MSK

Question 1

With aging, bone calcium loss can result in:

Answer 1

Fractures

Question 2

Joint stiffness and pain is the result of:

Answer 2

Articular cartilage wearing down

Question 3

Falls can indicate:

Answer 3

Muscle strength declines

Question 4

Other factors of the aging MSK are:

Answer 4

Decreased elasticity of ligaments/tendons/cartilage
Posture/gait changes
Poor nutrition/hormone loss
Occupational hazards (cartilage loss)

Question 5

What should be included in nursing history?

Answer 5

Mobility/assistive devices
Psycho-social info
Adls
Joint pain assessment
Previous MSK injury/congenial defect
Nutrition/wt. assessment
Potential risk factors

Question 6

During physical exams you should compare _______ to the _________

Answer 6

Affected extremity to unaffected extremity

Question 7

Pain unrelieved by narcs should be:

Answer 7

Reported to RN/Dr.

Question 8

Abnormal capillary refill is about how many seconds?

Answer 8

Anything over 3-5 seconds..report to Dr.

Question 9

Peripheral pulses should be _____ to the injury

Answer 9

Distal

Question 10

During an edema assessment, you assess:

Answer 10

Inflammation & fluid status I.e. WNL, +1 +2 +3 +4 & pitting

Question 11

Tingling/paresthesia/numbness/absence of sensation are apart of:

Answer 11

Assessing sensory nerves

Question 12

Limited or absent refers to

Answer 12

assessing motor nerves

Question 13

Describe the pain assessment factors

Answer 13

Location, duration, interventions/effectiveness, quality/severity (0-10), precipitating factors, when pain started, radiation

Question 14

This is a pain reliever

Answer 14

Analgesic

Question 15

What are some diagnostic tests for MSK?

Answer 15

Calcium total (Paget’s disease)..count: 8.4-10.2 phosphorus, alkaline phosphate total (Paget’s disease), myoglobin, creatine kinase..high level=tissue damage, CK3 (MM) isoenzyme, uric acid…high level indicate gout, ESR…level should be less than 20, CBC

Question 16

What are factors of complete blood count testing?

Answer 16

Red blood cell count, hemoglobin, hematocrit, white blood cell count (4.5-10.5 cells/L), platelet count (150,000-450,000/mcL

Question 17

Coagulation profile consists of:

Answer 17

•activated partial thromboplastin time (aTTP): uses heparin therapy, antidote is protamine sulfate
•prothrombin time (PT): warfarin therapy, antidote is vitamin k
•international normalized ratio (INR): anticoagulant PTs, warfarin therapy, antidote is vitamin k

Question 18

Heparin and warfarin are:

Answer 18

Blood thinners (anticoagulants)

Question 19

Strain vs sprain

Answer 19

•Strain: tendon or muscle excessively stretched…tearing occurs…RICE used
•sprain: ligament excessively stretched from twisting…RICE used

Question 20

A dislocation is:

Answer 20

Any joint in which ends of bones are forced from normal position

Question 21

Median nerve swelling within carpel tunnel is:

Answer 21

Carpal tunnel syndrome

Question 22

A hematoma may occur with a contusion due to:

Answer 22

Soft tissue injury by blunt force

Question 23

A break in a bone is a:

Answer 23

Fracture

Question 24

______ & ______ may cause a fracture

Answer 24

Stress and pathological issues

Question 25

An ______ fracture could risk the result of shock, hypovolemia, & osteomyelitis

Answer 25

Open

Question 26

A ____ doesn’t break skin but tachycardia and. Hypotension should be monitored

Answer 26

Closed

Question 27

What are factors of fracture pathophysiology

Answer 27

•Body tries to repair fracture immediately •adults > hematoma forms at fracture site 48-72 hours post injury •callus -non bony union- forms after week •healing depends on age/fracture location…avg. young healthy adult bones heal in ~6 weeks •vitamin D&C, calcium, protein, hydration intake important during healing

Question 28

What are some fracture symptoms

Answer 28

Pain, decreased ROM, limb rotation, deformity/shortening of limb, edema, ecchymosis, muscles spasms, crepitus

Question 29

What are the fracture types?

Answer 29

•Displaced (unaligned) •incomplete (unbroken in 2) •complete (broken in 2) •greenstick (bend/split; children) •comminuted (splinters/shatters..fragments) •impacted (bone goes into another) •avulsion (bone torn from main bone…still attached to ligament/tendon) •patho/neo (weakened bone>>tumor/tumor pressure) •compression (vertebrae collapse) •spiral (from twisting motion) •stress (overuse) •longitudinal (on length of bone) •oblique (diagonally) •transverse (horizontally)

Question 30

What’s the point of traction?

Answer 30

● Immobilize a fracture ● Maintain proper alignment of an extremity ● Relieve muscle spasm and relieve pain following injury, fracture or surgery ● Prevent soft tissue injury

Question 31

Hemoglobin value less than 7 likely requires

Answer 31

Transfusion

Question 32

What’s the 6 Ps of compartment syndrome & what is compartment syndrome ?

Answer 32

It’s compartments of fascia sheaths being pressured in reduced circulation Pain, Paresthesia, Paralysis, Pallor, Pulselessness, Poikilothermia

Question 33

______ & _____ should be accounted for before MRIs with contrast

Answer 33

Claustrophobia and metal

Question 34

Contrast allergy and kidney function relate to

Answer 34

CT with contrast

Question 35

High uric acid levels are associated with

Answer 35

Gout

Question 36

Post op for hip fracture includes

Answer 36

Buck’s traction, pain control, N-V assessment, correct co-existing conditions

Question 37

GFR, BUN, & creatinine levels should be tested before

Answer 37

CT scan