Ch 36: Management of Patients with Musculoskeletal Disorders

d Pg. 1118 Ergonomic changes, such as adjusting keyboard height, can help clients with carpal tunnel syndrome avoid hyperextension of the wrist. This condition is associated with repetitive tasks such as clerical work, not sports. The condition may be managed with medications, yoga, acupuncture, and wrist (not arm) splints.

A nurse is teaching a client who was recently diagnosed with carpal tunnel syndrome. Which statement should the nurse include? "Surgery is the only sure way to manage this condition." "Using arm splints will prevent hyperflexion of the wrist." "This condition is associated with various sports." "Ergonomic changes can be incorporated into your workday to reduce stress on your wrist."

b Pg. 1136 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.

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? "The posture begins to stoop after middle age." "After menopause, the body's bone density declines, resulting in a gradual loss of height." "After age 40, height may show a gradual decrease as a result of spinal compression" "There may be some slight discrepancy between the measuring tools used."

b Pg. 1121 Morton neuroma is swelling of the third branch of the median plantar nerve. Pes cavus refers to a foot with an abnormally high arch and a fixed equinus deformity of the forefoot. Flatfoot is a common disorder in which the longitudinal arch of the foot is diminished. Plantar fasciitis is an inflammation of the foot-supporting fascia.

Morton neuroma is exhibited by which clinical manifestation? Diminishment of the longitudinal arch of the foot Swelling of the third (lateral) branch of the median plantar nerve Inflammation of the foot-supporting fascia High arm and a fixed equinus deformity

d Pg. 1114 Instructions for the client with low back pain should include that, when lifting, the client should avoid overreaching. The client should also keep the load close to the body, bend the knees, and tighten the abdominal muscles; use a wide base of support; and use a back brace to protect the back. Bending at the hips increases the strain on the back muscles when lifting.

The nurse is educating a client with low back pain on proper lifting techniques. The nurse recognizes that the education was effective when the client bends at the hips and tightens the abdominal muscles. reaches over the head with the arms fully extended. uses a narrow base of support. places the load close to the body.

d Pg. 1134 Risk-lowering strategies include increased dietary calcium and vitamin D intake, smoking cessation, alcohol and caffeine consumption in moderation, and outdoor activity. Individual risk factors include low initial bone mass and increased age. A lifestyle risk factor is a diet low in calcium and vitamin D.

Which is a risk-lowering strategy for osteoporosis? Low initial bone mass Increased age Diet low in calcium and vitamin D Smoking cessation

b Pg. 1122 Obesity predisposes the client to degenerative joint disease. Obesity isn't a predisposing factor for muscular dystrophy, scoliosis, or Paget's disease.

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? Muscular dystrophy Degenerative joint disease Scoliosis Paget's disease

a Pg. 1114 The large muscles of the leg should be used when lifting.

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. Avoid twisting and flexion activities. Sleep on the stomach to alleviate pressure on the back. A soft mattress is most supportive by conforming to the body.

a Pg. The disorder can be confused with trigeminal neuralgia and migraine headaches. The client experiences clicking of the jaw when moving the joint, or the jaw can lock, which interferes with opening the mouth. Loose teeth will not cause a clicking of the jaw. The client does not have a dislocated jaw.

A client has been treated for migraine headaches for several months and comes to the clinicreporting no improvement. The nurse is talking with the client and hears an audible click when the client is moving the jaw. What does the nurse suspect may be happening? Temporomandibular disorder Loose teeth Dislocated jaw Trigeminal neuralgia

d Pg. 1137 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.

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? Green vegetables Red meat Bananas Vitamin D-fortified milk

a Pg. 1118 Evidence-based treatment of acute carpal tunnel syndrome includes the application of splints to prevent hyperextension and prolonged flexion of the wrist. Should this treatment fail, open nerve release is a common surgical management option. A variety of treatments may be tried by the client, however, they may fail to improve the condition. These treatments include laser therapy, ultrasound therapy, and the injection of substances such as lidocaine. Though these can be used, surgery to release nerves is the best option.

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 Injection of lidocaine Ultrasound therapy Laser therapy