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NSG 121 > musculoskeletal system > Flashcards

musculoskeletal system Flashcards

(116 cards)

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1
Q

What are 5 manifestations of NV compromise?

A

Pain
Pallor
Pulse
Paralysis
Parasthesia

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2
Q

What are the important labs for musculoskeletal system?

A

CK (muscle damage)
AST (muscle damage)
ALD (inflammation)
Calcium
Vitamin D

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3
Q

What diagnostics will be used for the musculoskeletal system?

A

X-ray (fractures)
CT (bones/trauma, allergies)
MRI (soft tissue/tumor)
Arthrogram
Arthroscopy (tube in joint, visualize)
Biopsy (infection in bone)
Electromyography (muscle strength)
Ultrasound

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4
Q

What are some age related changes in the musculoskeletal system?

A

osteopenia (decr bone density)
osteoporosis(severe decr bone density)
Kyphosis (spinal curvature)
Osteoarthritis (joint inflammation)
Decr ROM
Muscle atrophy
Slowed movements

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5
Q

Health promotion for the musculoskeletal system?

A

vitamin D supplement
Calcium supplement
weight bearing exercises
substance abuse
alcohol abuse
no smoking

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6
Q

What is Gout?

A

urate crystals in joints/ tissues leading to inflammation

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7
Q

Primary Gout?

A

issue with purine metabolism
uric acid production> excretion
middle aged men
inflammation
postmenopause women
obesity

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8
Q

Secondary Gout?

A

hyperuricemia (disease)
diuretic therapy
chemotherapy
renal insufficiency
underlying health issue
all ages

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9
Q

What occurs in the asymptomatic stage of Gout?

A

no obvious symptoms
incr in uric acid levels (>6.5mg/dL)

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10
Q

What occurs in an acute attack of Gout?

A

inflammation + joint pain
incr ESR
incr BUN/creatinine

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11
Q

Is acute Gout reversible?

A

yes with lifestyle changes and increased fluid intake

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12
Q

What occurs in the interstitial stage of Gout?

A

symptom free period

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13
Q

What occurs in a chronic attack of Gout?

A

crystals form + swelling
breaks through skin (infection risk)
kidney stones
joint inflammation
renal calculi/dysfunction

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14
Q

Is chronic Gout reversible?

A

no

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15
Q

What should those with Gout avoid?

A

alcohol/beer
fad diets
purine food (fish)
aspirin
diuretics
acid foods
red meat/organ meat
processed food
stress
protein
shrimp/scallops

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16
Q

what are the medications used for Gout?

A

Allopurinol
Probenecid
Colchicine
Naproxen

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17
Q

What is Allopurinol for?

A

alloPurinol = Prevents Gout
1) STOP taking = MILD RASH
(rash ALL Over=ALLOpurinol=deadly)
2) INCREASE fluids

AVOID kidney/liver disease
monitor liver and renal function

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18
Q

What is Colchicine for?

A

Colchicine = aCute attacks

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19
Q

What is Probenecid for?

A

Probenecid = inPlace of alloPurinol allergy

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20
Q

What is Naproxen for?

A

Pain management

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21
Q

What are signs and symptoms of Gout?

A

Pain (wakes you at night)
swelling
tophi
warmth
bone deformity
joint damage
renal calculi

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22
Q

What is Osteoporosis?

A

reduction in bone density
change in bone structure

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23
Q

Memory trick for Osteoporosis

A

osteoPORosis = PORous bones
decr bone mass = decr bone density
incr bone resorption = incr bone loss
decr Calcium

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24
Q

Risk factors for Osteoporosis?

A

Female gender
-older age
-postmenopausal
-Caucasian & asian
Bad habits
-caffeine intake
-smoking/alcohol abuse
Medications
-Anticonvulsants
-steroids
-Barbituates
Diseases
-hyperparathyroidism
-cushing syndrome
-diabetes
Other
-thin/frail
Decr calcium/vitamin D
decr wt bearing exercises

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25
Clinical manifestations of Osteoporosis?
porous bones frequent fractures reduced height kyphosis protruding abdomen fatigue
26
Primary Osteoporosis
Women -after menopause -decr estrogen Men -decr testosterone
27
Secondary Osteoporosis
Corticosteroids diabetes hyperthyroidism HIV cirrhosis diuretics immunosuppressants caffeine phosphorus carbonated drinks
28
Diagnostic tests for Osteoporosis
Dual energy X-ray -fracture -decr bone density Bone mineral density T score (-2.5 >) -base is 30yr old VItamin D levels -20mg/mL Serum Calcium levels -8.6-10.3mg/dL
29
Treatment for Osteoporosis?
Calcium + Vitamin D (1/3 at bedtime) sunshine wt. bearing exercise
30
Medication for Osteoporosis?
Raloxifene Bisphosphonates -alendronate -risedronate Calcitonin Calcium
31
What is Raloxifene for?
hormones incr risk of DVT, stroke, heart disease, cancer
32
What is Bisphosphonates for?
"-dronate" alendronate + risedronate Bisphosphonates Build Bone Burns esophagus sit up for 30 min after taking take on empty stomach
33
What is Calcitonin for?
inhibit osteoclasts
34
What is Calcium for?
makes bones strong Calcium = Constipation
35
What causes Osteoporosis?
Decr Calcium multiple causes decr tesosterone
36
What causes Osteomalacia?
decr vitamin D decr calcium lack of calcification
37
Cause of Osteoporosis?
bone loss fracture
38
Cause of Ostemalacia?
fracture bone softening
39
What is Osteoarthritis?
break down of cartilage in joint Oa = Ouch pain Bone on Bone rubbing
40
What are risk factors of Osteoarthritis?
obesity older age female occupation heavy labor genetics trauma malalignment joint location smoking diabetes sickle cell
41
Osteoarthritis clinical manifestations?
joint pain + stiffness deformity instability reduced function nodes decr ROM
42
Diagnostic test for Osteoarthritis?
physical examination x-ray MRI (metal) Arthroscopy (look at joint) Synovial fluid aspiration ESR C-reactive protein
43
Management of Osteoarthritis?
Lifestyle changes Wt loss Joint support Therapy Medications -acetaminophen -celebrex -cytotec -prednisone surgery -joint replacement -NV assessment -surgical dressing/drains -ROM -PT
44
What is a fracture?
break in the bone
45
What is the extent of a break?
complete incomplete
46
What is the extent of a soft tissue injury?
simple (closed) compound (open)
47
What are the main Types of fractures?
Trauma Pathological Stress
48
Compound fracture
bone is through the skin
49
Greenstick fracture
child prone
50
Spiral fracture
abuse situations (twisting)
51
History for a patient with a fracture?
cause drug use medical hx occupation recreational activities
52
Diagnostic tests for a fracture?
X-ray -bone disruption -changes in alignment -deformity CT -complex fracture MRI -soft bone injury Bone Scan
53
Interventions for a fracture?
depends on the fracture surgical or nonsurgical MAIN GOAL: PREVENT NV COMPROMISE
54
Best practice for those with a fracture?
ABCs Inspect for fracture -dont remove anything NV assessment Immobilize area Recheck NV status
55
What is a skeletal traction?
Surgical intervention Insertion of wires/pins in affected bone bone realignment
56
What is a skin traction?
Non surgical intervention boot around affected leg Decr painful muscle spasms
57
What is Bucks traction?
pully hanging over bed keeps bone in line
58
What is an ORIF?
Open reduction with internal fixation rods/wires/plates/screws immobilization
59
Management after ORIF?
maintain NV status monitor for S/S -infection -bleeding -fat embolism -DVT/PE check dressings turn/reposition nutrition
60
What is an external fixation?
pins/wire through skin/bone frame and support fracture with soft tissue injury
61
management after external fixation?
monitor NV status monitor for infection assess bleeding risk keep affected area elevated assess skin integrity
62
Pin care?
Prevent infection every 8-12hr leg exercises one swab per pin (no contamination) skin reacts to pins for 72 hrs
63
What fracture is most common in older people?
hip fracture (over 1/2 unable to live independently) incr mortality rate -osteoporosis -fall risks
64
Manifestations of a hip fracture?
groin pain lower back pain lower knee pain leg shorter and externally rotated
65
Diagnostic test for Hip fracture?
X-ray
66
What are the 2 types of hip fractures?
Intracapsular -femoral neck (disrupt blood supply) -Head Extracapsular -subtruchanteric -trochanteric
67
Treatment for a hip fracture?
ORIF Hip arthroplasty Hemiarthroplasty Bucks traction
68
Prevention for Hip dislocation
-no sitting/standing for long time -no cross legs over midline -no bending hips over 90 degrees -ambulatory devices when moving
69
What is a dislocation?
displacement from normal position -emergency -NV damage
70
Treatment for a dislocation?
reduction put back into place immobilization
71
what is the 2nd most common cause of death from trauma?
pelvic fracture (mv crash/ fall)
72
Why are pelvic fractures dangerous?
internal trauma/damage hemorrhage--> hypovolemic shock -blood in urine -blood in stool -abdominal swelling -arterial bleeding/venous oozing
73
Pelvic fracture treatment?
non wt bearing -bedrest -pain management wt bearing -immediate attention -ORIF -External fixation
74
What is osteomyelitis?
infection of bone
75
Three types of osteomyelitis?
Exogenous Endogenous Contiguous
76
what does Exogenous mean?
infection is from outside the body
77
What does Endogenous mean?
Infection is from inside the body
78
What does Contiguous mean?
infection from a penetrating wound
79
S/S of acute osteomyelitis?
pain (constant) Fever (101) swelling (affected area) Tenderness Erythmea
80
S/S of chronic osteomyelitis?
Ulceration (foot/ bone surgery) sinus tract formation (tunneling) Localized pain Drainage
81
Diagnostic tests for osteomyelitis?
MRI Bone scan Incr WBC Incr ESR + blood culture
82
Nonsurgical management of osteomyelitis?
IV abx. therapy wound irrigation pain management hyperbaric oxygen therapy standard/contact precaution
83
Surgical management of osteomyelitis?
sequestrectomy bone grafting muscle flap amputation
84
What is Fat Embolism Syndrome?
Fat release into blood stream from yellow marrow 24-72hr after injury
85
Early detection of FES?
trouble breathing -hypoxemia -SOB -dyspnea -incr RR tachycardia mental changes vision changes fever perechaie
86
Diagnostic test fro FES?
X-ray chest (snowstorm infiltrate) incr ESR decr calcium Decr RBC, Plt incr serum lipase fat in urine
87
Treatment for FES?
oxygen hydration with iv fluids bed rest steroid therapy vasopressor medications
88
What is a delayed union
fracture that doesn't heal after 6 mo
89
what is a nonunion
never heals
90
what is a malunion
incorrectly heals
91
Treatment for delayed union?
ORIF Bone graft electrical stimulation
92
What is a DVT?
Blood clot deep veins of legs (most common complication for musculoskeletal surgery) Virchows triad
93
What is Virchow's Triad
Stasis of blood flow endothelial injury Hypercoagulbility
94
S/S of DVT?
calf/groin pain unilateral swelling hardening warmth
95
What are risk factors for a DVT?
cancer/chemo smoking obesity heart disease hx of VTE immobility surgery longer than 30min oral contraceptive hormone medications
96
Diagnostic test for DVT?
Ultrasound MRI D-dimer VQ scan
97
What is a PE?
complication of DVT breaks off and goes to lungs
98
S/S of PE?
sudden onset of dyspnea sharp stabbing pain in chest restless impending doom cough hemoptysis diaphoresis incr RR crackles tachycardia low grade fever petechiae decr O2 stats
99
Diagnostic tests for PE?
chest X-ray CT chest
100
Management of a VTE?
prevent incr in size prevent further formation prevent complications pt/ education -hydration -leg exercises -ambulation -compression devices -no oral contraceptives
101
Treatment of VTE?
Nnsurgical -ambulation -elevate -compression -medication Surgical -thrombectomy -inferior vena canca filtration
102
What is avascular necrosis?
death of bone tissue disrupted blood supply
103
What is Compartment syndrome?
increased pressure in a "compartment" reducing circulation MEDICAL EMERGENCY
104
Early detection of ACS?
pain pallor paralysis paresthesia pulselessness palpate
105
Treatment for ACS?
Fasiotomy (incision to reduce pressure)
106
Complications of ACS?
infection contracture renal failure motor weakness
107
What is Rhabdo?
break down of muscle
108
Causes of Rhabdo?
burns compression crush injury seizures cocaine abuse physical training thyroid syndrome infection autoimmune stroke
109
Diagnostic test for Rhabdo?
hyperuricemia hypocalcemia hyperkalemia incr BUN/creatinine myoglobinuria CK
110
What is hypovolemic shock?
look of blood from vascular space incr HR decr BP
111
Treatment of hypovolemic shock?
oxygen therapy IV therapy/fluids PRBC plasma infusion
112
What is an amputation?
removal of a body part
113
What is an elective amputation?
pt elects to remove
114
what is a traumatic amputation
removal accident
115
Levels of amputation?
above the knee below the knee same mid-foot toe hip hemipelvectomy
116
Treatment of phantom limb pain?
calcitonin beta blockers mirror box electrical nerve stimulation

NSG 121 (6 decks)

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