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N2 Exam 3 > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

MVA, fractures, what blood tests need to be ordered

A

CBC - baseline, Hgb, Hct, electrolytes, coagulation, type and cross

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2
Q

what diagnostic tests are order after MVA/fractures

A

Xray, CT, MRI, EEG

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3
Q

KVO is how many mL per hour

A

25

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4
Q

NPO IV rate?

A

125 mL/hr

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5
Q

the 5 P’s (NV) post surgery

A

Pain, Pallor, Paralysis, Paresthesia, Pulselessness

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6
Q

how often do you assess NV/5 P’s post surgery

A

q 2-4 hrs and PRN

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7
Q

moderate to severe pain, can give with PC pump, oral, rectal, intranasal, or IV, monitor respirations

A

hydromorphone (Diluadid)

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8
Q

SE of hydromorphone (Diluadid)

A

lowered respirations, increased HR, orthostatic hypertension, drowsy, constipation, urinary retention

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9
Q

hydromorphone (Dilaudid) antidote

A

naloxone (Narcan)

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10
Q

what is normal dosage of morphine?

A

1-2 mg max dose q 4-6 hours otherwise question order

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11
Q

treats bacterial infections and MRSA. Monitor trough (30m before next dose) and peak (usually about an hour after taken)

A

vancomycin (Vancocin)

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12
Q

what should you monitor for with vancomycin

A

thomocytopenia, nephrotoxicity, ototoxicity (CN VII), and red man syndrome

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13
Q

how should you infuse vancomycin

A

slowly

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14
Q

hormones you need for bone development

A

thyroid, growth hormone (mainly kids), calcitonin, and VD

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15
Q

fat globules released from hello bone marrow form emboli in blood stream

A

shock/fat embolism

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16
Q

symptoms occur 12-72 hrs after injury (or surgery), lowered platelets, lower Hgb, and raised ESR. HR at about 110. Altered mental status, O2 down and SOB (chest pain) ,petechiae vest

A

fat embolism

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17
Q

how does compartment syndrome heal after being opened

A

secondary intention

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18
Q

what is the most important thing to avoid with compartment syndrome

A

tissue death

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19
Q

hip fracture that involves head or neck of femur

A

intracapsular

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20
Q

hip fracture involving trochanter below head/neck of femur

A

extracapsular

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21
Q

bone infection

A

osteomyelitis

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22
Q

discectomy

A

removal of herniated disk

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23
Q

laminectomy

A

removed of disk portion and bone between spinal process and junction

24
Q

“wear and tear” joint stiffness, decreased ROM, worse with activity throughout the day, most affects middle age and older people,

A

osteo-arthritis

25
Q

autoimmune, join issue, symmetrical, worse in the AM, can occur at any age

A

rheumatoid arthritis

26
Q

with RA the problem is with?

A

synovium

27
Q

which test shows RA

A

rheumatoid factor

28
Q

no tears or saliva

A

sjogren’s syndrome

29
Q

nodules, vasculitis, respiratory and cardiac complications, sjogren’s syndrome, raynaud’s synrome

A

RA

30
Q

lowers inflammatory process and pain, may need help with GI system due to irritation

A

NSAID. ibuprofen (Motrin, Advil)

31
Q

what do you have to patients taking NSIAD’s

A

PPI’s and H2 blockers

32
Q

an anti rheumatic drug that has also been used for chemo

A

methotrexate

33
Q

breakdown of cartilage. No systemic symptoms, onset is gradual, previous joint injury

A

osteoarthritis

34
Q

anesthetic. can cause redness, swelling, and blisters at site. Used for osteoarthritis

A

lidocaine patch (Xylocaine)

35
Q

due to overproduction of uric acid

A

gout

36
Q

medication that blocks formation of uric acid and treated in gout.

A

allopurinol (Zyloprim)

37
Q

Medication that blocks reabsorption of uric acid and promotes excretion. Used with gout. MANY DRUG INTERACTIONS

A

probenecid (Benemid)

38
Q

NSAID. Decreases joint pain. DO NOT USE WITH COUMADIN or ASTHMA. Can cause fatal liver disease

A

indomethacin (Indocin)

39
Q

if you see ESR (erythrocyte sedimentation rate) or CRP (c reactive protein) being ordered think?

A

inflammation

40
Q

is a type of blood test that measures how quickly erythrocytes (red blood cells) settle at the bottom of a test tube that contains a blood sample. Normally, red blood cells settle relatively slowly. A faster-than-normal rate may indicate inflammation in the body.

A

erythrocyte sedimentation rate (ESR)

41
Q

is a substance produced by the liver in response to inflammation. … A high level of CRP in the blood is a marker of inflammation

A

c reactive protein

42
Q

fracture with skin intact

A

closed

43
Q

bone pierces skin

A

Open/Compound

44
Q

fracture common in children

A

Greenstick – incomplete fracture

45
Q

multiple pieces of bone

A

Comminuted

46
Q

Emergent intervention required to prevent loss of limb
Fasciotomy required to relieve pressure
Once pressure goes down, can be closed or covered with skin graft

A

compartment syndrome

47
Q

therapeutic management of gout

A 
Avoid purines (Organ meat, Wine, Aged Cheese, Meats, especially seafood)
Adequate fluid intake
Bed rest during exacerbations
48
Q

Affects weight-bearing joints and joints that receive a lot of stress

A

osteoarthritis

49
Q

nodes that affect the medial joints

A

Bouchard (B, closer to the body)

50
Q

nodes that affect the Distal joints

A

Heberden’s (HE - pointing)

51
Q

side effects of methotrexate

A

rash, toxic to liver and bone marrow, birth defects, photosensitivity. MONITOR FOR HEMODYNAMIC CHANGES

52
Q

alternative therapies for OA

A

acupuncture, tai chi, magnets, lidocaine patch, TENS unit, copper bracelets

53
Q

what gout med do you not stop abrubtly

A

prednisone

54
Q

what gout med can weaken the immune system

A

prednisone (because corticosteroid)

55
Q

long term SE of prednisone (corticosteroid)

A

osteoporosis, cushings syndrome

56
Q

short term SE of prednisone

A

insomnia, mood swings, wt. gain, bruising, slow wound healing

N2 Exam 3 (5 decks)

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