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Acute and Chronic > Joint Replacement/Assessment > Flashcards

Joint Replacement/Assessment Flashcards

Exam 1 (96 cards)

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1
Q

ROM
Pain
Joint deformity

A

assessment for joint replacement

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2
Q

When pt has pain in the jont what should you look?

A

effusion, redness, and warmth (active inflammation

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3
Q

During the _______ __________ the patient may have __________ on palpation or when putting the joint through ________ __ ________

A

joint examination
tenderness
range of motion

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4
Q

t/f should you force a joint during ROM

A

false

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5
Q

The buildup of excessive ____ ______ that restricts joint motion and _________ ability.

A

Arthrofibrosis

scar tissue
functional

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6
Q

Severe pain and __________ often interfere with ___________ and self-care

A

deformity
ambulation

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7
Q

The presence of excess joint fluid especially common in the _____.

A

joint effusion

knee

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8
Q

A grating sound caused by loosened bone and _______ in a synovial joint

A

crepitus

cartilage

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9
Q

joints should move ___________ no grating should be heard

A

smoothly

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10
Q

__________ typically a result of a known event or condition that directly __________ cartilage or causes joint __________

A

osteoarthritis

directly damages
instability

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11
Q

which is the most commmon form of arthritis?

A

osteoarthritis

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12
Q

why would you get a joint arthroplasty?

A

impaired mobility, persistent pain, and disability

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13
Q

occurs less often than primary disease and can result from joint injury and obesity

A

Secondary OA

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14
Q

Injury to the ______ from excessive use, trauma, or other joint disease (e.g., ___________ __________) predisposes a person to OA

A

joints
rheumatoid arthritis

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15
Q

Joint arthroplasties are often ________, knee, and some shoulders

A

hips

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16
Q

Replaced mostly with ______ __________ ________ and polyethylene, ________

A

high density metal
ceramic

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17
Q

t/f should pt be optimal health prior to surgery

A

TRUE

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18
Q

what may be prescribed prior to surgery to increase hemoglobin

A

Epoetin alfa

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19
Q

what would you do if a surgery is not emergent?

A

make efforts to get pt to optimal health

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20
Q

Hypertension and _________ and chf and will need to stabilizes before surgery

A

diabetes

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21
Q

t/f Epoetin alfa may be given instead of giving blood products

A

TRUE

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22
Q

________ ____ _____________ is a replacement of a severely ___________ hip with an artificial joint

A

total hip arthroplasty

damaged

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23
Q

what are some diseases that might cause you to get a total hip arthroplasty

A

osteoarthritis, rheumatoid arthritis, femoral neck fractures

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24
Q

Pt and family will need to ___________ for life at home

A

accommodate

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25
t/f to have a toal hip arthroplasty the pt must have irreversibly damged hip joints and the potential benefits much outweight risks
TRUE
26
during a hip fracture a leg will...
shorten exrernal rotation adduction
27
older in age female history of osteroporsis decrease estrogen related to metaphase increase falls history of chronic conditions TIA's anemia medication cardiovascular disease
risk factors that increase the likihood that a pt may have hip fracture
28
Interventions for hip fractures
bucks traction, immobility ( trochanter roll or sand bags) surgery - internal fixation
29
surgically implanted devices applied directly to fractured bone segments to keep them temporarily or permanently in place.
surgery - internal fixation
30
t/f pt are at a high risk for venous thrmoembolism
true should take measures to prevent DVT
31
Stop meds that increase risk at least 1 wk before (unless emergent surgery) – will stop _________ _______ and ______ and OTC meds
blood thinners herbals
32
what pulse should you assess before and after surgery?
Assess distal pulses for arterial flow and compare to prior
33
t/f Intermittent compression device (SCUDS) intraop/postop don't help to prevent dvt
false
34
what should you take to for the prophylaxis of deep vein thrombosis (DVT) after surgery
LMWH (Lovenox)
35
what increases the risk for venous thromboembolism?
- Advanced age - obesity - preoperative leg edema - previous history of any VTE - varicose veins
36
may be applied before surgery to help decrease pain
skin (Buck) traction
37
t/f Most commonly done in hip replacements before surgery is when buck’s is used
TRUE
38
involves the use of a Velcro boot belt, or halter, which is usually secured around the affected leg
Buck traction
39
post op hip fracture what should you look for?
- sever pain - inability to move leg - shortening & external rotation of the leg
40
- dvt - bleeding, swelling - pulmonary complication (atelectasis_ - pressure ulcer - urinary retention
post op complications of hip fracyure surgery
41
Some fractures _____ achieve union; that is, they never completely _______ (________)
never heal nonunion
42
- coughing and deep breathing - stocking and compression devices - turn q2h - maintain leg abduction - neuro status check - pain contril - mobilize ASAP - check under client for drainage
Nursing care intervention for post op hip fractures
43
you will hear what when a joint comes out?
you will hear a pop
44
Infection_________ before surgery will delay surgery
2-4 weeks
45
what will you ask a patient to do before surgery to prevent infection?
Shower with antiseptic soap
46
what may a patient take to prevent infection after surgery and before a dental procedure?
Prophylactic antibiotics prior
47
what may a pt be given before surgery to decrease risk of infection?
prophylactic broad-spectrum antibiotics
48
if a pt has to have a foley what may you be worried about
CAUTI and this is why you want the foley out ASAP
49
a pt acuquires an infection in the no affected joint what my this cause the patient to do?
Persistent infection of a joint may require another replacement
50
how long should a pt be on an anticoagulant post op?
6 weeks post op to prevent dvt
51
- Dislocations - Excess _______ drainage - Heel pressure ulcers - Avascular necrosis (_____ ______ _ ___) - _________ of prosthesis
other issues that arise from post op wound cell death of bone Loosening
52
On all post op- want early _______ to prevent ___________!
mobilization complications
53
what will an older pt absolutely need to get post op?
Older patient will definitely need pressure reducing mattress
54
what may occur post op?
pt may be constipated
55
__________ position with his or her head slightly elevated
supine Preventing Dislocation of the Hip Prosthesis
56
_______ splint, a wedge pillow placed between the legs __________ ________ beyond the midline of the body.
abduction prevent adduction Preventing Dislocation of the Hip Prosthesis
57
hip is never flexed ____ _____ ___ degrees.
more than 90 Preventing Dislocation of the Hip Prosthesis
58
When turning patient keep the ________ hip in abduction
operative Preventing Dislocation of the Hip Prosthesis
59
When using fracture bedpan nurse reminds patient to flex the __________ __and to use the ______ __ _____the pelvis onto the pan.
unaffected hip trapeze to lift Preventing Dislocation of the Hip Prosthesis
60
On ______ times out of bed abduction pillow is _____ ___.
initial left in Preventing Dislocation of the Hip Prosthesis
61
full flexion (_________) , adducted (legs together), and _______rotated.
risj for dislocation when bending internally
62
t/f post op THA you want legs to be together when ambulating or moving
false you want something inbetween
63
away from midline
abduction
64
towards midline
adduction
65
t/f you should bend affected him more than 90 degrees
FALSE
66
t/f when lying on your back do NOT roll or turn your affect leg towards the other leg or turn your toes in ward?
TRUE
67
t/f you should let the toes of your affect leg turn downward?
FALSE you should not
68
t/f when lying on your side, keep the affect leg outside the midline of the body?
TRUE
69
t/f you can bend over to pick up objects post THA
FALSE
70
t/d do not rotate your leg when standing. Keep leg straight.
TRUE
71
t/f you can cross your legs when sitting?
FALSE
72
t/f keep leg in extention when getting up?
TRUE
73
t/f you should pivot on affected leg
FALSE pivot on unaffected leg
74
High-seat (orthopedic) chairs, __________ wheelchairs, and ________ toilet seats to prevent ________
semi-reclining raised flexion
75
Nurse protects leg from _________, flexion, ________ or _________ rotation, or excessive weight ________
adduction interal or external bearing
76
t/f a pt post op THA can put on shoes and socks
FALSE
77
t/f a pt will be able to go back to normal ADL without assistance or modifications
FALSE Will need someone to go to home to assess for need for modification- bath seat- elevated. Elevated toilet seat.
78
what will a pt need post op to gain some indepence?
rehab/PT/OT
79
__ __ __ _____is when the highest risks for the hip to come out
8 to 12 weeks
80
- Increased pain at the surgical site, ______, and immobilization - ________ ______ pain in the affected hip or increased discomfort - ___________ of the affected extremity - Abnormal external or internal rotation of the _____ extremity - Restricted ability or _________ to move the leg - Reported “________” sensation in the hip
S/S of dislocation swelling Acute groin Shortening affected inability popping
81
t/f if pain is bad and leg is rotated odds are you should not be concerned?
FALSE you SHOULD be concerned
82
you get a pt up post op and they complain of lightheadness, they are experincing...
Orthostatic hypotension
83
t/f a pt will have a weight bearing limit post op?
TRUE
84
t/f a pt may begin to ambulate within 24 hours after surgery
TRUE
85
t/f you should notify the surgeon of excessive or foul-smelling drainage?
TRUE
86
driange of 200 to 500 in the first 48 hours is expected?
FALSE it is normal the first 24 hours not 48
87
t/f a drain is usully removed within the first 24 hours post op
TRUE
88
t/f a there is no risk DVT after a TKA?
FALSE there is a risk
89
what can help decrease the risk for DVT?
Lovenoz (LMWH)
90
t/f Prophylactic antibiotics are only given for THA
FALSE Prophylactic antibiotics are also given for TKA
91
t/f pt shoul flex foot frequently
TRUE
92
t/f ice packs are used to control bleeding and swelling?
TRUE
93
t/f Assess neurovascular status (pulse, color )frequently
TRUE
94
when would a continuous passive motion machine be place post TKA
placed right after surgery
95
The ______ is usually protected with a knee __________ and is elevated when the patient sits in a chair
knee immobilizer
96
t/f pain post op of TKA is worse than a THA
FALSE hip pain is worse

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