Adult Musculoskeletal Flashcards
(42 cards)
1
Q
Fat embolism
A
- occurs within 48 hours following long bone fractures
- HYPOTENSION
- fever
- petechiae = reddish-purple spots
- not seen in pulmonary embolism
- symptoms mimic pulmonary embolism
- respiratory distress
- tachypnea
- low oxygen saturation
- tachycardia
- chest pain
- IMMOBILIZATION LOWERS RISK
2
Q
Huntington’s disease
A
- muscle atrophy and contractures
- give range of motion exercises
3
Q
Rheumatoid arthritis (RA)
A
- symmetrical joint involvement
- bilateral joint pain and swelling
- fatigue
- low-grade fever
- morning stiffness
- weight loss
- recommend handheld shower head
- give NSAID
- pain relieved by splint
4
Q
Parkinson’s
A
- blurred vision (not diplopia)
- emotional lability
- exaggerated changes in mood
- fatigue
- muscle incoordination
- dyphageia
- increase risk of aspiration and pneumonia
- dyphageia
- urinary urgency
5
Q
Myasthenia gravis
A
- muscle weakness
- risk for impaired gas exchange
- diplopia
6
Q
Myasthenia gravis care
A
- noninvasive mechanical ventilation
- thymectomy can help
7
Q
Multiple Sclerosis (MS)
A
- vision changes
- diplopia
- mood changes (lability)
- fatigue
- diminshed response to pain!
- muscle spasms and poor control
- heat sensitivity!
- urinary urgency
loss of myelin sheath on nerve
8
Q
Thymectomy
A
- removal of thymus
- monitor respiratory status
- ensure a bag-valve mask is available
9
Q
Thyroidectomy care
A
- calcium gluconate should be available because of the risk of severe hypocalcemia
- numbness/tingling/twitching
- tracheostomy kit because of the risk of airway edema
10
Q
Traction care
A
- avoid keeping the pulley system tight
- no weight on bed/floor
- weights 5-10 lbs
- overhead trapeze
- elevate feet to 10-20 degrees (prevent sliding)
- DO NOT ELEVATE HOB
- if pale, cold, unpalpable pulse
- indicate circulatory impairment
- NOTIFY PHCP
11
Q
Fiberglass
A
- waterproof synthetic casting material
- can dry and become rigid within 30 minutes
12
Q
Myopathy
A
- elevated creatine levels
- encourage active ROM exercises to prevent stiffness
13
Q
Continuous passive motion (CPM)
A
- use in total knee replacement
- flex and extend knee
- reduce scar tissue formation
- maintain joint mobility*
14
Q
Erythrocyte sedimentation rate (ESR)
A
- marker for inflammation
- elevated in osteomyelitis
15
Q
Osteomyelitis
A
- inflammation of the bone
- caused by staphylococcal bacteria
- follows respiratory or gastro infection
- fever greater than 101F(38.3C)
- antibiotics (6-12 weeks)
- elevated ESR
16
Q
Osteoarthritis
A
- Heberden nodes
- pea sized bony bumps on fingers close to nail
- Brouchard node
- bony bumps on middle joint of finger
- morning stiffness
- give NSAID
- pain relived by splinting
17
Q
Paget’s disease
A
- bones become weaked and deformed
- common areas are skull, pelvis, spine
18
Q
Asterixis
A
- hand flopping tremor
- nitrogenous waste buildup
- End stage renal disease (ESRD)
- hepatic encephalopathy
- drug intoxication with phenytoin
19
Q
Lumbar puncture
A
- used to obtain cerebrospinal fluid (CSF)
- diagnose meningitis
- encourage fluids
- positioned lying flat for several hours
- CONTRAINDICATED if increased ICP
20
Q
Halo fixator device
A
- pins in skull, maintain spinal alignment
- report infection or drainage
- can be osteomyelitis (cranial bone infection)
- wrench should be fixed to front of chest in case CPR
- roll on side and push to get up from bed
- cotton clothes worn under vest
- no lotion/powder used
- give straws for drinking
- cut food into small pieces
21
Q
Avulsion fracture
A
- fracture that pulls part of bone from tendon or ligament
22
Q
Complete fracture
A
- whole cross section of bone
23
Q
Greenstick fracture
A
- affects only one side of bone
24
Q
Polyarthritis
A
- seen in rheumatic fever
- give NSAID or steroid
- naproxen
25
Prolonged immobility can causes
- decrease bone density
- atelectasis
- high calcium level
26
Ganglion cyst
- benign tumors
- round and non-tender
- usually on wrists
27
Pilar cyst
- fluid filled cyst found in hair follicle (scalp)
28
Osteoporosis
- decrease in bone mass = monitor for fractures
- increased risk in
- postmenopause
- asian/white/women
- men over 70 y/o = low testosterone
- excessive smoking/drinking
- encourage weight-bearing, calcium, vitamin D
29
Laminectomy
- spine surgery = applies for all spinal surgeries
- LOCATION LOCATION LOCATION
- Cervical = neck
- Thoracic = upper back
- Lumbar = lower back
30
Cervical laminectomy
- supplies the diaphragm and the arms
- pre-op
- first, assess for breathing
- next, check functions of arms/hands
- post-op
- monitor for pneumonia
- permantely cannot lift over your head
31
Thoracic laminectomy
- supplies gut/abdominal muscles
- prpe-op
- assess cough and bowels (cannot cough when you cannot contract abs)
- post-op
- pneumonia and paralytic ileus
32
Lumbar laminectomy
- lumbar supplies bladder and legs
- pre-op
- assess for urinary retention/last void/empty bladder
- evaluate leg functions
- post-op
- urinary retention
- leg problems
- Lumbar = Legs, Urinary retention
33
Postop Laminectomy
- LOG ROLL for 6 weeks
- do not dangle
- supine to walking ASAP
- sit for 10-15 min MAX to avoid orrthostatic hypotension
- no more than 30 min
- dont drive for 6 weeks
- dont lift more than 5 pounds for 6 weeks
- never again lift with waist
- no jerking = no amusement park, horse riding, trail biking
34
Cheiloplasty
- cleft lip repair
- causes excessive secretions = aspiration risk
- ensure suction equipment available
- never lay prone
35
Cleft palate repair
- place prone to promote drainage of secretions
36
Micrognathia
- undersized jaw
37
Choanal atresia
- nasal opening clogged by soft tissue or bone
38
Osteomalacia
- bone softening from low Vitamin D levels
- monitor for fractures
- most common cause is malnutrition
- similar to osteoporosis
39
Knee arthroplasty
- require crutches
- high risk for venous thromboembolism
- resume anticoagulants for 14 days
40
Carpal Tunnel Syndrome (CTS)
- give NSAID
- pain relieved with splinting
- just like osteoarthritis, rheumatoid arthritis
41
Rheumatoid arthritis (RA) vs Osteoarthritis (OA) vs Carpal tunnel syndrome (CTS)
42
Contracture
- permanent tightening of muscles, tendons, and skin
- joints shorten and become stiff
- joints can’t achieve full ROM
- results from
- disuse of muscle
- atrophy
- shortening muscle fibers
