MUSCULOSKELETAL DISEASE Flashcards
(100 cards)
1
Q
The functions of the bone
A
-produce RBC: Long bone
-stock calcium: most abundant in bine
-protects vital organs: flat bones
-movements
-support muscles
2
Q
Most abundant in bone
A
Calcium
3
Q
Deposits ca+ in the bone
A
Phosphorus
4
Q
Maintains ca+ in the bone
A
Magnesium
5
Q
Absorb ca+ in the bone
A
vitamin D
6
Q
lacks of ca+ in the bone
↓ca+ in bone
A
Osteoporosis
7
Q
lack of vitamin D in children
A
Rickets
8
Q
lack of vit. D in adult
A
Osteomalacia
9
Q
-Degenerative
-aging process
-menopause
A
Type 1
10
Q
-disease condition
-steroid therapy
-immobility
-TAHBSO: Surgically induced menopause
A
Type 2
11
Q
Manifestation of ↓ Calcium:
A
-Prone to fratcure
-bone pain
-↓ in height
-kyphosis: Forward
-Bone affected: curvature of spine VERTEBRAE
12
Q
Diagnostic test for ↓ calcium:
A
X-ray: detects pathologic fracture
Bone scan: determines bone mass/ density
13
Q
Plan of care for ↓ca+:
A
- DIET:
↑ Calcium diet
milk & dairy products - CALCIUM SUPPLEMENT
- if due to menopause: Hormonal supplement
- stop smoking
- Preventive exercise: Weight bearing
-Walking
-Running
-Hiking
14
Q
Common site of dislocation
A
-Shoulder
-Knee
-Elbow
15
Q
least site of dislocation:
A
Foot
16
Q
Common site of dislocation in elderly?
A
Hip dislocation
17
Q
-Bone -Bone
-Ligaments: damage
-BO-BO-GA
A
Sprain
BO-BO-GA
18
Q
-Bone-muscle
-Tendon: damage
BO-MU-TE
A
Strain
BO-MU-TE
19
Q
Plan of care for Sprain & Strain:
A
RICE
R: Rest only affected area
-Crutches/ Walker
I: Immobilize:
-Apply Splint /Cast
C: Cold Compress wrap with elastic bandage
E: Elevate the affected area
20
Q
DOC for sprain/strain
A
NSAIDs
-Ibuprofen/ Mefenamic
21
Q
Management for strain/sprain
A
Close reduction
-Manual manipulation
22
Q
Good to know:
A
Kiphosis: Forward curvature “K”
Lordosis: Backwards “lord”
Scoliosis: Lateral; lateral curvature
23
Q
Discontinuity of the bone
Common cause: Trauma 90%
-Fall
-VA: Vehicular Accident
-Sports
-Violence
Disease condition: 10 %
A
Fracture
24
Q
Type of fracture
-intact skin
- (-) skin protusion
A
Simple/ close fracture
25
Type of fracture
-Prone to contamination
- (+) skin protusion
Compound/open fracture
26
Type of fracture
-one extremity is shorter than the other
Overriding
27
Type of fracture
-common in children
-1 bone is bent over
-crack in the bone
Green stick
28
(+) Bone fragments
Comminuted
29
Type of fracture
-cut straight across
-common: osteomalacia
transverse
30
Type of fracture
-cut diagonally
-common: trauma in low extremity
Oblique
31
Type of fracture
-twisted bone
-common: physical abuse
Spiral
32
Manifestations of fracture:
PA-PI-IN-DE
Pain
Crepitus: Grating sound
Inflammation
Deformity
33
What is the most significant to assess in fracture?
-Type of bone (Long bone)
34
Most-life threatening complication of fracture:
-Fat embolism: Airway
-Pulmonary embolism: Breathing
35
Manifestation of embolism due to LONG BONE fracture:
-Dyspnea
-Pleuritic chest pain
-Site: Blue spots (Ecchymosis)
36
Plan of care of Fracture:
General Priority: Immobilize
-Apply Splints
37
Plan of care of Fracture: Open fractures
Priority:
1) Cover with dry cloth
-to prevent contamination
2) Immobilize
3) Check the pulse below (distal) to affected area
4) O2 Administration: due to dyspnea
5) X-ray: confirmatory test
6) Surgery: Orif (Open Reduction)
38
Confirmatory test in Fracture:
-X-ray
39
Traction that relieves muscle spasm
Skin
40
Traction that immobilize the bone
skeletal
41
Skin traction
BRY -RUght-BUck
Bucks Traction: 1 bone fracture
Russel's Traction: 2 or more bone fracture
Bryant's Traction:
Children <3 y.o. ; <35 lbs
42
Skeletal traction
-Halo vest
-pelvic belt
-gardner well's
-crutch field tong
-Kierchner wire
-steinman pin
-balance suspension traction
43
Bedside equipment for skeletal traction
-Torque Wrench
44
Almost all traction refers to "skin" traction except balance suspension traction.
Good to know
45
Care for Traction:
BED
-Firm mattress: to maintain body alignment
ROM
-Unaffected area
USE OVERHEAD TRAPEZE
-when changing position
↑FLUID INTAKE
-Prevent renal calculi due to leakage of CA+
PUT PT. ON SLIGHT TRENDELENBURG
-To prevent pulling of traction
46
SKELETAL TRACTION FOCUS:
FOCUS: PINS
-Clean: Hydrogen peroxide
-REPORT: Movement on traction: ineffective traction
-INFECTION S/SX:
*Warm to touch
*Musty/ foul odor
47
SKIN TRACTION FOCUS:
Focus: Weights & Rope
-Force must be equal to counter force
-Never remove or readjust weights
-Weights must be free hanging
-Weight must never touch the floor
48
-immobilize the bone during the healing process
Casts
49
type of cast
-Dries only in 20 minutes
-dull in appearance
-may get wet
-durable
Fiberglass
50
Type of cast
-Dries in 1-3 days (72 hours)
-shiny in appearance
-heavy
-soften when wet
Plaster of Paris
51
Nursing Consideration Casts:
1. Cast must be carry with palms not fingers
2. when drying: expose or air dry
3.warm sensation while cast is drying: NORMAL
4. Dried cast: HARD, WHITE, RESONANCE SOUND
5.during application : ensure 1 finger can be inserted underneath the cast
6.Assess for signs of infection:
*Hot spots (warm to
touch)
*Musty odor (Foul smell)
7. Assess for neurovascular status (Circulation)
6'Ps
8. petalling
9. windowing
10. bivalving
52
Breaking the cast
Purpose:
-When casts softens
-compartment syndrome
-when healed
Bivalving
53
Rewrapping to relieve the roughness
Petalling
54
To assess for skin integrity
Windowing
55
6 P's for Neurovascular status (circulation)
PAIN: can't be releived by analgesics (Compartment syndrome)
PULSELESSNESS: Assess below affected area
PALLOR
PARESIS (weakness)
PARESTHESIA (numbness)
POIKILOTHERMIA: polar- Cold to touch
56
First person to be discharge is with what type of traction?
HALO VEST
-pt is ambulatory
57
Complication if cast is too tight?
Compartment Syndrome
58
Neurovascular status
-Assess circulation
-below/distal affected area when checking pulse
59
Complication from cast
Causes:
-Tight cast application
Hemorrhage from the
wound
↓
Compression of casts
↓
fascia is unable to expand
↓
O2 deprivation
↓
6-8 hours
↓
NECROSIS OF FASCIA
COMPARTMENT SYNDROME
60
Manifestations of Compartment Syndrome:
-Intractable pain: can't be relieved by analgesic
-Numbness/paresthesia
-Tingling sensation
61
Plan of care for compartment syndrome:
-Bivalving: break of cast
-Fasciotomy: Removal of dead fascia
62
-compression of median nerve
-Commonly seen to individuals that requires flexion of hands:
*Truck driver
*Carpenter
*Typist/ IT
CARPAL-TUNNEL SYNDROME
63
Manifestation of Carpal tunnel syndrome:
- (+) Pain: Wrist
- Numbness
-Tingling & Paresthesia
- (+) Phallen's sign
- (+) Tinel's sign
64
Assessment test done by Holding the wrist & flexing 60 degree angle that causes pain
(+)Phallen's sign
65
Assessment test done by Tapping the wrist that causes pain
(+) Tinel's sign
66
Plan of care for tunnel carpal syndrome:
-Apply splint: to prevent flexion of wrist
-DOC: Steroids- Inject on the site
-Surgery: Decompression of medial nerve
67
Exercises prior to assistive device
-Isotonic
-Isometric
-Isokinetic
68
Exercises prior to assistive device with opposing force
Isokinetic
69
Exercises prior to assistive device
-no change in length
-muscle contraction & relaxation
-keeps the muscle stationary
Isometric
70
Exercises prior to assistive device
-lengthening & shortening of muscles
-change in length (length & short)
Isotonic
71
Assistive device for weak leg/ paresis
-Cane
-walker
72
Assistive device for injured leg
-crutches
-walker
73
Assistive device
-Unaffected side
-shift the weight on the cane
-elbow must be slightly flexed 45 degree angle
CANE
74
Assistive device:
Height: 2 inches below axilla
Weight: Weight must be applied on the palm, not on axilla
Exercises: Weight bearing exercises:
*weight lifting:
-barbel,
-dumbell,
-push-ups
Purpose: Strengthen the biceps, triceps, flexor, extensor muscle.
Crutches
75
Complication of crutches:
Brachial plexus paralysis
-because of weight on axilla
76
GAIT:
-when weight bearing is allowed on both extremities whether affected/unaffected
-Faster
2 point gait
77
GAIT:
-when weight bearing is allowed on both extremities whether affected/unaffected
-Slower
4 point gait
78
GAIT
-when weight bearing is only allowed on 1 extremity (unaffected).
3 point gait
79
when the affected leg touches floor but has no weight.
Touch Down
80
Indicated: when partial weight bearing allowed on both extremities.
Swing to; swing through
81
When climbing the stairs:
-Good leg : goes to heaven first (unaffected leg)
-3 Point gait
82
When going down the stairs:
-Bad leg goes to hell first (affected leg)
-3 point gait
83
Assistive device
-Body must be at the center of walker
-walker serve as the balance
-walker at the level of the waist
-Instruct Patient: "LIFT & WALK"
WALKER
84
Cause:
-↑ Uricemia (↑uric acid)
-Overtake
-↓ excretion
-Common in male:
Big Dad ;Big toe
Uncle; Ankle
Gouty Arthritis
85
Manifestation of Gouty Arthritis:
-Pain
-Redness
-Swelling
-Tophi Fruits: Uric Crystals
Big Dad ;Big toe
Uncle; Ankle
86
Diagnostic test for gouty arthritis:
-↑ Uric Acid result
-X-ray
87
Plan of Care for gouty arthritis: DIET
DIET:
↓Protein, ↓Purine
AVOID:
-Organ (liver) meat
-meat
-beans/nuts
-dried fish
-sardines
↑FLUID INTAKE UP TO 3 LITERS/ DAY
- to dilute uric acid
88
Contraindications for Gouty Arthritis:
***ACID
-Coffee
-Alcohol
-Vinegar
-Vitamin C
-Aspirin (ASA) Aspirin Salicylic Acid
-Furosemide: promote crystallization
89
DOC of Acute gouty pain:
Colchicine: Relieve pain & Swelling
90
DOC for Chronic Gout:
Allopurinol: Breaksdown uric acid
91
How to relieve gouty pain (non-pharmacologic)
Apply bed Cradle
92
Common: both genders (Male & Female)
-Degenerative Dse
-Degeneration of: Cartilage
-Weight bearing joints (knees)
-Most common type of Arthritis
OsteoArthritis
93
Risk factors for osteoarthritis:
-1st : Aging process
-Obesity
-Overuse of joints
94
S/sx of Osteoarthritis:
-Asymmetrical (1 extremity)
-Pain: <30 minutes
-Alteration in pain: Common in the afternoon (Overuse)
Nodes:
-Heberden's: Distal Nodes
-Bouchard: Proximal Nodes
95
Nursing management for osteoarthritis:
WARM COMPRESS
-relieved by rest
96
DOC for Osteoarthritis:
Aspirin (Salicylate)
97
-common in women (20-40 y.o.)
-Inflammatory dse
-Inflammation: Synovial Fluids
-Small joints (Hands)
-Autoimmune (systemic)
Rheumatoid Arthritis
98
S/sx of Rheumatoid Arthritis:
-Small joints (Hands)
-Symmetrical (Both extremities)
-Pain: >30 minutes
-Alteration in pain: Early Morning Stiffness
-Ankylosis: Atrophy of joints
-Swan neck deformity
99
Nursing Management:
Cold compress
-Aggravated by rest
100
DOC for Rheumatoid Arthritis
-NSAIDS
-STEROIDS: Sulfasalazine (Gold Salts) ;long-term steroids
