Exam 3, Part 2 Flashcards

(36 cards)

1
Q

post-op assessments for prevention of complications

A
respiratory status
CV status
temp
fluid status
wound site
GI status (N/V or decreased bowels)
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2
Q

management of shock

A
  • keep flat with legs elevated
  • O2
  • vitals, HCT, and blood gas
  • maintain temp
  • maintain volume
  • medication administration
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3
Q

when should you remove an oral airway

A

when gag reflex returns

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4
Q

prevention of dehiscence/ evisceration

A

teach the patient splinting

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5
Q

what to do in the case of evisceration

A

find sterile lap pad and cover it; do not push contents back in

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6
Q

important pre-op assessments

A
  • make sure they have actually fasted

- anticoagulants

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7
Q

risk factors for osteoporosis

A
ACCESS
alcohol use
corticosteroids
calcium low
estrogen low
smoking
sedentary lifestyle
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8
Q

clinical manifestations of osteoporosis

A

lordosis or kyphosis, bone loss of 25-40% must occur efore it can be identified on an xray

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9
Q

diagnosis of osteoporosis

A

bone density scans starting at age 40

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10
Q

best exercise for osteoporosis

A

walking (it is weight bearing but not high impact)

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11
Q

medications for osteoporosis

A
  • Fosamax (Alendronate): sit upright for 30 mins and take on empty stomach, these drugs are very absorbant and will get stuck and cause erosion in the esophagus
  • Boniva: once a month
  • Calcitronin: s/e GI upset, inflammation at injection site; monitor serum calcium
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12
Q

complications of osteoporosis

A
  • hip fractures
  • T8 and below fractures
  • spinal compression and shortened stature
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13
Q

calcium and vitamin D sources

A
  • calcium: spinach, fish, orange juice, oatmeal, fortified cereals
  • vitamin D: milk, yogurt, eggs, cheese, fish
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14
Q

childhood diseases that could result in osteoporosis

A
  • juvenile idiopathis arthritis

- osteogenesis imperfecta

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15
Q

paget’s disease

A

excessive bone destruction occurs with replacement of bone by fibrous tissues and abnormal bone, most commonly affecting skull, femur, pelvis, and vertebrae

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16
Q

clinical manifestations of paget’s disease

A
  • bowing of the legs
  • waddling gait
  • pain, tenderness, and warmth over bones
17
Q

Tx of paget’s disease

A
  • *NSAIDS
  • Cacitonin
  • Fosamax
18
Q

complication with skeletal traction

A

more likely to get infections

-low grade fever, abscess around the pin with green, smelly drainage

19
Q

nursing diagnosis for a patient with musculoskeletal problems and/or an ambulation device

A
  • activity intolerance
  • impaired mobility
  • risk for falls
20
Q

when is a brace used for scoliosis

A

for 25-45 degree abnormalities, anything greater requires surgery

21
Q

clinical manifestations of DDH

A
  • one leg shorter than the other
  • restricted abduction of the hip
  • unequal gluteal folds when infant is prone
  • if bilateral dislocations: waddling gait and marked lordosis
22
Q

tests for DDH

A
  • ortolani test- move the leg out (abduct)
  • barlow test- move the leg in (adduct)
  • trendelenburg- greater trochanter is prominent and appears above the line from the anterosuperior iliac spine to the tuberosity of the ischium
23
Q

therapeutic management of DDH in infants newborn to 6 months

A

pavlik harness

24
Q

care of a child in a pavlik harness

A
  • provide skin care
  • check 2-3 times a day for redness
  • gently massage the skin once a day
  • avoid lotions and powders
  • diaper under straps
  • remove for bathing
25
test for juvenile idiopathic arthritis
slit lamp eye exam: find iridocyclitis and uveitis (inflammation of the uvea- middle later of the eye that consists of the iris, ciliary body and choroid) -this is unique to JIA
26
pathophys of JIA
- chronic inflammation of the synovium with joint effusion - destruction of cartilage - ankylosis (stiffening) of the joints as the disease progresses
27
goals of therapy for JIA
preserve function, prevent deformities, and relieve symptoms
28
main therapy for JIA
NSAIDS and pool exercises
29
systemic lupus erythematosus
- chronic, multi-system autoimmune disease of connective tissues and blood vessels - characterized by inflammation - symptoms are variable and unpredictable - most common in girls age 10-19
30
therapies for osteosarcoma
- radical resection or amputation of area - limb-salvage procedures with prosthetic replacement - chemo accompanying surgery
31
therapes for ewings sarcoma
- irradiation is first approach - chemo is adjunct to irradiation - sometimes surgical resection
32
where do you find ewings sarcoma
in the marrow (femur, tibia, ulna, humerus, vertebrae, pelvis, scapula, ribs, skull
33
treatment of osteomyelitis
antibiotics for 6-8 weeks
34
Legg-calve-perthes disease
- self-limiting, idiopathic in children age 3-12 years | - avascular necrosis of the femoral head
35
clinical manifestations of legg-calve-perthes disease
- insidious onset - may have limp - soreness or stiffness - limited ROM - vague history of trauma
36
goal of treatment for legg-calve-perthes disease
keep the head of the femur in the acetabulum