Musculoskeletal MedSurg

nurse is caring for a patient with Paget's disease and is reviewing the patient's most recent laboratory values. Which of the following values is most characteristic of Paget's disease?

An elevated serum alkaline phosphatase level and a normal serum calcium level

A nurse is caring for an adult patient diagnosed with a back strain. What health education should the nurse provide to this patient?

Avoid lifting more than one-third of body weight without assistance

Prior to discharge, when teaching the patient, the nurse should include information about which major complication of osteoporosis?

Bone fracture Bone fracture is a major complication of osteoporosis that results when loss of calcium and phosphate increases the fragility of bones.

A patient has been admitted to the medical unit for the treatment of Paget's disease. When reviewing the medication administration record, nurse should anticipate

Calcitonin, Bisphosphonates are the cornerstone of Paget therapy in that they stabilize the rapid bone turnover.

A nurse is providing an educational class to a group of older adults at a community senior center. In an effort to prevent osteoporosis, the nurse should encourage participants to ensure that they consume the recommended adequate intake of what nutrients?

Calcium Vitamin D

A nurse is teaching a patient with osteomalacia about the role of diet. What would be the best choice for breakfast for a patient with osteomalacia?

Cereal with milk, a scrambled egg, and grapefruit

patient returned to the unit after undergoing limb-sparing surgery to remove a metastatic bone tumor. The nurse providing postoperative care in the days following surgery assesses for what complication from surgery?

Delayed wound healing

A nurse is caring for a patient who is 12 hours postoperative following foot surgery. The nurse assesses the presence of edema in the foot.What nursing measure will the nurse implement to control the edema?

Elevate the foot on several pillows.

A nurse is planning the care of an older adult patient with osteomalacia. What action should the nurse recommend in order to promote vitamin D synthesis?

Ensuring adequate exposure to sunlight

nurse is providing care for a patient who has a recent diagnosis of Paget's disease. When planning this patient's nursing care, interventions should address what nursing diagnoses?

Impaired Physical Mobility Acute Pain Disturbed Auditory Sensory Perception Risk for Injury

An older adult woman's current medication regimen includes alendronate . What outcome would indicate successful therapy?

Increased bone mass Bisphosphonates such as Fosamax increase bone mass and decrease bone loss by inhibiting osteoclast function

A nurse is caring for a patient who is being treated in the hospital for a spontaneous vertebral fracture related to osteoporosis. The nurse should address the nursing diagnosis of Acute Pain Related to Fracture by implementing what intervention?

Intermittent application of heat to the patient's back

An older adult patient sought care for the treatment of a swollen, painful knee joint. Diagnostic imaging and culturing of synovial fluid resulted in a diagnosis of septic arthritis. The nurse should prioritize which of the following aspects of care?

Intravenous administration of antibiotics

A patient is undergoing diagnostic testing for osteomalacia. Which of the following laboratory results is most suggestive of this diagnosis?

Low serum calcium and low phosphorus level

A nurse is providing care for a patient who has osteomalacia. What major goal will guide the choice of medical and nursing interventions?

Maintenance of adequate levels of activated vitamin D

A patient has come to the clinic for a routine annual physical. The nurse practitioner notes a palpable, painless projection of bone at the patient's shoulder. The projection appears to be at the distal end of the humerus. The nurse should suspect the presence of which of the following?

Osteochondroma is the most common benign bone tumor. It usually occurs as a large projection of bone at the end of long bones at the knee or shoulder.

patient with diabetes has been diagnosed with osteomyelitis. nurse notes that the patient's right foot is pale and mottled, cool to touch, with a capillary refill of greater than 3 seconds. nurse should suspect what type of osteomyelitis?

Osteomyelitis with vascular insufficiency

A nurse is providing discharge teaching for a patient who underwent foot surgery. The nurse is collaborating with the occupational therapist and discussing the use of assistive devices. On what variables does the choice of assistive devices primarily depend?

Patient's general condition, balance, and weight-bearing prescription

A patient with diabetes is attending a class on the prevention of associated diseases. What action should the patient perform to reduce the risk of osteomyelitis?

Perform meticulous foot care.

A patient presents to a clinic complaining of a leg ulcer that isn't healing; subsequent diagnostic testing suggests osteomyelitis. The nurse is aware that the most common pathogen to cause osteomyelitis is what?

S. aureus causes over 50% of bone infections. Proteus, Pseudomonas, and E. coli are also causes, but to a lesser extent.

A nurse is providing a class on osteoporosis at the local seniors' center. Which of the following statements related to osteoporosis is most accurate?

Slow discontinuation of corticosteroid therapy can halt the progression of the osteoporosis

A nursing educator is reviewing the risk factors for osteoporosis with a group of recent graduates. What risk factor of the following should the educator describe?

Small frame, female gender, and Caucasian ethnicity

nurse is collaborating with the physical therapist to plan the care of a patient with osteomyelitis. What principle should guide the management of activity and mobility in this patient?

Stress on the weakened bone must be avoided.

The health care team is caring for a patient with osteomalacia. It has been determined that the osteomalacia is caused by malabsorption. What is the usual treatment for osteomalacia caused by malabsorption?

Supplemental calcium and increased doses of vitamin D

nurse is caring for a patient with a bone tumor. The nurse is providing education to help the patient reduce the risk for pathologic fractures. the nurse teach the patient?

Support the affected extremity with external supports such as splints.

An orthopedic nurse is caring for a patient who is postoperative day one following foot surgery. What nursing intervention should be included in the patient's subsequent care?

The foot should be elevated in order to prevent edema.

An 80-year-old man in a long-term care facility has a chronic leg ulcer and states that the area has become increasingly painful in recent days. The nurse notes that the site is now swollen and warm to the touch. The patient should undergo diagnostic testing for what health problem?

When osteomyelitis develops from the spread of an adjacent infection, no signs of septicemia are present, but the area becomes swollen, warm, painful, and tender to touch.

nurse is reviewing the pathophysiology that may underlie a patient's decreased bone density. What hormone will nurse identify as inhibiting bone resorption and promoting bone formation?

Calcitonin Calcitonin inhibits bone resorption and promotes bone formation,

patient has been admitted to the hospital with a spontaneous vertebral fracture related to osteoporosis. the following nursing diagnoses must be addressed in the plan of care?

Constipation Related to Vertebral Fracture

Which of the following patients should the nurse recognize as being at the highest risk for the development of osteomyelitis

those who are poorly nourished, elderly, and obese