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
