alignment and prevent further curvature, decreasing the symptoms. The brace will not correct the problem. Adolescents have a hard time being compliant with the brace due to body image disturbance and peer reaction. The brace can also cause discomfort and be hot to wear.

Pain management

techniques for preventing, reducing, or relieving pain

Pain tolerance

the amount of pain a patient can endure without its interfering with normal function

Opioid withdrawal Stage 1

up to 8 hours and sxs are anxiety & drug craving