PrepU Ch 36: Management of Patients with Musculoskeletal Disorders

The nurse has educated a patient with low back pain about techniques to relieve the back pain and prevent further complications. What statement by the patient shows understanding of the education the nurse provided?

"I will avoid prolonged sitting or walking."

A nurse is planning discharge instructions for the client with osteomyelitis. What instructions should the nurse include in the discharge teaching?

"You will receive IV antibiotics for 3 to 6 weeks."

The community health nurse is assessing the risk factors for osteoporosis in a female client at a health fair. Risk Factors FOR Osteoporosis Include:

-66 years of age -Asian Heritage -Postmenopausal Status -Takes Fluticasone Inhaler

A patient shows the nurse a round, firm nodule on the wrist. The pain is described as aching, with some weakness of the fingers. What treatment does the nurse anticipate assisting with? (Select all that apply.)

-Corticosteroid injections -Surgical excision -Aspiration of the cyst

A client with a musculoskeletal injury is instructed to make dietary alterations to facilitate calcium absorption. Considering the food intake objective, which food item(s) should the nurse encourage the client to include in the diet? Select all that apply.

-Fatty Fish -Vitamin D-fortified milk -Eggs

The community health nurse is assessing the risk factors for osteoporosis in a female client at a health fair. NOT a Risk Factor for Osteoporosis

-Large Frame -Nonsmoker -Alcohol intake of 3 drinks/week -Walks 2 miles, 3 days/week

The nurse is collaborating with the health care provider on a plan of care for a 54-year-old male client with osteomyelitis of the left femur secondary to uncontrolled type 1 diabetes. What prescriptions for care that the nurse should anticipate for this client.

-Perform neurovascular checks of lower extremities every 8 hours. -Administer IV antibiotic based on culture and sensitivity report. -Administer ibuprofen 400 mg orally three times daily, as needed for pain. -Make referral to dietitian to discuss nutrition for healing and blood glucose control. -Provide education on self-blood glucose monitoring and insulin administration.

A client with osteoporosis is prescribed calcitonin 100 units subcutaneously. The medication is available 200 units per ml. How many milliliters will the nurse administer to the client?

0.5 mL

The nurse is caring for a client with a hip fracture. The physician orders the client to start taking a bisphosphonate. Which medication would the nurse document as given?

Alendronate

The nurse is preparing a client for a surgical procedure that will allow visualization of the extent of joint damage of the knee for a client with rheumatoid arthritis and also obtain a sample of synovial fluid. What procedure will the nurse prepare the client for?

Arthroscopy

Which of the following is the first-line medication that would be used to treat and prevent osteoporosis?

Bisphosphonates

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

What food can the nurse suggest to the client at risk for osteoporosis?

Broccoli

Which medication directly inhibits osteoclasts, thereby reducing bone loss and increasing bone mass density (BMD)?

Calcitonin

Which medication directly inhibits osteoclasts, thereby reducing bone loss and increasing BMD?

Calcitonin (Miacalcin)

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?

Carpal tunnel syndrome

When an infection is bloodborne, the manifestations include which symptom?

Chills

The nurse is asked to explain to the client the age-related processes that contribute to bone loss and osteoporosis. What is the nurse's best response?

Decrease in estrogen

What clinical manifestation would the nurse expect to find in a client who has had osteoporosis for several years?

Decreased height

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

Which term refers to a flexion deformity caused by a slowly progressive contracture of the palmar fascia?

Dupuytren's contracture

Which group is at the greatest risk for osteoporosis?

European American women

Which of the following was formerly called a bunion?

Hallux valgus

The client with osteoarthritis is seen in the clinic. Which assessment finding indicates the client is having difficulty implementing self-care?

Has a weight gain of 5 pounds

A healthcare provider asks a nurse to test a client for Tinel's sign to diagnose carpal tunnel syndrome. What should the nurse do to perform this assessment?

Have the client hold the palm of the hand up while the nurse percusses over the median nerve.

A nurse notices a client lying on the floor at the bottom of the stairs. The client is alert and oriented and denies pain other than in the arm, which is swollen and appears deformed. After calling for help, what should the nurse do?

Immobilize the client's arm.

Assessment of a client reveals signs and symptoms of Paget's disease. Which of the following would be most likely?

Long bone bowing

A client with carpal tunnel syndrome has had limited improvement with the use of a wrist splint. The nurse knows that which procedure will show the greatest improvement in treatment for this client?

Open nerve release

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?

Perform neuromuscular assessment every hour.

A patient had hand surgery to correct a Dupuytren's contracture. What nursing intervention is a priority postoperatively?

Performing hourly neurovascular assessments for the first 24 hours

Which term refers to a disease of a nerve root?

Radiculopathy

A client has Paget's disease. An appropriate nursing diagnosis for this client is:

Risk for falls

Which is a strategy for lowering risk for osteoporosis?

Smoking cessation

Most cases of osteomyelitis are caused by which microorganism?

Staphylococcus aureus

A patient is having low back pain. What position can the nurse suggest to relieve this discomfort?

Supine, with the knees slightly flexed and the head of the bed elevated 30 degrees

In chronic osteomyelitis, antibiotics are adjunctive therapy in which situation?

Surgical debridement

Morton neuroma is exhibited by which clinical manifestation?

Swelling of the third (lateral) branch of the median plantar nerve

A nurse is teaching a client about preventing osteoporosis. Which teaching point is correct?

The recommended daily allowance of calcium may be found in a wide variety of foods.

A client with low back pain is being seen in the clinic. In planning care, which teaching point should the nurse include?

Use the large muscles of the leg when lifting items.

The nurse teaches the client with a high risk for osteoporosis about risk-lowering strategies, including which action?

Walk or perform weight-bearing exercises outdoors

A nurse is planning discharge teaching regarding exercise for a client at risk for osteoporosis. Which exercise would the nurse be most likely to suggest?

Walking