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NURS241 Med Surg 2 > Med Surg 2- Musculoskeletal Exam > Flashcards

Med Surg 2- Musculoskeletal Exam Flashcards

(72 cards)

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1
Q

Ibandronate (Boniva)- Biophosphonates

A

For osteoporosis, osteoarthritis
Take on empty stomach 1st thing in morning, sit up 30 min after taking, take on same day weekly/monthly

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2
Q

Estrogen (hormone therapy)

A

Osteoporosis, osteoarthritis
At risk for blood clots

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3
Q

Ibuprofen
Naproxen

A

NSAIDs for RA pain

At risk for Gi distress, bleeding, strokes

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4
Q

Prednisone (corticosteroid)

A

Immunosuppresion- avoid large crowds and sick people

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5
Q

Methotrexate (DMARD)

A

Used for RA

Use contraception- can cause birth defects, abortion, death; avoid alcohol

Leukopenia, thrombocytopenia; will have increased creatinine and LFT

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6
Q

Hydroxychloroquine (DMARD)

A

retinal and corneal damage- must have regular eye exams every 6months

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7
Q

BRM’s (Biologic Response Modifiers)

A

Decreased immune response- avoid large crowds and sick people

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8
Q

Alloprurinol

A

CHRONIC antigout drug

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9
Q

Colchicine

A

ACUTE gout pain

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10
Q

Gabapentin

A

Used for phantom limb pain

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11
Q

Monoclonal Antibodies- Belimumab

A

Management of SLE (lupus)

Assess/check the CBC values (lower)

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12
Q

Heparin

A

Blood thinner used to prevent DVT and PE

Check PTT

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13
Q

Arthrogram

A

xray with contrast dye to visualize joint (knee)

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14
Q

Arthoscopy

A

diagnostic surgical procedure in which firbo-optic tube inserted for direct visualization

AFTER SURGERY- elevate extremity 12-24 hrs, apply ice

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15
Q

Osteoporosis

A

A condition in which the body’s bones become weak and break easily.

genetically linked

gentle in handling, give pt time

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16
Q

osteomalacia

A

softening of the bone due to vit. D deficiency

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17
Q

Ca and P relationship

A

when calcium rises, phosphorus drops

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18
Q

When collecting HH, ask about these drugs

A

Prednisone- fragile bones

Statins- achilles tendon rupture

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19
Q

What puts stress on joints

A

Weight

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20
Q

Gout has a genetic link with

A

osteoporosis

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21
Q

ALP level

A

30-120

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22
Q

Normal platelet count

A

150,000-400,000

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23
Q

Normal WBC

A

5,000-10,000

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24
Q

Normal ESR

A

anything above 20 means inflammation, 0-20

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25
MRI
allergy to shellfish/iodine remove metals and jewelry Increases fluids to flush out contrast after procedure
26
CMS
circulation, motion, sensation
27
One cause of osteoporosis
Phosphorus in carbonated drinks
28
What to get on admission
Height, weight
29
What is best exercise?
Walking
30
Osteomyelitis
infection of the bone Increased WBC, ESR, positive blood cultures (B4 antibiotics)
31
Bone tumors/cancer
usually metastasized from another area, leads to amputation and usually fatal Most common type is osteosarcoa- focus on pain mainagement
32
RICE
rest, ice, compression, elevate
33
Gout
a type of arthritis characterized by deposits of uric acid crystals in the joints elevated ESR and CRP (c-reactive protein) can happen in other parts of body not only feet
34
Gout treatment
Encourage fluids, decrease alc and purines in diet tylenol, NSAIDs
35
Post-Op Hip Replacement
Pillow between legs, prevents Adduction & dislocation Encourage fluid intake, prevents DVT prevent 90 degree flexion, legs always straight, HOB 30 degrees prehab for exercises check circulation every hour!
36
Post-op, what to watch for
Delirium in elderly
37
Assistive devices for hip surgery
Walker, cane goes on stronger/unaffected side
38
RA factor testing
unusual antibodies in IGG- indicates connective tissue disease no single test confirms
39
What elevates blood sugar
steroids
40
fatty embolism syndrome
life-threatening! bone breaks and fat from inside bone can become a clot and travel through bloodstream early s/s- hypoxemia, dyspnea, tachypnea
41
Acute compartment syndrome
Swelling in a confined space that produces dangerous pressure; may cut off blood flow or damage sensitive tissue- serious edema! S/S- 6 P's
42
Post- Op nursing interventions
ABCs Assess patient CMS Neuro checks q1hr
43
Treating phantom limb pain
gabapentin
44
What to do if pt has traction on post-op
if weights are messed up, call ortho tech or provider
45
S/S Lupus
fever, fatigue, pain, butterfly rash, vasculitis, alopecia in women
46
What to do with open bone fracture
cover with clean/sterile gauze possibly splint, cover, ice, remove jewelry
47
Emergent managing fracture
remove clothing (NOT SHOES), jewelry, CMS, control bleeding, cover
48
Biphosphonates
slows bone resorption and may cause GI upset
49
Fat embolism s/s
tachycardia, dyspnea
50
Neurovascular assessment
CMS hourly
51
Increased fracture healing diet
healthy diet (vit. B/C, iron, high protein/calories)
52
BMRIs
decreased immunity- increased infections
53
rheumatoid arthritis s/s
pain, limited ROM, swelling, fatigue, low grade fever (body attacks itself)
54
Calcium foods
dark leafy green veggies, dairy
55
RA determining labs
RA factor (IGG), ANA
56
sign of osteoporosis
Kyphosis (change in height with humpback)
57
Signs of fracture
serous drainage, weeping, edema
58
What foods cause increased calcium excretion
high protein, caffeine, carbonation
59
Dietary supplements for aid in treatment for osteoarthritis
Glucosamine and chrondoitin (bioflex) (OTC)
60
Whats linked to Alkaline phosphate (ALD)
metabolic bone disease, bone cancer, problems with liver
61
When is osteoporosis diagnosed
T-score is at or lower than -2.5
62
S/S of osteomyelitis
Pain Pallor Puslelessness Paresthesia Paralysis Poikilothermia
63
Bone healing stages
Stage 1-Hematoma formation within 48 to 72 hr. after injury Stage 2-Hematoma to granulation tissue (3 days to 2 weeks) Stage 3- Callus formation (3-6 weeks)-the beginning of a non-bony union (bump on fracture) Stage 4- Callus is resorbed and transformed into bone. Stage 5- Consolidation & remodeling of bone.(4-6 weeks /1 year)
64
Closed reduction
manipulation of the bone fragments without surgical exposure of the fragments
65
Open reduction
surgical realignment of broken bone ends
66
Bandages, splints, and boots/shoes
Assess CMS Plaster cast- will feel burning sensation due to chemical hardening, normal reaction
67
Traction
CMS checks Buck's traction- velcro boot being pulled
68
Skeletal traction
Screws inserted into surgical site Pin care q8hr to prevent infection
69
carpal tunnel syndrome
caused by repetitive hand movements can wear wrist brace
70
Rotator cuff injury s/s
limited ROM, shoulder pain, weakness, loss of function, muscle atrophy
71
Who is at increased risk for osteoporosis
Chinese american woman *Older caucasian woman more at risk for injury (bone mass decreases)
72
Dupuytren's contracture
Thickening and shrinking of the fascia of the palm with fingers being drawn into a flexed position

NURS241 Med Surg 2 (3 decks)

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