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Nursing II > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

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1
Q

Developmental Dysplasia of Hip treatments

A

surgery, Pavlik harness, Bryants traction, Spica cast

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2
Q

Children with DDH have to wear pavlik harness for how long?

A

3-6months

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3
Q

Spica cast

A

cast that covers one whole leg and part of the other. Used in DDH

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4
Q

Clubbed foot treatments

A

cast application, corrective shoes, surgical correction

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5
Q

Scoliosis

A

permanent lateral curvature of spine

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6
Q

scoliosis problems

A

breathing

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7
Q

Idiopathic scoliosis treatment <20 degrees

A

none

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8
Q

idiopathic scoliosis treatment 20-40 degrees

A

milwaukee brace to prevent further curvature

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9
Q

Milwaukee brace is used for

A

scoliosis. wear 23/24 hrs a day

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10
Q

idiopathic scoliosis treatment >40 degrees

A

Harrington rods are put in place

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11
Q

Harrington rods are used for?

A

idiopathic scoliosis treatment >40 degrees

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12
Q

Osteogenesis Imperfecta (OI)

A

brittle bone fractures with minimal stress. Defect collagen synthesis

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13
Q

Defect collagen synthesis

A

OI

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14
Q

OI symptoms

A

blue sclera, deafness, dentinogenisis (tooth probs)

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15
Q

OI treatments

A

IM rods, reclast (biophosphonate), NO BPs, encourage independence

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16
Q

Reclast (biophosphonate) is used for?

A

OI & osteoporosis It decreased serum calcium, decreases fractures

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17
Q

Slipped Capital Femoral Epiphysis

A

slipping of the femoral head in relation to neck

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18
Q

Slipped Capital Femoral Epiphysis usually occurs in what kinds of people?

A

obese or rapidly growing kids

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19
Q

Slipped Capital Femoral Epiphysis symptoms

A

hip, knee, groin pain (long duration), Limp, decreased ROM

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20
Q

Hallmark sign of Slipped Capital Femoral Epiphysis

A

Lack of internal rotation

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21
Q

Slipped Capital Femoral Epiphysis treatment

A

bedrest, NWB, crutches, surgical pinning, teach s/s for other hip

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22
Q

Legg-Calve-Perthes Disease

A

avascular necrosis of the head of femur

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23
Q

age of peak incidence for Legg-Calve-Perthes Disease

A

4-8 years old

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24
Q

Legg-Calve-Perthes Disease symptoms

A

pain in the hip accompanied by spasm and limited motion, progress thru 4 stages, knee of thigh pain, limp

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25
Legg-Calve-Perthes Disease diagnostics
arthrogram (they put dye into body to see where it builds up)
26
Legg-Calve-Perthes Disease treatment
Hip spica cast for left hip for Legg-Calve-Perthes, petrie brace
27
petrie brace
metal bar that goes between legs for Legg-Calve-Perthes Disease
28
Osgood-Schlatter Disease
thickening and enlargement of tibial tuberosity. Athletes
29
Osgood-Schlatter Disease symptoms
painful swelling, cosmetic deformity. They will grow out of it
30
Osgood-Schlatter Disease treatments
Rest, ice, stretch hamstrings, casting, they'll grow out of it
31
Osgood-Schlatter Disease diagnostics
x-ray
32
Rheumatoid Arthritis
chronic, systemic, inflammation of connective tissue in joints.
33
RA etiology
EBV initiates autoimmune response
34
RA symptoms
fatigue, anorexia, weight loss, generalized stiffness, fever, warmth, redness, swelling, weak muscles, ligaments, tendons
35
RA diagnostics
Synovial fluid aspiration, CBC, ESR, X-ray
36
CBC will show what with RA
anemia
37
ESR will be what with RA
elevated d/t inflammatory response
38
RA goals
reduce pain & inflammation, preserve function, prevent deformity
39
Plasmaphoresis is used with RA inorder to
to reduce autoimmune response by removing circulating antibodies
40
RA treatment
1.) give NSAIDS/corticosteriods 2.) DMARD's (Disease-modifying antirheumatic drugs, surgery
41
DMARDs
Gold, D-penicillamine, Antimalarial agents (Plaquenil)-monitor visual acuity q 6 months sulfasalzine
42
Plaquenil
antimalarial agent used for RA & SLE. Causes visual probs
43
types of surgery for RA
Synovectomy, arthrodesis, arthroplasty
44
Arthrodesis
the fusion of two bones. Used for RA surgery
45
Arthroplasty
surgery to reshape, reconstruct or replace a diseased or damaged joint
46
JRA polyarticular
effecting many joints
47
JRA pauclarticular
4 or fewer joints are effected. screening q 6 months
48
JRA systemic s/s
high fever, rashswollen lymph nodes
49
JRA s/s
eye inflammation, stiff and painful joints, decreased appetite, poor weight gain, slow growth
50
JRA exercise
ROM, bike, swim
51
JRA treatment
NSAIDS, DMARDs, Cytotoxic (methotrexate), steriods
52
Cytotoxic (methotrexate) is used for
JRA. Used in chemo. Are we going to set them up for cancer later on?
53
SLE does what to the body
attacks the organs
54
SLE s/s
joint pain, butterfly rash, oral ulcers, alopecia, renal failure, seizures, depression,
55
SLE teaching
avoid sun exposure, limit stress,
56
SLE treatments
Plaquenil, Cytoxan (immunosuppressive drugs), NSAIDS, high dose steriods
57
Osteoarthritis
degenerative joint disease. Bone on bone rubbing
58
Osteoarthritis(DJD) diagnostics
x-ray, bone scan, CT, MRI
59
Osteoarthritis treatments
Opioids, heat, cold, joint arthroplasty, TENS, NSAIDs, Glucosamine, ASA, corticosteriods, Surgery if nothing else works
60
For a Total joint Arthroplasty (TJA) what is stopped 1 week before the surgery and what is given 1 hour before surgery
NSAIDS are stopped 1 week before surgery and an IV antibiotic is given 1 hour before surgery
61
With a Total Hip Arthroplasty (THA) a patient can become...
hypotensive. After 4 or 5 hip revisions there isn't much you can do
62
THA postoperative care
abductor pillow, turn patient with pillow between legs. don't let legs cross, don't want knee to go higher than hip
63
THA discharge instructions
No driving for 6 weeks, resume sexual activity when comfortable, prophylactic antibiotic coverage for invasive procedures (dental work)
64
TKA discharge instructions
no driving, continue dvt prophalyxsis, antibiotics for dental work, home care c physical therapy, don't put a pillow under knee cap
65
Osteoporosis
most common, porous bone
66
How does estrogen effect Bone mass density
An estrogen deficiency rapidly decreases BMD, up to 20% during the first 5-7 yrs post-menopause
67
Surgically induced menopause does what to BMD
it results in severe decrease in BMD
68
type 1 osteoporosis
postmenopausal, accelerated bone loss
69
type II osteoporosis
senile. male & female, age >70 related to nutrition, decreased physical activity, non-accelerated bone loss
70
Secondary osteoporosis
male & femal, occurs at any age. Its a result of a disease process or medical treatment
71
osteoporosis: which fractures are seen with elderly men
vertebral compression fractures
72
osteoporosis risk factors
smoking, sedentary, alcohol use
73
Osteoporosis prevention
weight bearing exercises, medications, proper nutrition, education
74
recommended amount of Calcium D for 35-50 yr olds
1000mg
75
recommended amount of Calcium D for pregnant women
1200-1500mg
76
recommended amount of Calcium D for 51-64 yrs old on ERT/ 51+ not on ERT
1000mg/1500mg
77
Calcium bicarbonate vs. Calcium Citrate
relief of indigestion, heart burn vs adjunct in the prevention of postmenopausal osteoporosis
78
Estrogen replacement therapy should be started when?
within 3 years of menopause
79
Estrogen replacement therapy increases which risk and what should be added in no hysterectomy?
increases endometrial cancer. Progesterone must be added if no hysterectomy
80
Osteoporosis meds
Antiresorptive meds that slow bone loss (bisphosphonates, calcitonin, denosumab, estrogen/estrogen agonists/antagonists-Evista) & Anabolic drugs that increase the rate of bone formation (PTH- Fortteo)
81
bisphosphonates, calcitonin, denosumab, estrogen do what?
antiresorptive meds that slow bone loss
82
PTH-Fortteo do what?
Anabolic drugs that increase the rate of bone formation
83
Bonica, Reclast, Actonel, Fosamax are what kinds of drugs
Bisphosphonates. Osteonecrosis of the jaw (ONJ) is a side effect
84
Kyphotic deformity
seen with osteoporosis. Its the normal posterior curvature of the thoracic and sacral spine
85
What GI/Bowel alterations will you see with a patient with osteoporosis?
a protrusion of the abdomen
86
When would you do surgery for HIVD?
if leg pain longer than 6 weeks.
87
What surgical interventions are there for HIVD
minimally invasive discectomy, laminectomy (remove part of lamina), spinal fusion (realign vertebra)
88
HIVD postop complications
CSF leakage (look for yellow fluid), nerve root injury, bowel bladder changes, hematoma
89
Conservative treatment for HIVD
rest 3 days max, ice or heat, analgesics, physical therapy, epidural steriods
90
what do you look at postop for HIVD
Need to look at orthostatic hypotension. Log rolling
91
Gout is what kind of disorder?
metabolic
92
what is elevated in Gout?
serum uric acid-hyperuricemia >7.5, ESR levels/sed rate
93
With Gout, urate crystals are found in..
synovial fluid, surrounding tissues. Uric acid excrete in urine <800 mg/24hrs
94
Gout diagnostics
x-ray, urate crystal aspiration
95
Hammer toe
claw toe is the dorsiflextion of the 1st phlanx with plantar flexion of the 2nd and 3rd phlanges
96
Zyloprim, Colchicine, NSAIDS (Indocin), corticosteroids are meds to treat?
Gout
97
Hallux Valgus
Bunion. Enlargement and lateral displacement of the first metatarsal. Congenital but most from wearing pointed shoes
98
daily colchicine and urosuric agents(allopurinol) are for?
Chronic Gout

Nursing II (16 decks)

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