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Flashcards in Musculoskeletal System (PNP) Deck (46)
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1

Rheumatoid Arthritis(systemic)

etiology:
-most painful and crippling form
-75% are women, 20-50yrs(young person disease)
-autoimmune
-chronic inflammation of synovial membrane and joints

S/S:
-inflames synovial joints
-cartilage gets eaten away
-bone rubs on bone
-joint calcifies
-remission and exacerbation
-maliase/fatigue
-loss of appetite
-fever
-edema,erythema,warmth of joints
-decrease ROM(stifness), pain/tenderness

Diagnostic test:
-sedimentation rate is postitive
-h&p, looking for joint pain, morning stifness,muscle weakness,fatigue
-rhematoid factor is positive in 80% abnormal protein
-synovial fluid is suppose to be clear, if yellow indicates arthritis

medical management:
-maintain function
-get into remission
-decrease inflammation
-drug therapy-NSDAIDs, aspirin, antinflammatories(steriods)
-PT,OT

nursing intervention:
-rest due to fatigue
-exercise to prevent joints from freezing
-ROM w/ frequent rest periods
-hot packs-warm soaks
-parafifn wax

patient teaching:
-understand medication
-major side effect of antinflammatory: gi distress/bleeding
-check stools for dark tarry stools
-safety: use of cane and walkers
-morning stiffnes(warm shower in morning)

2

osteoarthritis

etiology:
-related to aging
-specific to joint or two
-wear and tear
-degenerative joint disease
-primary-dont know cause
-secondary-can figure cause cause excess weight on weight bearing joints
-non-systemic inflammatory disease
-bones,cartilage, and joints degenerate
-wear and tear

s/s:
-related to aging
-affects joints in hands,knees,hip,cervical an lumbar vertebrae
-stiffness and pain
-muscle spasms
-decreased grip strength
-joint edema
-tenderness
-deformities

diagnostic test:
herberden nodes(distal joints in fingers)
bouchard nodes fingers- hard bony enlargements
-history/physical, X-rays, orthroscope

medical management:
-excercise and rest periods
-heat application
-walkers, canes,
-larges doses of asa,nsaids,steroids
-joint replacement or arthroplasty(knee replacement)

nursing intervention:
-maintain ADLs
-weight reduction
-check for Gi bleeding
-guiac stools

patient teaching:
-know medication
-can cause gi bleeding

3

Ankylosing spondylitis(etiology)

-chronic progressive disorder of sacroiliac and hip joints, synovial joints of spine, and adjacent soft tissue
-seen more in young men
-hereditary

4

Ankylosing Spondylitis(Signs & Symptoms)

-inflamation of spine
-bones grow together
-ligaments ossify
-enlarged heart, pericarditis
-kyphosis
-ibd(irritable bowel disease)
-vision loss

5

Ankylosing Spondylitis(assessment)

-low back pain
-stiffness
-tenderness in spine and sacroiliac
-peripheral joint edema
-decrease ROM

6

Ankylosing Spondylitis((medical management)

-analgesics
-NSAIDS
-surgery to replace fused joints

7

Ankylosing Spondylitis(nursing intervention)

-maintain alignment of spine
-postural and breathing exercise
-lye on abdomen for 15-30min QID to extend spine
-back braces
-firm braces
-warm compresses

8

Gout(etiology)

-metabolic disease
-body unable to metabolize purines
-uric acid accumulates in blood
-crystal deposits in joints cause inflammation
-occur more often in men
-involves big toe,knee,ankle

9

Gout(signs/symptoms)

-onset occurs at night
-severe pain, inflammation,edema,
-erythema of join
-episodes lasts from hours to days
-one episode or repeated attacks

10

Gout(assessment)

-dietary history: alcohol,cheese,organ meats, scallops, anchovies
-edema
-discoloration
-increased temp.
-decrease movement
-increase HR, RESP RATE, BP
-decrease urine output
-crystal stone(kidney stones)

11

Gout(medical management)

-cholchicine
-phenylbutazone-anti-inflammatory
-indomethacin
-steroids
-allopurinol

12

Gout(nursing intervention)

-protect affected joint with bed cradle
-warm and cold compresses
-elevate joint
-increase fluids

patient teaching
-follow prescribed diet
-medication as ordered

13

Osteoporosis(etiology)

-demineralization of bone
-bone mass decreases
-women 35-65 yrs
-related to menopause

contributing factors:
-immobilization, steroids, increased caffeine, decreased calcium in diet, smoking, white and asian and small stature

14

Osteoporosis(signs and symptoms)

-develops slowly and progresses
-bones become porous and brittle due to decreased calcium in diet

15

Osteoporosis(assessment)

-pathological fractures
-difficulty weight bearing
-loss of height, kyphosis

16

Osteoporosis(diagnostic test)

-bone density test(dexa scan)
-check calcium level

17

Osteoporosis(medical management)

-calcium supplement(sardines,green leafy veggie,salmon has alot of calcium
-weight bearing exercises
-estrogen
-fosamax,boniva,actonel(bone reabsorbtion inhibitors-stop you from losing bone

18

Osteoporosis(nursing intervention)

-increase calcium diet
-decrease caffeine, smoking
-safety measures
-walking, biking, swimming=excellent ways to build bones

19

Osteomyelitis(etiology)

-serious bone infection
-acute:results from compound bone fracture that exposes to the bone to infection
-inflammation,ischemia,necrosis

20

Osteomyelitis(signs/symptoms)

-pain,fever,flushed appearance
-skin over affected area(warm,erythema,edema)
-increased wbc
-positive culture
-elevated ESR

21

Osteomyelitis(medical management)

-iv antibiotics(4-8weeks)
-early detection
-drains
-complete immobilization of body parts
-pain management
-increased protein,carbohydrates,calcium, and fluids

22

chronic osteomyelitis

-antibiotics are ineffective
-abscess forms
-micro-organisms may be drug resistant
-sign/symptoms: purulent drainage,pain,edema,weakened bone

23

Herniated intervertebral disk(etiology)

-disk of cartilage btw two vertebrae weakens and presses on spinal nerves/ spinal cord

24

Herniated intervertebral disk(signs/symptoms)

-back,shoulder,neck pain
-neurological dysfunction
-radicular pain(that radiates)

25

Herniated intervertebral disk(risk factors)

-age, smoking,
-degenerative joint disease(osteoarthritis)
-osteoporosis
-heavy lifting

26

Herniated intervertebral disk(nursing interventions)

-pain medication
-increase protein and vitamin diet
-routine post-op care
-neurovascular checks
-check dressing OOB day 1

27

Hip and knee Arthroplasty

-repair or replacement of a joint
-total hip or total knee replacement

:pre op and post op interventions
-neurovascular checks qhrly for first 24hra
-turn toward unoperative side
-cpm=continous passive motion=machine does range of motion for them, promotes healing, increase circulation
-premedicate b4 going on machine
-total hip precautions: no adducting and bending

28

Amputation

-absence or removal of all or part of limb
-due to injury=traumatic amputation
-wrap, amputated part in cool moist clothe and put in plastic bag and then put plastic bag in ice
-planned amputation: for malignancy, infection, gangrene, trauma,peripheral vascular disease
-wear prosthesis to prevent hip contraction and lying prone(stomach/abdomen)
-phantom limb pain=nerves are still sending pain messages to brain
-complication: hemorrhage, stomp doesnt heal, infection
-teach post op: compression dressing w/ ace bandages, done to protect limb, control edemal pain, shape the stomp

29

contusions

-soft tissue injury from a blunt force or blow
-causes local bleeding under skin(hematoma)
-seriousness depends on location
treatment: REST ICE ELEVATION COMPRESSION, pain medication

30

sprains

-injury to ligaments surrounding joints causing them to stretch and tear
-may involve bleeding into joints
-REST ICE ELEVATION COMPRESSION
-common sprain in ankles