periop/musculoskeletal

The patient asks the nurse how long the local infiltration anesthetic will last. What is the nurse's best response?

"The anesthetic may last for 3 hours."

A patient undergoes induction for general anesthesia at 8:30 a.m. and is being assessed continuously for the development of malignant hyperthermia. At which time would the patient be most likely to exhibit manifestations of this condition?

8:40 to 8:50 a.m.

morton neuroma

Benign mass of plantar digital nerves of the foot.

ligaments

Connect bone to bone

What medication should the nurse prepare to administer in the event the client has malignant hyperthermia?

Dantrolene sodium

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

Decreased serum calcium level

circulating nurse

Nurse who assists the surgeon and scrub nurse by providing needed materials during the procedure and by handling the surgical specimen. This person does not wear sterile clothing and may enter and leave the operating room during the procedure.

what are the 5 Ps

Pain Pulse Pallor Paresthesia Paralysis

what disease is commonly associated with a shuffling gait?

Parkinson's

During the preoperative assessment, the nurse learns that the client has been taking prednisone. The nurse realizes that the client is at risk for:

cardiovascular collapse

osteoclasts

change bone (destroy/break down)

The client is experiencing intractable hiccups following surgery. What would the nurse expect the surgeon to order?

chlorpromazine

A client reports to the emergency department after experiencing pain in the left arm. The client reports having extended both arms in an attempt to prevent a fall. Which fracture type does the nurse anticipate?

colles fracture

Dupuytren's contracture

Thickening and shrinking of the fascia of the palm with fingers being drawn into a flexed position

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

hammer toe

a toe that is curled due to a bend in the middle joint of the toe

fat embolism triad

altered LOC hypoxemia/resp distress Petechial rash

osteoblasts

build bone

hallux valgus

bunion (big toe)

A client has low back pain and the healthcare provider needs to rule out the presence of a tumor. Which diagnostic procedure would the nurse anticipate to be ordered for the client?

Bone scan

osteomalacia

disease marked by softening of the bone caused by calcium and vitamin D deficiency (mineral deficit)

epiphysis

end of bone

stage 2 anesthesia

excitement

where is red bone marrow found?

flat bones and epiphysis of long bones (sternum, ribs, vertebrae, ilium)

pes planus

flat foot

isotonic

flexion/extension/ROM

diarthrosis

freely movable joint

plaster cast

hard white substance to protect a broken bone

bone healing stages

hematoma fibrous cartilage formation bony callus bone remodeling

kyphosis

hunchback

fx management

immobilize assess 5 Ps cover open fx w sterile dressing

Synarthrosis

immovable joint

osteomyelitis

infection of bone and bone marrow, causing inflammation commonly caused by staph

sprain

injury to a ligament 1,2,3 degree

plantar fascitis

intense heel pain/ knife like

tendons

muscle to bone

A significant mortality rate exists for patients with alcoholism who experience delirium tremens postoperatively. When caring for the patient with alcoholism, the nurse should assess for symptoms of alcoholic withdrawal:

on the second or third day

secondary malignant bone tumor

originating in other tissue and metastasizing to the bone palliative

primary malignant bone tumor

originating in the bone

hip fx manifestations

pain, short leg, external rotation, adduction

osteoid osteoma

painful/benign

strain

pulled muscle

scrub role

registered nurse, licensed practical nurse, or surgical technologist who scrubs and dons sterile surgical attire, prepares instruments and supplies, and hands instruments to the surgeon during the procedure

RICE

rest, ice, compression, elevation

diaphysis

shaft of a long bone

Amphiarthrosis

slightly movable joint

contusion

soft tissue injury produced by blunt force (can cause ecchymosis/hematoma)

isometric

squeezing muscles (like kegals)

external fixation

the fixation of a fractured bone from the outside

The nurse is aware that which of the following helps to stimulate T-cell response:

arginine

bone cysts

benign, neoplastic bone lesions filled with clear fluid that most often occur near the knee joint in children and adolescents

A client is informed of having a benign bone tumor but that this type of tumor that may become malignant. The nurse knows that this is characteristic of which type of tumor?

Osteoclastoma

A list of commonly used medications for a particular surgical procedure is provided to the nurse. The anesthesiologist announces the administration of a nondepolarizing muscle relaxant. Which medication should the nurse document as having been administered?

Pancuronium

Swan neck deformity

RA

loose bodies

Small pieces of bone or cartilage within a joint space

A nurse is assessing the postoperative client on the second postoperative day. What assessment finding requires the nurse to immediately notify the health care provider?

The client has an absence of bowel sounds.

internal fixation

fracture treatment in which pins or a plate are placed directly into the bone to hold the broken pieces in place

bursitis

inflammation of a bursa

compartment syndrome

injury caused when tissues such as blood vessels and nerves are constricted within a space as from swelling or from a tight dressing or cast

scoliosis

lateral curvature of the spine

osteocytes

mature bone cells

carpal tunnel

median nerve compression

paget disease

more common in men skeletal deformities

A patient has a long leg cast applied. Where does the nurse understand a common pressure problem may occur?

peroneal nerve

The physician schedules an elective surgical procedure for a patient who smokes cigarettes. When should the nurse recommend that the patient cease smoking before the surgical procedure to minimize risks associate with cigarette smoking?

1 to 2 months

While riding a bicycle on a narrow road, the patient was hit from behind and thrown into a ditch, sustaining a pelvic fracture. What complications does the nurse know to monitor for that are common to pelvic fractures?

Hemorrhage and shock

A client has an elbow injury that involves the cartilage in that joint. The nurse understands that which type of cartilage has been affected?

Hyaline cartilage

The function of skeletal muscle is promoting:

movement of skeletal bones

Fiberglass cast

Stronger than plaster, achieves weight-bearing, strength faster than plaster, waterproof (but must get dried after getting wet), durable, and lightweight. Disadvantage: $$$$

osteoporosis

-most prevalent bone disease in the world -bone becomes more porous, brittle, and fragile -crush fractures common -slender, female, white, alcohol users, smokers, steroid users @ high risk

stage 1 anesthesia

"beginning anesthesia" warmth, dizziness, feeling of detachment, ringing, roaring, buzzing in ears, inability to move extremities, noises are exaggerated

stage 4 anesthesia

"medullary depression" reached if too much anesthesia. Respirations become shallow, pulse is weak and thready, pupils widely dilated no longer contract, cyanosis develops, death can occur rapidly

stage 3 anesthesia

"surgical anesthesia" unconscious and lies quietly, pupils are small but contract, respirations are regular, pulse rate normal, skin is pink

When describing malignant bone tumors to a group of students, which of the following would the instructor cite as the usual location?

Distal femur around the knee

compartment syndrome manifestations

Deep throbbing unrelated pain-continous to increase even with treatment Hallmark sign-pain occurs or worsens during passive ROM -Decrease in blood flow to surrounding area OVER 30mmHG is CONCERNING

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

Increased diameter of the calf

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

Obtain a blood specimen.

Which laboratory study indicates the rate of bone turnover?

Serum osteocalcin

A nurse is caring for a client who is scheduled to have a thoracotomy. When planning care for this client, what mobility teaching will the nurse include in the plan of care?

Shoulder and upper arm range-of-motion exercises

ganglion cyst

a harmless fluid-filled swelling that occurs most commonly on the outer surface of the wrist

traction

a pulling force exerted on a limb in a distal direction in an effort to return the bone or joint to normal alignment

osteoclastomas

a tumor that is usually benign and characterized by osteolytic areas, most commonly found around the knee and wrist of young adults and composed of numerous, multinucleated osteoclasts; also called giant cell tumor

lordosis

abnormal increase in the forward curvature of the lumbar spine (pregnancy, athletes, beer belly)

RNFA

actively assists the surgeon by providing exposure of the operative area, hemostasis (blood clotting), and wound closure

A client is preparing for a surgical procedure is taking corticosteroids for Crohn's disease. What is most important for the nurse to monitor during the operative experience with the client?

adrenal insufficiency

callus

area of thick hard skin

cortical bone

dense, solid bone that covers the outer surface of all bones and is the main form of bone tissue in the long bones

tendonitis

inflammation of a tendon

impingement syndrome

inflammation of tendons that get caught in the narrow space between the bones within the shoulder joint

osteoarthritis (degenerative joint disease)

inflammation of the bone and joint non systemic/inflammatory osteophytes (bone spurs) primary: no prior event secondary: resulting from injury

septic arthiritis

inflammation of the joint caused by infection

What is the lithotomy position used for?

perineal surgery