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From Flashcardlet > (3) All Musculoskeletal > Flashcards

(3) All Musculoskeletal Flashcards

0
Q

What is joint replacement

A

Surgical procedure in which a mechanical device, designed to act as a joint, is used to replace a diseased joint

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1
Q

What is carpal tunnel syndrome

A

Condition caused by compression of the median nerve

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2
Q

What is bursitis

A

Inflammation of bursa, resulting from repeated or excessive trauma, friction, gout, rheumatoid arthritis, or infection

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3
Q

What is Paget’s disease

A

Chronic skeletal bone disorder in which there is excessive bone resorption

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4
Q

What is osteomyelitis

A

Severe infection of bone, bone marrow, and surrounding tissue

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5
Q

What is osteoporosis

A

Fragile down disease. Low bone mass and structural deterioration of bone tissue, leading to bone fragility

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6
Q

What is a contusion

A

A bruise; A region of injured tissue or scan in which blood capillaries have been ruptured

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7
Q

What is arthritis

A

Inflammation of the joint

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8
Q

What is reactive arthritis

A

Symptom complex that includes urethritis, conjunctivitis, and mucocutaneous lesions

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9
Q

What is septic lupus erythematous

A

Multi system inflammatory autoimmune disease

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10
Q

What is Sjogren’s syndrome

A

Autoimmune disease that targets the moisture producing exocrine gland

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11
Q

What is fibromyalgia

A

Chronic disorder characterized by widespread, nonarticular musculoskeletal pain and fatigue with multiple tender points

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12
Q

What is gout

A

Reoccurring acute arthritis characterized by the accumulation of uric acid crystals in joints

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13
Q

What is a strain

A

Excessive stretching of the muscle, it’s fascial sheath, or a tendon

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14
Q

What is a fracture

A

Disruption or break in continuity of structure of bone

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15
Q

What is another name for reactive arthritis

A

Reiter’s syndrome

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16
Q

What is a dislocation

A

Separation of two bones from normal position within a joint

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17
Q

What is rheumatoid arthritis

A

Inflammation of connective tissue in the diarthrodial (synovial) joints

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18
Q

What is osteomalacia

A

Caused by vitamin D deficiency resulting in decalcification and softening of bone

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19
Q

What is a sprain

A

Injury to ligamentous structures surrounding a joint, usually caused by a wrenching or twisting motion

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20
Q

What is another name for osteomalacia

A

Rickets

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21
Q

What is osteochondroma

A

Overgrowth of cartilage and bone near the end of the bone at the growth plate

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22
Q

What is Dupuytren’s Disease

A

Fixed flexion contracture of hand, where fingers band tour the palm and cannot be fully extended. Inherited connective tissue disorder involving palmar fascia

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23
Q

What is ankylosing spondylitis

A

Chronic inflammatory disease that primarily affects the axial skeleton

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24
Q

What is osteosarcoma

A

Primary malignant bone tumor that is extremely aggressive in rapidly metastasizing to distant sites

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25
Q

What is septic arthritis

A

Infectious or bacterial arthritis caused by microorganisms invading the joint cavity

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26
Q

What is osteoarthritis

A

Slowly progressive non-inflammatory disorder of the diarthrodial (synovial) joints

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27
Q

What is muscular dystrophy

A

Progressive symmetric wasting of skeletal muscles without evidence of neurological involvement

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28
Q

What is a psoriatic arthritis

A

Progressive inflammatory disease that affects people with psoriasis

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29
Q

What is tendinitis

A

Inflammation of tendon as a result of overuse or incorrect use

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30
Q

What is traction

A

Application of the pulling forces

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31
Q

💊Prednisones, hydrocortisone, dexamethasone, and flunisolide are what type of drugs

A

Corticosteroids

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32
Q

💉Anti-DNA antibody detect antibodies that react with DNA and is most specific for what disease

A

Lupus

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33
Q

What type of cartilage tissue is the most common

A

Hyaline

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34
Q

The skeletal muscle is enclosed by a continuous layer of what tissue that helps muscles to slide over nearby structures

A

Deep fascia

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35
Q

During musculoskeletal assessment, question patients about possible secondary bacterial infections such as

A

Ears, Tonsils, Teeth, Sinuses, Lungs, and GI Tract

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36
Q

Why does a decrease in height occur with aging

A

Vertebrae becomes more compressed with thinning of intervertebral discs

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37
Q

Sacrum, Mandible, and Ear Ossicles are examples of what type of bone

A

Irregular

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38
Q

Range of motion is most accurately assessed with

A

Goniometer

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39
Q

What type of muscle is found in the walls of hallow structures such as airways, arteries, GI tract, urinary bladder, and uterus

A

Smooth

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40
Q

💺What do you want to ask patients before an MRI

A

Pacemakers, metallic implants, etc.

No metals!!

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41
Q

A place where the ends of two bones are in proximity and move in relation to each other.

A

Joint

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42
Q

Which joints are capable of flexion and extension

A

Knee and elbow

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43
Q

💺What diagnostic study allows visualization of intervertebrae disc abnormalities

A

Diskogram

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44
Q

Ribs, Skull, Scapula, and Sternum are what types of bones

A

Flat

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45
Q

Almost 30% of muscle mass is lost by what age

A

70

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46
Q

Each long bone consists of

A

Epiphysis, Diaphysis, Metaphysis

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47
Q

If fascia is not connected well in surgery it can lead to

A

Hernia

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48
Q

💊What type of drugs are Allopurinol and Probenecid

A

Anti-Gout

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49
Q

What is it called when the patient has footdrop in the foot slips down on the floor as the patient walks

A

Steppage gait

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50
Q

What is the area between the epiphysis and Metaphysis that actively produces bone to allow longitudinal growth in children

A

Epiphyseal Plate or Growth Zone

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51
Q

How do you determine a patients functional range of motion

A

Ask if activities such as eating or bathing need to be performed with assistance or cannot be done at all.

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52
Q

Carpals and Tarsals are examples of what type of bone

A

Short

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53
Q

💺How is an arthroscopy performed

A

Under Anastasia

Needle inserted and distended with air or fluid

Joint cavity examined

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54
Q

💊Side effects of NSAID’s

A

Stomach & Intestine problems
Bleeding / Ulcers
Risk for MI

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55
Q

Bone loss begins around what age

A

40

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56
Q

💊Side effect of Allopurinol

A

May cause stomach upset or drowsiness

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57
Q

💊What medication can cause rash, stomach upset, or toxicity to liver or bone

A

Methotrexate

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58
Q

What is the Epiphysis

A

Widened area found at each end of a long bone

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59
Q

💉What antigen is present with RA and ankylosing spondylitis

A

Human Leukocyte Antigen (HLA)

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60
Q

💺What diagnostic study gives visualization of anterior portion of joint capsule

A

Arthroscopy

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61
Q

What type of bone cells responsible for the reabsorption of bone

A

Osteoclast

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62
Q

💺What diagnostic study shows how bone is affected by nerve root damage

A

Myelogram

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63
Q

💉What serologic tests would be done to evaluate rheumatoid arthritis

A

RF

ANA

ESR

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64
Q

💺What do you want to ask the patient before a diskogram

A

Ask the patient if they’re allergic to shellfish or contrast medium

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65
Q

During palpation of physical examination, what can you do to prevent muscle spasms

A

Warm your hands

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66
Q

💺What test provides fast, precise measurement of the bone mass of the spine, forearm, and total body to evaluate osteoporosis

A

DXA

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67
Q

What are the three types of cartilage

A

Hyaline
Elastic
Fibrous

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68
Q

What type of muscle is voluntary and accounts for about half of a human beings bodyweight

A

Skeletal

Cardiac and smooth muscle or involuntary

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69
Q

💉What serologic study is increased with muscle trauma

A

potassium

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70
Q

What attaches muscles to bones

A

Tendons

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71
Q

Why do you want to ask the patient about secondary bacterial infections during a musculoskeletal assessment

A

Infections can enter the bone and result in osteomyelitis or joint destruction.

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72
Q

💉Positive ANA may indicate

A

Lupus or rheumatoid arthritis

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73
Q

💉Depletion of CH50 may be found in

A

Lupus and rheumatoid arthritis

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74
Q

💉Normal levels for aldolase

A

1.5-8.1

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75
Q

What part of the long bone is the main shaft of the bone and provides structural support

A

Diaphysis

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76
Q

What part of the long bone allows for greater weight distribution and provides stability for the joint

A

Epiphysis

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77
Q

What connects bones to bones

A

Ligaments

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78
Q

💉What serologic study is greater in MD, Polymyositis, and traumatic injury

A

Creatine Kinase (CK)

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79
Q

💺What is the patient instructed to do before a bone scan

A

Empty the bladder

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80
Q

What is typically located at bony prominences or joints to relieve pressure and decrease friction between moving parts

A

bursea

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81
Q

💺What is the most common diagnostic test used to assess musculoskeletal disorders

A

Standard x-ray

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82
Q

What occurs as thick and thin filaments slide past each other, causing the sarcomeres to shorten

A

Muscle Contractions

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83
Q

Small sacs of connective tissue lined with synovial membrane and containing viscous synovial fluid

A

bursea

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84
Q

What is scoliosis

A

Lateral curvature of the spine

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85
Q

💉With what disease do you monitor aldolase

A

MD

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86
Q

💉What serologic study will diagnose inflammatory disease, infections, and active malignancy

A

C-Reactive Protein (CRP)

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87
Q

💊Side effects of corticosteroids

A

Infection and weakening of bones

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88
Q

If the patient has a disturbed gate, what action should the nurse take to further assess this problem

A

Measure the length of both legs

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89
Q

💉What serologic test can diagnose inflammatory disease, infections, and active malignancy >18-20 hours after tissue damage

A

C-Reactive Protein (CRP)

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90
Q

What type of bone cell is responsible for the formation of bone

A

Osteoblast

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91
Q

Which joints are capable of abduction and abduction

A

Hip, wrist, thumb, shoulder

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92
Q

What connective tissues have a relatively poor blood supply, usually making tissue repair a slow process after injury

A

Ligaments and tendons

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93
Q

💉What is the normal level of potassium

A

3.5-5

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94
Q

💉What is the normal levels for Creatine Kinase

A

Male: 20-200
Woman: 20-180

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95
Q

💺What diagnostic study determines the density of bone, evaluate structure or function, and bone changes

A

X-ray

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96
Q

What part of the long bone is the flared area between the epiphysis and diaphysis

A

Metaphysis

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97
Q

Femur, Humerus, and Tibia are examples of what type of bone

A

Long

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98
Q

What are the 4 types of bone in the human body

A

Long
Short
Flat
Irregular

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99
Q

💊How long can it take for DMARD’s to be effective

A

3 to 6 weeks

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100
Q

Preoperative teaching for amputation

A

Reason for amputation
Prosthesis
Mobility training
Phantom pain

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101
Q

When using crutches, how far do you instruct the client to move the crutch/crutches forward

A

12 inches

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102
Q

Grade 2 open/compound fracture

A

Total breakthrough skin with soft tissue and muscle damage

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103
Q

With what traction is part of the body off the bed

A

Balanced Suspension Traction

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104
Q

Most strains occur in large muscle groups such as

A

Lower back, calf, hamstrings

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105
Q

What is an oblique fracture

A

Line fracture is angled

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106
Q

What are the goals of amputation

A

Adequate relief from the underlying health problem
Satisfactory pain control
Reach maximum rehabilitation potential for with use of a prosthetic
Cope with body image changes
Make satisfying lifestyle adjustments

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107
Q

Weight for skeletal traction ranges from

A

5 to 45 pounds

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108
Q

Contractures, disability, and loss of function can occur with what complication

A

Compartment syndrome

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109
Q

Complications of traction

A

Atelectasis and pneumonia

Constipation and anorexia

Urinary stasis an infection

Venus thromboembolism

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110
Q

What is internal fixation

A

Metal pins and rods are surgically inserted to realign and maintain bony fragments

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111
Q

In what traction are weights attached directly to the bone

A

Skeletal traction

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112
Q

What to assess for with fat embolism

A

Respiratory distress

Restlessness

Irritability

Fever

Petechiae

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113
Q

What is often considered an orthopedic emergency

A

Dislocation

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114
Q

What do you do if you’re falling while ambulating with crutches

A

Throw crutches out and to the side and use arms to break the fall

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115
Q

When using a walker, how far do you instruct the client to move the Walker forward

A

6–8 inches

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116
Q

The nurse suspects a fat embolism rather than a pulmonary embolism from a vascular thrombosis when the patient with a fracture develops

A

Petechiae around the neck and upper chest

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117
Q

What is a displaced fracture

A

Absent of any alignment

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118
Q

What type of traction is generally used for short-term treatment until skeletal traction or surgery is possible

A

Skin Traction

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119
Q

What is a transverse fracture

A

Fracture runs across the bone

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120
Q

What gait is used when client can bear little or no weight on one leg or one client has only one leg

A

Three point gait

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121
Q

The majority of fractures are from Trumatic injuries such as

A

Direct blow
Crushing force
Sudden twisting motion

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122
Q

What condition is associated with continuous wrist movement

A

Carpal tunnel syndrome

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123
Q

What are the major disadvantages of skeletal traction

A

Infection in the area of the bone where the skeletal pin is inserted and the consequences of prolonged immobility

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124
Q

What is an avulsed fraction

A

Torn away by a ligament or tendon

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125
Q

Patient who has a dislocated joint is a greater risk for repeated dislocation related to

A

Loose ligaments

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126
Q

😷 Nursing Management / Treatment for soft tissue injuries

A

“RICE”

Rest – immobilize patient
Ice – first 24 hours. 24–48 hours use warm compress
Compress
Elevate

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127
Q

Dislocation can be accomplished by a closed reduction, but often requires

A

Surgery

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128
Q

Steps to take when going from standing to sitting position using crutches

A

Walk up to chair ➡️ when one step away from chair, turn until you’re back faces the chair using the unaffected leg and crutches ➡️ move backwards until chair touches back of unaffected leg ➡️ remove scratches from under arms, hold both in one hand (side of affected leg) and reach for the chair with the other hand ➡️ stretch the affected leg out in front ➡️ sit down slowly

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129
Q

What type of traction?
The application of traction to the joints of the spine or extremities to know appropriate positions and intensities for the force.
Applied through hands of clinician (Hands on)

A

Manual traction

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130
Q

What is a closed/simple fracture

A

Fractured bone doesn’t break through the skin

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131
Q

Fractures of bone, especially if long bones are involved, predisposes clients to

A

Anemia

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132
Q

What to do if fat embolism is suspected

A

Notify provider stat

Draw blood gases

Administer O2

Assist with endotracheal intubation/treatment of respiratory failure

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133
Q

How long is skin traction used

A

48-72 hours

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134
Q

What gait is used for clients who have paralysis of hips or legs or who wears bilateral braces on legs

A

“Swing To” gait

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135
Q

How often are the lungs auscultated when using traction

A

Q4-8 hours

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136
Q

With what traction do you make use of Thomas Splint with Pearson Attachment

A

Balanced Suspension Traction

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137
Q

A patient with a fractured right hip has an anterior Open reduction and internal fixation of the fracture. What should the nurse plan to do postoperatively

A

Get the patient up to the chair on the first postoperative day

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138
Q

What is the traction weight for skin traction

A

5 to 10 pounds

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139
Q

😰Clinical manifestations of dislocation

A

Obvious deformity

Pain

Tenderness

Loss of function

Swelling

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140
Q

In compartment syndrome what should not be used because it may result in vasoconstriction and exacerbate

A

Ice or cold compresses should not be applied

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141
Q

Positions to relieve edema and spasms at residual limb (stump) site after amputation

A

Elevate stump for first 24 hours on one pillow

Do not elevate stump after 48 hours postoperatively

Keep stump in extended position and turn client to prone position 3x/day

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142
Q

What areas are most commonly dislocated

A

Thumb, elbow, shoulder, hip, patella

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143
Q

What are the two basic types of compartment syndrome

A

Decreased compartment size (From restrictive dressings, splints, casts, excessive traction, premature closure of fascia)

Increased compartment content (due to bleeding, inflammation, edema, or IV infiltration)

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144
Q

After amputation why do you want to turn the client to the prone position 3x/day

A

To prevent hip flexion contraction

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145
Q

Care of pin site for skeletal traction

A

Clean with antiseptic
Apply antibiotic
No Betadine (rust pins)
No peroxide (aerobic infection)

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146
Q

What do you never want to do when going in or coming out of sitting position

A

Never pivot

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147
Q

How long does it take for a plaster cast to dry

A

24–36 hours

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148
Q

What traction incorporates the use of a knee sling

A

Russel’s Traction

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149
Q

In joint replacement, what are the most commonly replaced joints

A

Hip
Knee
Shoulder
Finger

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150
Q

After the onset of compartment syndrome, ischemia can occur within how many hours

A

4 to 8 hours

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151
Q

What is a potential problem following a fasciotomy

A

Infection resulting from delayed wound closure

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152
Q

What do you want to monitor after joint replacement surgery

A

Incision site

Functioning of extremity

I&O- encourage fluid intake

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153
Q

What type of traction?
Traction pull on a bone structure mediated through a pen or wire inserted into the bone to reduce a fracture of long bones

A

Skeletal traction

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154
Q

😷 Nursing management of amputations postoperatively

A

Pain control
Prosthetics
Rehabilitation
Bandage

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155
Q

What is the cause of amputation in approximately 80% of cases

A

Peripheral vascular disease

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156
Q

What is the simplest form of traction

A

Bucks extension traction

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157
Q

Too much weight used for skeletal traction can result in

A

Delayed union or nonunion

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158
Q

😰 Clinical manifestations of compartment syndrome

A

“6 P’s”

Pain- distal to injury that is not relieved by opioid analgesics
Pressure
Paresthesia- numbness or tingling
Pallor- coolness and loss of normal color
Paralysis- loss the function
Pulselessness- diminished or absent peripheral pulses

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159
Q

What is a comminuted fracture

A

Broken in more than two places

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160
Q

What is a Longitudinal fracture

A

Fracture runs length of bone

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161
Q

What is an impacted fracture

A

Fragments driven into each other

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162
Q

🍓Diet for constipation due to complications of traction

A

High fiber and increased fluids (>2500 mL/day)

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163
Q

For healing without delays, interruptions or problems, when must traction weight hang freely

A

At all times!!

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164
Q

What type of traction?
A system of splints, ropes, slings, pulleys, and weights for suspending the lower extremities of the body, used as an aid to realignment and healing for fractures or from surgical intervention

A

Balance suspension traction

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165
Q

After amputation, instruct the client to clean prosthesis socket daily with

A

Milk soap and rinse thoroughly

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166
Q

Steps to take when going from sitting to standing position using crutches

A

Hold handgrips of both crutches in one hand (side of affected leg) ➡️ place other hand on the side of the chair ➡️ stretch the affected leg out straight ➡️ push on the crutches, chair and unaffected leg and stand up

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167
Q

What gait looks like a marching soldier

A

Two point gait

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168
Q

What type of traction?

Traction on an extremity by means of adhesive tape or other types of strapping applied to the limb

A

Skin traction

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169
Q

What is the purpose of traction

A

Reduce, align and immobilize fractures
Minimize muscle spasms
Reduce deformity
Increase space between opposing services

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170
Q

Complications of dislocations

A

Open joint injuries

Intra-articular fracture’s

Avascular necrosis (bone death)

Damage to adjacent tissue

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171
Q

To ensure adequate soft tissue decompression, how long is the fasciotomy site left open

A

Several days

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172
Q

💉After joint replacement surgery how often do you want to check the hematocrit to monitor RBC production

A

Every 3-4 days

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173
Q

In compartment syndrome how should the extremity be elevated

A

Did extremity should not be elevated above the heart level. Elevation my lower venous pressure and slow arterial perfusion

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174
Q

With traction, what must not touch the pulley or foot of the bed

A

Knots in the ropes or foot plates

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175
Q

With what traction is the hip flexed to 20° from the mattress

A

Russel’s traction

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176
Q

What type of traction is Buck’s, Russel’s and Bryant’s Tractions

A

Skin traction

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177
Q

In compartment syndrome what do you want to assess due to the possibility of muscle damage

A

Urine output and kidney function

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178
Q

When using a walker the elbows should bend at what angle

A

30°

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179
Q

What fractures most often cause fat embolism

A

Those of the long bones, ribs, tibia, and pelvis

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180
Q

Principles of effective skeletal traction

A

Continuous (never interrupted)
Weights are not removed
Good body alignment
Ropes must be unobstructed

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181
Q

What is one of the more common types of skeletal traction

A

Balanced suspension traction

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182
Q

What is the most rapid gait of all “point” gaits

A

Two point gait

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183
Q

When is Bryant’s traction indicated

A

Children with congenital hip dislocation

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184
Q

What gait do you move both crutches and the affected leg forward first

A

Three point gait

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185
Q

During assessment of an open fracture what specifically should the nurse question the patient about

A

Status of tetanus immunization

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186
Q

When using crutches the patients elbows are flexed at what degree

A

15–30°

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187
Q

How do you treat phantom pain

A

Phantom pain is real! Treated as such

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188
Q

When traction is used to treat fractures, the forces are usually exerted on the

A

Distal fragment

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189
Q

What gait is used when the client can move and bear weight on each leg

A

Four point gait

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190
Q

When is Bucks extension traction indicated

A

Femur / hip involvement

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191
Q

For the first 24 hours after amputation, why do you want to elevate stump on only one pillow

A

It can cause contracture if too high

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192
Q

Grade 3 Open/compound fracture

A

Same as 2 but more excessive with nerve tissue and blood vessel damage

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193
Q

With balanced suspension traction at what degree are the hips fixed

A

30°

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194
Q

What is an Open/compound fracture

A

Fractured bone breaks through the skin

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195
Q

🍓Nutrition management for fracture

A

Protein (1 g/kg body weight)

Vitamin B (dairy, salmon, vegetables, nuts, avocado, watermelon), C (peppers, green leafy vegetables, Keewee, oranges, strawberries), D (tuna, salmon, dairy, beef liver, cheese, egg yolks)

Calcium (dairy, sardines, dark leafy vegetables, fortified cereals and juices)

Phosphorus (milk, meat, soy)

Magnesium (dark green leafy vegetables)

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196
Q

When is russel’s traction indicated

A

Femur / hip joint fracture

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197
Q

Transport safe wheelchairs have undergone several crash tests and are able to withstand a collision at what speed

A

30 mph

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198
Q

What is external fixation

A

Metal pins and rods are inserted into the bone and attached to external rods to stabilize the fracture while it heals

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199
Q

What is a spiral fracture

A

Fracture is a result of twisting or rotation of bone

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200
Q

When using crutches, The crutch pads should be how many inches below the armpits with the shoulders relaxed

A

1.5–2 inches

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201
Q

When assessing urine output and kidney function with suspected compartment syndrome, what is a common sign of acute kidney injury

A

Dark reddish brown urine

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202
Q

With a strain full function returns within how many weeks

A

3–6 weeks

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203
Q

Bryant’s traction is for children below 2–3 years and weighs less than

A

30 to 40 pounds

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204
Q

Some fractures are secondary to process of diseases such as

A

Cancer or osteoporosis

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205
Q

With a fat embolism clients often report a feeling of

A

Impending doom or disaster

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206
Q

After joint replacement surgery, how do you monitor functioning of the extremity

A

Check circulation, sensation, movement of extremity distal to replacement

Provide proper alignment of affected extremity

Provide abductor appliance (hip replacement) or continuous passive motion (CPM) device if indicated

207
Q

What traction is at risk for osteomyelitis

A

Skeletal traction

208
Q

After fracture, veins of lower extremities and pelvis are highly susceptible to

A

Thrombus formation

209
Q

What signs and symptoms are monitored of urinary stasis an infection when using traction

A

Hesitancy
Urgency
Frequency
Dysuria

210
Q

When walking down stairs with crutches what leg goes first

A

The affected leg goes down first and the crutches move with the affected leg

211
Q

😷Nursing management of dislocation

A

“PROM”

Pain relief
Support, protect injured joint
Gentle ROM exercises
Exercise program to slowly restore the joint

212
Q

With the skeletal traction the patient should be in the center of the bed and in what position

A

Supine

213
Q

Complications of a fracture

A

Venus thromboembolism (VTE)
Fat embolism
Compartment syndrome

214
Q

When monitoring the incision site after joint replacement surgery what do you want to assess for

A

Bleeding/drainage
Suture line for erythema/edema
Suction drainage apparatus for proper functioning

215
Q

What type of assessment is imperative when using skin traction

A

Skin assessment and prevention of breakdown

216
Q

What traction incorporates the use of a knee sling

A

Russel’s traction

217
Q

What is the cardinal sign of a fracture

A

Obvious deformity

218
Q

Fractures are managed by

A

External and internal fixation

219
Q

What is the most common compression neuropathy in the upper extremity

A

Carpal tunnel syndrome

220
Q

😷 Nursing Management / Collaborative care for compartment syndrome

A 
No elevation above the heart
No ice or cold compress
Loosen bandage or splint cast
Remove all external sources of pressure
Reduce traction weight

Surgical decompression (fasciotomy)

221
Q

What is the #1 concern post operatively after joint replacement

A

Infection

222
Q

Interventions to prevent Venus thromboembolism

A

Compression stockings

Sequential compression devices

Instruct patient to move fingers or toes of affected extremity against resistance

Perform ROM exercises on the unaffected lower extremity

223
Q

What gait do you advance the right crutch and the left foot simultaneously

A

Two point gait

224
Q

After a fracture when is the patient at greatest risk for fat embolism

A

In the first 36 hours

225
Q

With traction, weight is not removed unless it is what type of traction

A

Intermittent traction

226
Q

😰 Clinical manifestations of a fracture

A 
Pain
Muscle spasm
Loss of function
Deformity
Shortening because of muscle spasm
Swelling and discoloration
Crepitus
Localized edema and Ecchymosis
227
Q

When walking up stairs with crutches what leg goes first

A

The unaffected leg goes first and the crutches move with the affected leg

228
Q

Keep plaster cast uncovered until

A

Fully dry

229
Q

What is the initial symptom of a fat embolism

A

Confusion due to hypoxemia

230
Q

After joint replacement surgery why do you want to instruct the client not to lift the leg upward from a lying position or to elevate the knee when sitting

A

It could pop the prosthesis out of the socket

231
Q

What complication can occur with traction due to the inability of the patient to perform deep breathing exercises

A

Atelectasis and pneumonia

232
Q

🚬What is the most common factor that triggers systemic lupus erythematous

A

Sunlight and sunburns

233
Q

💉In laboratory testing what is present in ankylosing spondylosis

A

HLA-B27

234
Q

😰Crepitation is a common clinical manifestation of

A

Osteoarthritis

235
Q

💺What diagnostic studies detect early joint changes in osteoarthritis

A

Bone scan, CT, MRI

236
Q

💊What steroid sparing drug may be given with systemic lupus erythematous

A

Methotrexate

237
Q

Osteoarthritis pain may be referred to what areas

A

The groin, buttock, or medial side of thigh or knee

238
Q

🚬The mechanism of ankylosing spondylitis is unknown but there is what type of predisposition

A

Genetic predisposition

239
Q

😰Manifestations of Psoriatic arthritis

A

Arthritis of hands/feet
Asymmetric arthritis of extremities
Symmetric arthritis resembles rheumatoid arthritis
Arthritis of SI (Sacroiliac- Sacrum & Iliac) joints/Spine

240
Q

💺X-ray of Psoriatic arthritis reveals cartilage loss and erosion that resembles

A

Rheumatoid arthritis

241
Q

What organs can be affected by the accumulation of circulating immune complexes in systemic lupus erythematous

A

Any organ

242
Q

What type of arthritis can travel from another site of active infection or be introduced directly through trauma or surgery

A

Septic arthritis

243
Q

😰What connective tissue disease manifests violet colored, cyanotic, or erythematous rash

A

Dermatomycosis (DM)

244
Q

💊What type of drugs may be given to slow the progression of osteoarthritis

A

Disease modifying osteoarthritis drugs (DMOAD’s)

245
Q

Rheumatoid arthritis is characterized by

A

Inflammation

246
Q

💊Drug therapy for patients with fibromyalgia that have chronic pain

A

Non-opioid analgesics

247
Q

😰 Clinical manifestations of bilateral inflammation rheumatoid arthritis

A 
Decreased ROM
Warmth
Edema
Erythema (redness of skin) 
Joint pain
248
Q

What is crepitation

A

A grading sensation

249
Q

📚Discharge and home care teachings for the patient with osteoarthritis

A

Use correct posture/body mechanics
Keep joints in functional position
Sleep w/ rolled terrycloth towel under cervical spine if neck pain

250
Q

What can result from scleral nodules in rheumatoid arthritis

A

Cataract development and loss of vision

251
Q

💊 What prompt drug treatment is used to prevent joint destruction/bone loss in septic arthritis

A

Broad-spectrum antibiotics until the organism is identified

252
Q

😷When is heat application such as hot packs, whirlpool baths, ultrasound and paraffin wax baths needed in osteoarthritis

A

Stiffness

253
Q

The onset of ankylosing spondylitis is prior to what age

A

40

254
Q

📚 What needs to be avoided with knee osteoarthritis

A

Prolonged standing, kneeling, squatting

255
Q

😰Clinical manifestations of fibromyalgia

A

▪️Irritable bowel syndrome (IBS)
▪️Widespread burning pain that worsens & improves through the day
▪️Head or facial pain
▪️Difficulty concentrating, memory lapses, feeling of being overwhelmed
▪️Sensitive to pain stimuli throughout the body
▪️Non-restorative sleep
▪️Abnormal sensory processing
▪️Paresthesia (numbness/tingling in hands and feet)
▪️Restless leg syndrome
▪️Difficulty swallowing
▪️Increased frequency of urination and urinary urgency
▪️Difficult menstruation
▪️Anxiety / depression
▪️Migraine headaches

256
Q

What is the appearance of the affected joint after acute gout subsides

A

Joint usually returns to normal

257
Q

😰In the early disease process of rheumatoid arthritis what shape is seen in the fingers

A

Spindle-shaped fingers

258
Q

🚬What positive test results has increased risk of developing reactive arthritis after sexual contact or exposure to certain pathogens

A

HLA-B27

259
Q

In the acute phase, gouty arthritis may be precipitated by what type of triggers

A

Trauma
Surgery
Alcohol ingestion
Systemic infection

260
Q

💉As chronic gout progresses what serum levels increase

A

Serum uric acid levels

261
Q

💊What type of drug may be given to treat fatigue and moderate skin and joint problems in patients with systemic lupus erythematous

A

Antimalarial Agents

262
Q

Diversionary activities for patients with rheumatoid arthritis

A

Imaging
Distraction
Self hypnosis
Biofeedback

263
Q

What injury has been linked to increased risk of knee osteoarthritis

A

Interior cruciate ligament (ACL)

264
Q

Fibromyalgia affects how many Americans

A

> 5 million

265
Q

Fibromyalgia is diagnosed if what two criteria are met

A

▪️Pain/tenderness and 11 of the 18 tender points of palpation.
▪️Widespread pain > 3 months

266
Q

📚During collaborative care of rheumatoid arthritis patient teaching should focus on

A

Drug therapy – methotrexate/steroids
Disease process
Home management strategies

267
Q

📚Teach patients with fibromyalgia to limit the consumption of

A

Sugar, caffeine, and alcohol

268
Q

What type of gout accounts for 90% of all cases and is predominately in middle-aged men

A

Primary gout

269
Q

What type of exercises are encouraged with osteoarthritis💪

A

Aerobic conditioning, our ROM exercises and quadriceps strengthening

270
Q

What type of movement therapies are suggested with osteoarthritis💪

A

Yoga and tai chi

271
Q

💊What OTC topical agents may be used with osteoarthritis

A 
Capsaicin cream (Zostix)
Topical Salicylates (Aspercreme)
272
Q

👉RANDOM👈

To reduce edema after endoscopy what do you want to teach the patient to do for the first 24 hours

A

Ice extremity (no heat)

273
Q

What are the classifications of secondary gout

A

Related to another acquire disorder

274
Q

What does occupational therapy do for the patient with rheumatoid arthritis

A

Develops upper extremity function and encourages joint protection using splints or assistive devices

275
Q

In osteoarthritis when is sitting and getting up from a chair more difficult

A

When hips are lower than knees

276
Q

How is systemic lupus erythematous diagnosed

A

Diagnosed primarily on criteria related to history, physical examination, and laboratory findings

277
Q

Chronic gout can result in

A

▪️Joint deformity ▪️Skin breakdown / infection ▪️Cartilage destruction
▪️Predisposition to secondary osteoarthritis do to cartilage destruction

278
Q

🚬What gender is more likely to have ankylosing spondylitis 👫

A

Men 3–5 Times more likely than women

279
Q

🚬Incidence of rheumatoid arthritis increase with age but peek at what years

A

30 - 50 years

280
Q

What type of red, swollen, and tender nodes are common in osteoarthritis

A

Heberden’s and Bouchard’s

281
Q

When do you want to remove and reapply splints for rheumatoid arthritis

A

Remove splints at regular intervals to give skin care and perform ROM

Reapply splints as prescribed after assessment

282
Q

In patients with rheumatoid arthritis, how many hours of sleep is necessary in addition to daytime rest

A

8–10 hours of sleep

283
Q

💊What may be given for mild to moderate knee osteoarthritis that is given in three weekly injections in the joint space

A

Hyaluronic Acid (HA) Viscosupplementation

284
Q

🚬What gender is more likely to have systemic lupus erythematous👫

A

Women are 10 times more likely

285
Q

How long does morning stiffness last with rheumatoid arthritis

A

For 60 minutes to several hours or more

286
Q

💉Although not specifically diagnostic, serum uric acid increases to what level in gout

A

Serum uric acid increases above 6 mg/dL

287
Q

In patients with rheumatoid arthritis encourage use of assistive devices such as

A 
Build up utensils
Shower chair
Velcro shoes
Raised toilet seat
Cane/walker/wheelchair
Reachers
Straight back chair with elevated seat
Buttonhooks
Modified drawer handles
Lightweight plastic dishes
288
Q

When is joint stiffness common in osteoarthritis and how long does it usually take to relieve

A

Early morning and is usually related within 30 minutes

289
Q

💺In rheumatoid arthritis, joint space narrowing is indicated by what exam

A

Arthroscopic Exam (provides joint visualization)

290
Q

🚬What is a major risk factor for rheumatoid arthritis

A

▪️Positive family history

291
Q

What type of education is needed with osteoarthritis due to an even distribution of stress across the joint

A

Education in motion

292
Q

😰As a extraarticular manifestation of rheumatoid arthritis what appears subcutaneous as firm, nontender, granuloma type mass that is usually located over exterior surface of joints such as fingers and elbows

A

Rheumatoid nodules

293
Q

50% of what age group have at least one joint affected by osteoarthritis

A

People older than 65 years

294
Q

💉An increase in ESR and CRP in rheumatoid arthritis indicate

A

Active inflammation

295
Q

😷 Balance rest and activity with Osteoarthritis. Rest is needed during acute inflammation but immobilization should not exceed

A

One week

296
Q

💊What anti-inflammatory agent may be given with gout

A

Colchicine

297
Q

💉Why are diagnostic labs drawn with fibromyalgia

A

Rule out other suspected disorders

298
Q

🚬What are the risk factors of osteoarthritis

A

▪️Increased age ▪️Estrogen production at menopause ▪️Obesity ▪️Injury ▪️Frequent kneeling and stooping

299
Q

What can help prevent osteoarthritis

A

Regular exercise

300
Q

To manage pain, when do you want to plan care for the patient with rheumatoid arthritis

A

Plan care around patients morning stiffness and perform activities during time of day when patient feels most energetic

301
Q

💉Rheumatoid arthritis is characterized by the presence of autoantibodies against the abnormal IgG. The autoantibodies are known as

A

Rheumatoid factor (RF)

302
Q

💊What drugs are used for early treatment of rheumatoid arthritis

A

DMARD’s and methotrexate

303
Q

What are the leading causes of death in systemic lupus erythematous

A

Kidney involvement

Cardiac involvement

304
Q

😷 Nursing Management of Gout

A

Immobilize Joint
Application of Heat and Cold
NSAID’s / Analgesics

305
Q

When does systemic lupus erythematous tend to worsen

A

In the immediate postpartum period

306
Q

💊Drug therapy for fibromyalgia

A

▪️Non-opioid analgesics ▪️SSRI or benzodiazepines
▪️Low dose tricyclic antidepressants ▪️Muscle relaxants
▪️Zolpidem (Ambien) ▪️Vitamin and mineral supplements

307
Q

😰In what disorder is it often difficult for the patient to discriminate if the pain occurs in the muscles, joints, or soft tissue

A

Fibromyalgia

308
Q

At what location are rheumatoid nodules common in older adults

A

Base of spine and back

309
Q

What is most often implicated in sexually-transmitted reactive arthritis

A

Chlamydia

310
Q

💊Drug used if acetaminophen does not relieve pain in osteoarthritis

A

NSAID’s (Ibuprofen)

311
Q

😰 Clinical manifestations of ankylosing spondylitis

A

Low back pain
Postural deformity
Stiffness
Limitation of motion

312
Q

😰 In ankylosing spondylitis when does limitation of motion worsen and improve

A

Worse at night and in the morning. Improves with mild activity

313
Q

What disease has bilateral and symmetrical joint involvement

A

Rheumatoid arthritis

314
Q

What joints are most frequently involved and septic arthritis

A

Leg joints (knee and hip)

315
Q

🚬What are the risk factors for gout

A

▪️Obesity in men ▪️Family history ▪️Excessive alcohol consumption ▪️Diuretics ▪️Purine rich foods

316
Q

How many Americans are affected by osteoarthritis

A

27 million

317
Q

💊What drug is used to treat chlamydia infection of patients in their partners

A

Doxycycline

318
Q

🍓What foods are high in purine

A

▪️Shellfish / Fish / Sardines / Crabs / Shrimp
▪️Red and organ meats- Beef, chicken, pork
▪️Wine / Beer ▪️Lentils ▪️Asparagus ▪️Spinach

319
Q

😷 What care is needed during acute inflammation of osteoarthritis

A

Rest

320
Q

What is the most common form of joint disease in North America

A

Osteoarthritis

321
Q

In systemic lupus erythematous what may serve as a stimulus for immune hyperactivity

A

Infectious agents

322
Q

💊Drug therapy to relieve pain in osteoarthritis

A

Acetaminophen

323
Q

👉RANDOM👈
Are the following musculoskeletal disorders more common in men or woman
▪️Systemic Lupus Erythematosus ▪️Osteoporosis
▪️Rheumatoid Arthritis ▪️Sjogren’s ▪️Fibromyalgia

A

WOMAN

324
Q

👉RANDOM👈

🍓To prevent constipation after surgery PO fluids are increased to how many ml/per day unless contraindicated

A

2500 mL/day

325
Q

How many joints does osteoarthritis usually affect

A

1 to 2 joints

326
Q

Individual attacks of acute gout, treated or untreated, usually subside in how many days

A

2–10 days

327
Q

What type of gout can range from infrequent mild attacks to multiple severe episodes associated with progressive disability

A

Chronic gout

328
Q

🚬Why are diuretics a risk factor for gout

A

Causes concentration of body fluid which increases risk of developing uric acid crystals

329
Q

🚬Gout is most common in what ethnicity and gender 👫

A

African-American males

330
Q

For joint protection in patients with rheumatoid arthritis what may be prescribed to rest an inflamed joint and prevent deformity from muscle spasms and contractures

A

Lightweight splint

331
Q

💺What type of procedure may be required with septic arthritis

A

Local aspiration and surgical drainage

332
Q

What is the cause of Psoriatic arthritis

A

Exact cause is unknown but appears to have a genetic link

333
Q

💊What drugs for rheumatoid arthritis require administration of TB test and a chest x-ray before initiation of therapy

A

Tumor necrosis factor inhibitors (TNF)

334
Q

💊What do you teach the patients taking TNF drugs for rheumatoid arthritis

A

Stop drug if acute infection develops and avoid live vaccinations while taking the drug

335
Q

😰What is the most common initial complaint in limited scleroderma

A

Raynaud’s phenomenon (Excessively reduced blood flow more common in fingers and toes. Feel numb and cool)

336
Q

💊What medications may be given to prevent further attacks of gout

A

Allopurinol
Probenecid
Febuxostat (Uloric)

337
Q

Chronic gout is characterized by

A

Multiple joint involvement and visible deposits of sodium urate crystals (tophi) after many years of the onset of gout

338
Q

In what years is systemic lupus erythematous most likely to occur

A

During childbearing years

339
Q

💊What are used to promote physical comfort in rheumatoid arthritis

A

NSAID’s

340
Q

😰 What is the most common initial manifestation in acute gout

A

Inflammation of the big toe

341
Q

Process of osteoarthritis

A

New joint tissue forms in response to cartilage destruction ➡️ cartilage becomes dull, yellow, granular, soft, less elastic and less able to resist wear with heavy use ➡️ fissuring/erosion of articular surface ➡️ formation of osteophytes (bone spurs) ➡️ incongruity in joint surface creates and an even distribution of stress across the joint.

342
Q

What is the exact cause of rheumatoid arthritis

A

Exact cause is unknown

343
Q

👉RANDOM👈
In what disorder is there a gradual decrease in respiratory function that leads to use of a CPAP and eventually the need for tracheostomy and mechanical ventilation to sustain respiratory function

A

Muscular Dystrophy

344
Q

👉RANDOM👈
Are the following musculoskeletal disorders more common in men or woman
▪️Gout ▪️Reactive arthritis ▪️Osteoarthritis before age 50
▪️Ankylosing spondylitis ▪️Paget’s disease
▪️Muscular Dystrophy ▪️Indirect Osteomyelitis

A

MEN

Indirect Osteomyelitis (Boys<12)

345
Q

Exercise recommended for fibromyalgia💪

A

▪️Low impact aerobics exercises such as walking

▪️Yoga or tai chi

346
Q

💺X-rays are normal in early stages of gout, but what may appear in chronic disease

A

Tophi

347
Q

What is the most common central nervous system problems associated with systemic lupus erythematous

A

Seizures

348
Q

💊Drug therapy treatment for Psoriatic arthritis

A

▪️️NSAID’s

▪️DMARD’s - methotrexate

349
Q

It is difficult to establish a definitive diagnosis for fibromyalgia, but what may cause delays and diagnosis and treatment

A

Lack of knowledge about the disease and is manifestations among healthcare providers

350
Q

😰Nonspecific clinical manifestations of rheumatoid arthritis

A 
Joint deformity
Anorexia (weight loss)
Generalized weakness
Morning stiffness
Fatigue
351
Q

😷Can you use heat and cold applications with gout

A

Yes, application of heat and cold are nursing implementations of gout

352
Q

What is the cause of systemic lupus erythematous

A

Etiology is unknown

353
Q

🚬What disease sometimes occurs after the onset of menarche, with the use of oral contraceptives, and during and after pregnancy

A

Systemic lupus erythematous

354
Q

Psoriatic arthritis effects what percentage of the 3 million people with psoriasis

A

10%

355
Q

What bacteria or virus has been proposed as a possible antigen for rheumatoid arthritis

A

To date, no infection or organism has been identified as the cause

356
Q

😰What are the symptoms/generalize complaints of systemic lupus erythematous

A

▪️Fever ▪️Limitation of motion ▪️Weight-loss
▪️Arthralgia (joint pain) ▪️Excessive fatigue
▪️Serous Membranes

357
Q

What type of therapy is needed for assistive devices

A

Occupational therapy

358
Q

💉What abnormal laboratory results are found with osteoarthritis

A

There are no specific lab abnormalities.

Wbc <2000 – mild leukocytosis

359
Q

💺What type of diagnostic study differentiates between osteoarthritis and other forms of inflammatory arthritis

A

Synovial fluid analysis

360
Q

💺What test determines if gout is caused by decreased renal excretion or overproduction of uric acid

A

Elevated 24 hour urine uric acid

361
Q

💊In gout, joint aspiration may be performed along with

A

Intra-articular corticosteroids

362
Q

How many people in the US have systemic lupus erythematous

A

2-8 per 100,000

363
Q

What disorder involves neuroendocrine/neurotransmitter dysfunction

A

Fibromyalgia

364
Q

Severe cases of rheumatoid arthritis may require

A

Joint replacement

365
Q

💉Although there is no specific test to diagnose systemic lupus erythematous, what abnormalities may be present in the blood

A

▪️ANA – present and 97% of persons with disease

▪️Anti- DNA ▪️Antinuclear Antibodies ▪️Anti-Smith (Sm)

366
Q

The treatment for fibromyalgia is symptomatic and requires a high level of

A

Patient motivation

367
Q

What type of foods will not cause gout, but can trigger an acute attack if the person is susceptible to gout

A

Purine- rich foods

368
Q

😰What systemic manifestations are present with osteoarthritis

A

Systemic manifestations such as fatigue, fever, and organ involvement are NOT present with osteoarthritis

369
Q

😰What is the predominant symptom of osteoarthritis and the typical reason for seeking medical attention

A

Joint pain

370
Q

Is osteoarthritis symmetrical or asymmetrical

A

Usually affects joints asymmetrically

371
Q

How long does treatment last for septic arthritis

A

2–8 weeks

372
Q

💊What intra-articular injections may be given with osteoarthritis

A

Corticosteroid

373
Q

💊What drugs may be given in systemic lupus erythematous for polyarthralgia or polyarthritis

A

NSAID’s

374
Q

💊What drug should not be taken with rheumatoid arthritis

A

Tylenol

375
Q

😰Upon assessment of what disease would you find dry, scaly rash on face/upper body, fever, joint pain/decreased mobility, pleural effusion (Excess fluid around lungs), nephritis (Inflammation of Kidneys), Pericarditis, abdominal pain, photosensitivity, and hypertension

A

Systemic lupus erythematous

376
Q

💊How is acetaminophen prescribed in osteoarthritis

A

1000 MG Q6 with daily dose not exceeding 4G

377
Q

🚬What factors trigger systemic lupus erythematous

A

▪️Sunlight ▪️Stress ▪️Pregnancy ▪️Drugs

378
Q

🚬What gender is more likely to have rheumatoid arthritis 👫

A

Women

379
Q

😰Effusion (escape the fluid into body cavity) is common in what disease

A

Rheumatoid arthritis

380
Q

Autoimmune etiology suggest that changes associated with rheumatoid arthritis begin when a genetically susceptible person has an initial immune response to antigen that triggers the formations of

A

An abnormal immunoglobulin G (IgG)

381
Q

😰What classic rash may appear over the cheeks in bridge of the nose in systemic lupus erythematous

A

Butterfly rash

382
Q

💊Why would Procainamide and Hydralazine be given to patients with systemic lupus erythematous

A

Seizures

383
Q

💺Arthrocentesis of rheumatoid arthritis show results of

A

Abnormal synovial fluid

384
Q

Is osteoarthritis considered a normal part of aging

A

No, osteoarthritis is not considered a normal part of aging

385
Q

😰What disease has manifestations of dry eyes – decreased hearing, gritty sensation in the eyes, burning, blurred vision, and photosensitivity

A

Sjogren’s Syndrome

386
Q

Non drug pain management for patients with rheumatoid arthritis

A

Moist heat compresses
Whirlpool baths
Hot showers in the morning
Transcutaneous electrical nerve stimulation
Alternating scheduled rest periods with activity throughout the day to help relieve fatigue and pain

387
Q

😰Clinical manifestations of late stages of osteoarthritis

A

Pain with rest.

Sleep is disturbed due to pain and increased joint discomfort

388
Q

Cartilage distraction and osteoarthritis begins between ages 20 and 30 but symptoms do not manifest until after age

A

50–60

389
Q

What can temporarily increase stiffness in osteoarthritis

A

Overactivity

390
Q

Rheumatoid arthritis is progressive deterioration of

A

Connected tissue (synovium) of the joints

391
Q

💺How is the diagnosis of septic arthritis determined

A

Aspiration of the joint and culture of synovial fluid

392
Q

😰What renal system problems may occur with systemic lupus erythematous

A

Nephritis (Inflammation of the Kidneys)

393
Q

75-90% with fibromyalgia or what gender👫

A

Female

394
Q

💊What is taught to the patient taking methotrexate, sulfasalazine, Or leflunomide

A

The drugs are teratogenic. Possibility of pregnancy must be excluded

395
Q

😰What Serous Membranes may occur with systemic lupus erythematous

A

Pleurisy (inflammation of the lining around the lungs associated with sharp chest pain upon inhalation)

Pericardium (enclosing the heart)

396
Q

Rheumatoid arthritis affects how many Americans

A

1.3 million

397
Q

💉In what disease is ANA present

A

Rheumatoid arthritis & Lupus

398
Q

😰What dermatologic problems may occur with systemic lupus erythematous

A

Butterfly rash

Alopecia (hair loss)

399
Q

How many people does ankylosing spondylitis effect

A

7 in 100,000

400
Q

Fibromyalgia can accompany what dysfunction

A

TMJ- Temporomandibular joint

401
Q

90% of patients with Sjogren’s syndrome or what gender👫

A

Female

402
Q

📚Energy conservation techniques taught to patients with rheumatoid arthritis

A 
Simplification techniques
Joint protection devices (electric can opener) use whenever possible
Delegation to family members
Use of carts
Pacing and organizing
403
Q

💉What are hematologic system problems associated with systemic lupus erythematous

A

Anemia
Mild leukopenia- ⬇️WBC
Thrombocytopenia – deficiency of platelets in blood

404
Q

😷 When are cold applications needed for osteoarthritis

A

Ice for Acute inflammation

405
Q

👉RANDOM👈

What are the 5 P’s when performing neurovascular checks

A

▪️Pain ▪️Pallor ▪️Pulse ▪️Paresthesia ▪️Paralysis

☝️If you add “▪️Pressure” to the list, you have the manifestations of Compartment Syndrome.

406
Q

Early stages of osteoarthritis is relieved by

A

Rest

407
Q

💺What diagnostic study is helpful in confirming osteoarthritis and staging the progression by detecting joint space narrowing the, bone sclerosis, and osteophyte formation

A

X-ray

408
Q

🚬What race has a higher incidence of ankylosing spondylitis

A

Caucasians

409
Q

Systemic lupus erythematous is characterized by

A

Chronic and unpredictable course with altering exacerbations and remission

410
Q

😰 In acute gout, joints are extremely tender and appear

A

Dusky and cyanotic

411
Q

💊What drugs may be given with acute gout

A

Colchicine

NSAID’s (acetaminophen) for pain

412
Q

Malalignment and ankylosis are often evidence of what in rheumatoid arthritis

A

Advanced disease

413
Q

💺What procedures do you want to teach the patient with osteoarthritis about that they may need in the future

A

Arthroscopy / replacement

414
Q

💊What drugs may be given for severe cutaneous systemic lupus erythematous

A

Corticosteroids

415
Q

💺Muscle biopsy of fibromyalgia may reveal

A

Nonspecific moth-eaten appearance or fiber atrophy

416
Q

😷 Nursing Management for Psoriatic arthritis

A

▪️Splinting
▪️Joint protection
▪️Physical therapy

417
Q

What does physical therapy do for the patient with rheumatoid arthritis

A

Helps patient maintain joint movement and muscle strength

418
Q

👉RANDOM👈
💺If a woman has a bone scan before age 65 as recommended and the results are normal, how long before another scan is needed

A

15 years

419
Q

💊What COX-2 inhibitor maybe prescribed with osteoarthritis

A

Celecoxib (Celebrex)

420
Q

😰 Onset of acute gout symptoms usually occur at night with what manifestations

A

Low-grade fever
Sudden swelling
Excruciating pain

421
Q

Is rheumatoid arthritis chronic or acute

A

Chronic, systemic autoimmune disease

422
Q

Classifications of primary gout

A

Hereditary

Overproduction/retention of uric acid

423
Q

💊When taking Salmon calcitonin, calcium supplement is necessary to prevent

A

Secondary hyperparathyroidism

424
Q

Who is at high-risk for osteomalacia

A

Morbidly obese

425
Q

😰 Over time, wedging and fractures of the vertebrae produce what clinical manifestations in osteoporosis

A

Gradual loss of height (2 to 3 inches)
Dowagers Hump
Kyphosis

426
Q

Nursing diagnosis for osteomalacia

A

Potential for injury

427
Q

💉Laboratory findings that the nurse would expect to be present in the patient with rheumatoid arthritis

A

Anti-citrullinated protein antibody (ACPA)

428
Q

💊How much calcium is needed in women with osteoporosis taking estrogen

A

1000 mg/day

429
Q

💺On an x-ray, signs suggestive of osteomyelitis usually do not appear until how long after the initial symptoms

A

10 days to weeks

430
Q

💊Drug therapy for acute osteomyelitis

A

Vigorous and prolonged IV antibiotic therapy

431
Q

💉When would you expect a patient with systemic lupus erythematous being treated with corticosteroids to be tapered off of the drug

A

Serum laboratory results show decreased anti-DNA

432
Q

Muscular dystrophy is most commonly seen in what gender👫

A

Males

433
Q

Radicular pain that radiates down the buttock and below the knee, along with the distribution of the sciatic nerve, generally indicates

A

Herniated intervertebral disc

434
Q

Why is osteoporosis common in women

A

Lower calcium intake
Less bone mass – smaller frame
Bone resorption begins earlier and accelerates after menopause
Pregnancy and breast-feeding
Longevity – women live longer
Man age 15 to 50 consume twice as much calcium as women

435
Q

What often occurs in metastatic bone cancer due to weakness of the bone structure

A

Pathogenic fractures

436
Q

Nursing diagnosis for osteomyelitis

A

Acute pain

437
Q

💊How is the vitamin D deficiency corrected and osteomalacia

A

Vitamin D3 and vitamin D2 supplements

438
Q

💺In a radionuclide bone scan for osteomyelitis what area will show positive

A

The area of the infection

439
Q

What is the most common malignant bone tumor

A

Osteosarcoma

440
Q

What type of bone tumors are relatively rare in adults

A

Benign bone tumors

441
Q

😰 Clinical manifestations of Paget’s disease

A 
Bone pain
Fatigue
Progressive development of waddling gait
Enlarged/thickened skull 
Bowed legs
Decreased height
Shortened trunk with long appearing arms
Kyphosis
442
Q

What disease is called the “Silent thief”

A

Osteoporosis

443
Q

😰 Local manifestations of acute osteomyelitis

A

Constant bone pain and relieved by rest or worsens with activity, swelling, tenderness, warmth at infection site, restricted movement of affected part

444
Q

💊Why are corticosteroids given with muscular dystrophy

A

They may halt disease progression for up to two years

445
Q

What is the cause of osteoporosis

A

The cause is unknown

446
Q

💊What therapy is given for women with osteoporosis

A

Hormone replacement therapy

447
Q

What is the treatment for osteochondroma

A

No treatment is necessary

448
Q

What are common sites for metastatic bone cancer

A

Breast, prostate, lungs, kidneys, thyroid

449
Q

What is the most common primary benign bone tumor

A

Osteochondroma

450
Q

💊Medications and treatment for bone cancer

A

Pain medications and radiation

451
Q

🍓Nutrition for Paget’s disease

A

High vitamin D

452
Q

💺How is osteosarcoma diagnosed

A

Tissue biopsy

453
Q

What two metabolic bone diseases are chronic

A

Osteoporosis and Paget’s disease

454
Q

💺What is the most common diagnostic study for osteoporosis

A

Dual energy x-ray absorptiometry (DXA)

455
Q

What is an ominous sign of advanced systemic lupus erythematous

A

Dysrhythmias from fibrosis of the atrioventricular node

456
Q

Nursing diagnosis for Paget’s disease

A

Potential for injury

457
Q

💉Lab test for Paget’s disease

A

⬆️Alkaline phosphatase- normal= 38 - 126

458
Q

💺Diagnostic studies to diagnose osteomyelitis

A

Bone and soft tissue biopsy, blood and wound cultures, x-ray, radionuclide bone scan, MRI and CT

459
Q

What is used to immobilize the effected limb in osteomyelitis

A

Splint or traction

460
Q

Which other extra-articular manifestation of rheumatoid arthritis is most likely to be seen in the patient with rheumatoid nodules

A

Felty Syndrome

461
Q

😰 Clinical Manifestations of Scleroderma

A

Thickening of the skin of the fingers and hands

462
Q

💺How are DXA scores reported

A

T scores

463
Q

What may occur in the presence of a foreign object such as implant or orthopedic prosthetic device (plate, total joint prosthesis).

A

Osteomyelitis

464
Q

What is a direct entry of osteomyelitis

A

Open wound

465
Q

How many men over the age of 50 sustain an osteoporosis related fracture

A

1 in 4

466
Q

What does a positive straight leg raise test indicate

A

Nerve root irritation

467
Q

🍓Foods that are encouraged with osteomalacia

A

Eggs, milk, breakfast cereal with calcium and vitamin D

468
Q

What is the most common complication of Paget’s disease

A

Pathogenic fracture

469
Q

💊What drugs can be given with osteoporosis because it is a good source of calcium and sodium

A

Tums

470
Q

Traction and braces after spinal fusion

A

TLSO or chair back brace

471
Q

🍓High calcium foods that are encouraged with osteoporosis

A

Whole or skim milk, yogurt, turnip greens, spinach, cottage cheese, ice cream, sardines

472
Q

💉Lab test results for osteomyelitis

A

⬆️WBC

⬆️Erythrocyte sedimentation rate (ESR)

473
Q

What is the most common cause of osteomyelitis

A

Staphylococcus aureus

474
Q

Collaborative care for osteomyelitis

A

Surgical debridement or decompression

475
Q

😰 What are the first clinical manifestations of osteoporosis

A

Back pain that radiates around trunk or spontaneous fracture

476
Q

What regions are affected by Paget’s disease

A

Pelvis, long bones, spine, ribs, sternum, cranium

477
Q

💊How much calcium is needed in postmenopausal women with osteoporosis who are not taking estrogen

A

1500 mg/day

478
Q

😰 Manifestations of osteomalacia

A

Bone pain
Difficulty rising from a chair
Weakness
Kyphosis

479
Q

Metastatic bone cancer travels from tumors to the bone via

A

Lymph and blood supply

480
Q

😰 Systemic manifestations of acute osteomyelitis

A

Fever, night sweats, chills, restlessness, nausea, malaise

481
Q

What is used in muscular dystrophy to prevent deformity

A

Orthotic jacket

482
Q

Indirect entry of osteomyelitis is more frequent in what age group and gender👫

A

Boys younger than 12

483
Q

Is degenerative disc disease (DDD) a normal part of aging

A

Yes, DDD is a normal part of aging

484
Q

Pillow placement after a lumbar fusion

A

Pillows under the thighs of both legs in between legs

485
Q

How long does it take for disc damage to heal

A

Six months

486
Q

Why is chemotherapy used preoperatively with osteosarcoma

A

To decrease tumor size

487
Q

💊Drug therapy for chronic osteomyelitis

A

Oral therapy with a fluoroquinolone (Cipro)

488
Q

Risk factors for osteoporosis👫

A 
Over age 60. 
Female (post menopause). 
Low bodyweight. 
White or Asian. 
Smoking. 
Low testosterone for men
489
Q

What do you want to assess when there is a compression fracture of the spine

A

The ability to void and defecate

490
Q

💺X-ray of osteomalacia will show

A

Porous bones

491
Q

Nursing diagnosis for osteoporosis

A

Acute/chronic pain

492
Q

What palliative therapy is given to shrink tumor and decrease pain

A

Radiation

493
Q

In Paget’s disease new bone is larger, disorganized, and structurally weaker because normal bone marrow is replaced by

A

Vascular, fibrous connective tissue

494
Q

😷 Management for osteomalacia

A

Correct vitamin D deficiency
Exposure to the sun
Administer analgesics

495
Q

What is the most common type of muscular dystrophy

A

Duchenne

496
Q

Multiple nerve root compression’s from a herniated disc, tumor, or an epidural abscess is a medical emergency and maybe manifested as

A

Bowel or bladder incontinence

497
Q

What are the causes of osteomalacia

A

Lack of exposure to UV rays
G.I. Malabsorption
Drug – Dilantin

498
Q

💺When is a bone scan recommended for men and women

A

Women – before age 65

Men – before age 70

499
Q

What gender is affected 2:1 in Paget’s disease👫

A

Men

500
Q

💺What is the definitive way to determine the causative micro organism in osteomyelitis

A

Bone and soft tissue biopsy

501
Q

💊How long is a patient with acute osteomyelitis on IV antibiotic therapy

A

4 to 6 weeks or as long as 3 to 6 months

502
Q

What are positive results of a straight leg raise test

A

Back or leg pain by raising leg and flexing foot 90°

503
Q

What brace may be used to maintain the spine in proper alignment after a fracture or treatment of vertebral fracture

A

Thoracic lumbar sacral orthosis (TLSO)

504
Q

How many women sustain an osteoporosis related fracture

A

1 in 2

505
Q

How many people in the US have osteoporosis

A

Over 44 million

506
Q

💊Calcium is given in divided doses with food because it is difficult to absorb in single doses greater than

A

500

507
Q

What is an indirect entry of osteomyelitis

A

Blunt trauma

508
Q

Foot disorders want to be immobilized by

A

Bulky dressing, short leg cast, slipper (plaster) cast, or bunion boot

509
Q

The most common type of malignant bone tumor occurs as a result of metastasis from

A

A primary tumor located at another site

510
Q

What are the three metabolic bone diseases

A

Osteomalacia
Osteoporosis
Paget’s disease

511
Q

😷 Nursing Management for Paget’s disease

A

Administer analgesics
Increase sun exposure
Encourage rest
Prevent pathogenic fractures by using safety precautions

512
Q

💺What T score is diagnostic of osteoporosis

A

BMD -2.5 or lower

513
Q

Complications of Paget’s disease

A 
Uncontrolled pain
Fractures
Psychosocial issues
Immobility
Decalcification of bones
514
Q

Collaborative care for Paget’s disease

A

Symptomatic and supportive care

From Flashcardlet (47 decks)

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