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HESI NCLEX-RN EXAMINATION > Musculoskeletal System > Flashcards

Musculoskeletal System Flashcards

1
Q

What are the common symptoms of rheumatoid arthristis?

A
  • morning stiffness
  • weight loss
  • swelling of both hands and wrists
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2
Q

What methods would a nurse use to assess rheumatoid arthritis?

A
  • Inspection
  • Palpation
  • strength testing
  • Avoid ROM b/c ROM promotes pain
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3
Q

What activity recommendations should the nurse provide to a client with rheumatoid arthritis?

A
  • Do not exercise painful, swollen joints
  • Do not exercise any joint to the point of pain
  • Perform exercises slowly and smoothly; avoid jerky movements
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4
Q

Avoiding sunlight is key in the management of

A

Lupus erythematosus

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5
Q

What four factors trigger lupus?

A
  1. Sunlight
  2. Stress
  3. Pregnancy
  4. Drugs
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6
Q

What population is at the highest risk for osteoporosis?

A

Postmenopausal, thin white women.

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7
Q

What is a great source of calcium that is available over the counter encouraged for osteoporosis?

A

Tums

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8
Q

The main cause of factures in older adults is

A

Osteoporosis

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9
Q

What are the four classifications of fractures

A

Complete: A break across the entire cross section of the bone
Incomplete: A break across only part of the bone
Closed: No break in the skin
Open: Broken bone protrudes through skin or mucous membranes

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10
Q

What type of fracture is more difficult to heal: An extracapsular fracture or an intracapsular fracture?

A

Intracapsular because of a decrease in blood flow

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11
Q

How do you properly used crutches?

A

The client advances both crutches and the impaired leg at the same time. The client then swings the uninvolved leg a head to the crutches

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12
Q

What side is the cane placed on?

A

The affected side

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13
Q

What time frame is a patient most at risk for developing a fat emboli post fracture?

A

36 hours

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14
Q

What is the initial symptom of a fat emboli?

A

Confusion due to hypoxemia

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15
Q

In clients with hip fractures what is the most common complication?

A

Thromboemboli

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16
Q

What are prevention strategies for thromboemoli?

A
  • Passive ROM
  • use of elastic stockings
  • elevation of the foot of the bed to 25 degrees
  • low dose heparin therapy
17
Q

Where do you check for compartment syndrome?

A

Distal to the injury

18
Q

What are the 5P’s for neurovascular functioning?

A 
Pain
Paresthesia
Pulse
Pallor
Paralysis
19
Q

What is the biggest complication post op for a joint replacement/.

A

Infection

20
Q

Fractures of bone predispose the client to anemia, especially if long bones are involved. Check pts hematocrit….

A

every 3-4 days to monitor erythropoiesis

21
Q

What complications are immobile clients prone to

A
  • Skin integrity
  • formation of urinary calculi- limit milk
  • venous thrombosis
22
Q

How long do you elevate the stump post operatively?

A

24 hours

23
Q

What happens if the stump is elevated too high?

A

contracture

24
Q

What time frame do you not elevate the stump?

A

after 48 hours

25
Q

how often does an amputee need to be in the prone position?

A

Three times a day to prevent hip flexion contracture

26
Q

Differentiate between RA and OA in terms of joint involvement?

A

RA - occurs bilaterally

OA- occurs asymmetrically

27
Q

Identify the categories of drugs commonly used to treat arthritis

A
  • NSAIDS

- Corticosteroids

28
Q

Identify pain relief interventions for clients with arthritis

A
  • Warm, moist heat
  • Diversionary activities
  • medications
29
Q

What measures should the nurse encourage female clients to take to prevent osteoporosis?

A
  • Possible estrogen replacement after menopause
  • High calcium and vitamin D intake beginning in early adulthood
  • Calcium supplements after menopause
  • weight bearing exercise
30
Q

What are the common side effects of salicylates?

A
  • Gi irritation,
  • tinnitus
  • thrombocytopenia
  • mild liver enzyme elevation
31
Q

What is the priority nursing intervention used with clients taking NSAIDS

A

Administer or teach clients to take drugs with food or milk

32
Q

List three most common joints that are replaced

A

Hips
Knee
Finger

33
Q

Describe postoperative residual stump care for the first 48 hours

A
  • Elevate residual limb for the first 24 hours
  • Do not elevate residual limb after 48 hours
  • Keep residual limb in the extended position
  • Turn client prone three times a day to prevent flexion contracture
34
Q

Describe nursing care for the client who is experiencing phantom pain after amputation

A

Be aware that phantom pain is real and will eventually disappear. Administer pain medication . Phantom pain responds to medication

35
Q

A nurse discovers that a client who is in traction for a long bone fracture has a slight fever, is short of breath, and is restless. What does the client most likely have?

A

A fat embolism

36
Q

What are the immediate nursing actions if fat embolism is suspected in a client with a fracture or other orthopedic condition?

A

Notify the physician stat, draw blood gases,

administer o2 according to blood gas results, assist with endotracheal intubation and treatment of respiratory failure

37
Q

List three problems associated with immobility?

A

Venous thrombosis
urinary calculi
skin integrity problems

38
Q

List three nursing intervention for the prevention of thromboembolism in immobilized client with musculoskeletal problems.

A
  • Passive ROM
  • elastic stockings
  • elevation of the foot of the bed to 25 degrees to increase venous return.

HESI NCLEX-RN EXAMINATION (6 decks)

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