Musculoskeletal System

Question 1

What are the common symptoms of rheumatoid arthristis?

Answer 1

• morning stiffness
• weight loss
• swelling of both hands and wrists

Question 2

What methods would a nurse use to assess rheumatoid arthritis?

Answer 2

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

Question 3

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

Answer 3

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

Question 4

Avoiding sunlight is key in the management of

Answer 4

Lupus erythematosus

Question 5

What four factors trigger lupus?

Answer 5

1. Sunlight
2. Stress
3. Pregnancy
4. Drugs

Question 6

What population is at the highest risk for osteoporosis?

Answer 6

Postmenopausal, thin white women.

Question 7

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

Answer 7

Tums

Question 8

The main cause of factures in older adults is

Answer 8

Osteoporosis

Question 9

What are the four classifications of fractures

Answer 9

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

Question 10

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

Answer 10

Intracapsular because of a decrease in blood flow

Question 11

How do you properly used crutches?

Answer 11

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

Question 12

What side is the cane placed on?

Answer 12

The affected side

Question 13

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

Answer 13

36 hours

Question 14

What is the initial symptom of a fat emboli?

Answer 14

Confusion due to hypoxemia

Question 15

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

Answer 15

Thromboemboli

Question 16

What are prevention strategies for thromboemoli?

Answer 16

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

Question 17

Where do you check for compartment syndrome?

Answer 17

Distal to the injury

Question 18

What are the 5P’s for neurovascular functioning?

Answer 18

Pain
Paresthesia
Pulse
Pallor
Paralysis

Question 19

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

Answer 19

Infection

Question 20

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

Answer 20

every 3-4 days to monitor erythropoiesis

Question 21

What complications are immobile clients prone to

Answer 21

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

Question 22

How long do you elevate the stump post operatively?

Answer 22

24 hours

Question 23

What happens if the stump is elevated too high?

Answer 23

contracture

Question 24

What time frame do you not elevate the stump?

Answer 24

after 48 hours

Question 25

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

Answer 25

Three times a day to prevent hip flexion contracture

Question 26

Differentiate between RA and OA in terms of joint involvement?

Answer 26

RA - occurs bilaterally | OA- occurs asymmetrically

Question 27

Identify the categories of drugs commonly used to treat arthritis

Answer 27

- NSAIDS | - Corticosteroids

Question 28

Identify pain relief interventions for clients with arthritis

Answer 28

- Warm, moist heat - Diversionary activities - medications

Question 29

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

Answer 29

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

Question 30

What are the common side effects of salicylates?

Answer 30

- Gi irritation, - tinnitus - thrombocytopenia - mild liver enzyme elevation

Question 31

What is the priority nursing intervention used with clients taking NSAIDS

Answer 31

Administer or teach clients to take drugs with food or milk

Question 32

List three most common joints that are replaced

Answer 32

Hips Knee Finger

Question 33

Describe postoperative residual stump care for the first 48 hours

Answer 33

- 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

Question 34

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

Answer 34

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

Question 35

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?

Answer 35

A fat embolism

Question 36

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

Answer 36

Notify the physician stat, draw blood gases, | administer o2 according to blood gas results, assist with endotracheal intubation and treatment of respiratory failure

Question 37

List three problems associated with immobility?

Answer 37

Venous thrombosis urinary calculi skin integrity problems

Question 38

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

Answer 38

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