muscular skeletal test Flashcards
MRI (musculoskeletal magnetic resonance imaging)
assists in diagnosing abnormalities of the bones and joints and surrounding soft tissue structures, including cartilage, tendons, etc.
uses magnetism and radio waves to make images (more detailed pictures of fluid-filled soft tissue and blood vessels than any other test)
Pts required to lie still for 45-60 minutes while in the machine
Take vitals after test and allow pt to resume pretest activities; no adverse effects
CT scan (computed tomography scan)
produces three-dimensional pictures
should not be used unnecessarily b/c of radiation exposure
Iodine contrast dye is sometimes used
Useful in locating injuries to the ligaments or tendons, tumors of the soft tissue, and fractures in areas difficult to define by other means
Important Prep:
keep pt on NPO status 3-4 hours before the test (if contrast dye is used)
have pt void before test
having pt void before test
Nuclear medicine scan
uses scanners or camera detectors that record images on radiographic film. Uses low dosages of radioactive isotopes.
Nursing interventions:
obtaining written consent from the patient
Informing the patient that the radioactive isotopes will not affect family or visitors.
following the nuclear medicine department’s instructions for special preparations for specific scans.
know what orif is
(Open reduction with internal fixation)- surgical procedure allowing fracture alignment under direct visualization while various internal fixation devices applied to the bone. (P.145)
what the 7 Ps are (P.144)
Pain, Pallor, Paresthesia, Paralysis, Polar temperature, Puffiness, Pulselessness.
know s/s of CTS- carpal tunnel syndrome (pg. 163-134)
painful disorder of the wrist and hands, caused by inflammation and edema of the synovial lining of the tendon sheaths in the carpal tunnel of the wrist
S/S (subjective):
burning pain; tingling in the hands relieved by shaking or exercising the hands
inability to grasp or hold small objects
edem; muscle atrophy or a depressed appearance of the soft tissue at the base of the thumb on the palmar surface
Diagnostic Test: electromyogram, MRI. handheld electro neurometer
how and when to assess for cap refill and a blanching test
(p.170)- compress each fingernail or toenail of the affected extremity, release, and note how quickly the pink color returns to the nailbed. nailbed color return to normal within 2 or 3 seconds. if the color is slow to return, circulation is impaired and requires prompt attention.
these assessment are made on patients with musculoskeletal trauma or damage to nerves and blood vessels resulting from surgery, tight bandages, splints, or casts. impaired circulation resulting in alteration of nerve function can cause loss of the use of an extremity.
what a fat embolism is? and what causes them? (pg. 150)
the embolization of tissue fat with platelets and circulating free fatty acids within the pulmonary capillaries
rare, but life threatening - cause brain hypoxia and tissue death
suspect fat embolism if the pt has multiple fractures, can occur within 48 hrs of injury
most serious complication of long bone fractures
what bucks traction is?
(p.156) used as a temporary measure to provide support and comfort to a fractured extremity while waiting for more definitive treatment. is in a horizontal plane with affected extremity. frequently used to maintain the reduction of a hip fracture before surgery. can also be used to treat muscle spasms and minor fractures of the spine.
what type of nursing int for rheumatoid arthritis. (pg. 123)
Nursing Diagnoses
Pain, r/t joint inflammation
-Administer salicylate or NSAIDS
-Assist pt w/exercise program
-Pt is to rest inflamed joints
-Maintain bed rest as ordered and proper body alignment
-Assist and teach pt to extend joints as possible and avoid external rotation of extremities; use sandbags or trochanter rolls
-Avoid using pillows under knees
-Immobilize and or support joints
Chronic low self-esteem, r/t negative self evaluation about self or capabilities
know s/s of gout (p.127)
subjective= noticing complaint of pain occurring at night involving the great toe or other joints. dietary history with specific questions on consumption of alcohol and foods high in purines, such as organ meats (brains, kidney, liver, and heart), anchovies, yeast, herring, mackerel, and scallops.
objective: assessment of the joints (especially the great toe) for signs of edema, heat, discoloration, and limited movement. vital sign data may reveal an elevated temperature and hypertension, tachycardia, and tachypnea. Assess patient for urinary output as trophi can form in the kidneys and alter kidney function.
know what gout is (pg. 128)
a metabolic disease resulting from an accumulation of uric acid in the blood.
an acute inflammatory condition associated with ineffective metabolism of purines
primary linked w/hereditary factors; secondary resulting from use of certain meds or complications of another disease; or idiopathic (of unknown source)
affects more men than woman, takes about 20 years for sufficient urates to accumulate in the body before causing signs and symptoms
Prognosis: s/s are recurrent; episodes become longer each year, the disorder is disabling and if untreated can progress to the development of tophi and destructive joint changes
know scoliosis
(p.170)- lateral (or S) curvature of the spine.
know lordosis(p.170)
an increase in the curve at the lumbar space region that throws the shoulders back, making the “lordly” or “kingly” appearance
know kyphosis
(p.170)- rounding of the thoracic spine (humpback appearance).
know s/s of osteoporosis, especially R/T to menopausal pt.
Subjective: complaints of pain that worsen with sitting, standing, coughing, sneezing, and straining
if a pt had a comminuted fx and got a fat embolism, what should you do first?
maintain adequate oxygenation and ventilation.
is there a cure for rheumatoid arthritis?
NO CURE
Teach a pt how to walk with crutches.
Pg 158
a pt going for a CT using contracts, what do you need to ask the pt? -if allergies to iodine or fish and if the pt had eaten (dye can cause nausea and vomiting)
.
know what the procedure is for doing a CXR
.
pt in skeletal leg traction they are not allowed to move side to side, what is the best way to provide good skin care? (pg. 157)
CircOlectric Bed: vertical turning bed that can be operated by one person and placed in a variety of positions, Side-to-side movement can be accomplished while maintaining proper positioning if traction is ordered
if you have a pt that is going to get a cast on, what is the best way to prevent department syndrome
Elevation of the extremity