Ortho

Question 0

True or false: with compartment syndrome, the tissue cannot expand anymore and it implodes and moves inwards.

Answer 0

True

Question 1

What syndrome is associated with fractures or extensive soft tissue damage or crush injury of an extremity?

Answer 1

Compartment syndrome

Question 2

What are the internal factors of compartment syndrome?

Answer 2

Edema and extreme muscular activity

Question 3

What are the causes of external compartment syndrome?

Answer 3

Burns, tight dressing, cast

Question 4

What is the classic sign of compartment syndrome?

Answer 4

Pain unrelieved by analgesic

Question 5

What is the appropriate nursing care for compartment syndrome?

Answer 5

Raise extremity to heart level- no higher!
No ice- vasoconstriction exacerbates syndrome
Loosen bandages

Question 6

What is the treatment option for compartment syndrome?

Answer 6

Fasciotomy (slits cut into skin)

Question 7

What is it called when fat from the bone enter circulation and form emboli in the pulmonary capillaries and arterioles?

Answer 7

Fat embolism

Question 8

True or false: fat embolisms are very rare

Answer 8

True

Question 9

Name the disease: fluid leaks into the alveoli, increases workload on right side of heart, decrease lung compliance, triggers hypoxemia.

Answer 9

Fat embolism

Question 10

What is the distinguishing factor of a fat embolism?

Answer 10

Petechia

Question 11

What are the major signs and symptoms of a fat embolism?

Answer 11

Hypoxemia, tachypnea, tachycardia, pulmonary edema, crackles, confusion, fever

Question 12

True or false: there is no definitive lab work to diagnose a fat embolism

Answer 12

True (however there can be fat in urine or sputum)

Question 13

What is the best prevention for a fat embolism?

Answer 13

Try to limit touching the fracture

Question 14

Name the disease: muscles break down, releases myoglobulin, causes acute renal failure.

Answer 14

Rhabdomyolysis

Question 15

What are the major causes of rhabdomyolosis?

Answer 15

Trauma, poison bites, infections, HIV, statins, alcohol

Question 16

What are the clinical manifestations of rhabdomyolosis?

Answer 16

Agitation, delirium, reddish/brown urine, high K high PHOS

Question 17

What labs diagnose rhabdomyolosis?

Answer 17

Increase CK, increase BUN/Creatinine, hypocalcemia, elevated wbc

Question 18

How do you treat rhabdomyolosis?

Answer 18

Osmotic/loop diuretics, admin NSS Iv 12-15liters over 24hr, dialysis if needed

Question 19

What nursing care is provided for rhabdomyolosis?

Answer 19

Monitor all levels, analgesics

Question 20

What are the major causes of low back pain?

Answer 20

No exercise, prior injury, obesity, age ( time wears away the cushion between the vertebrae), spinal stenosis, Clauda equina

Question 21

What do you assess for with low back pain?

Answer 21

Palpation, symmetry, uneffected side first, reflexes, bowel/bladder issues, nv checks, gait

Question 22

What is the difference between mild and severe back pain?

Answer 22

Mild is relieved by rest. Severe has significant neurological deficets

Question 23

True or false: diagnostic studies are not used for mild back pain.

Answer 23

True

Question 24

What is the collaborative care for lower back pain?

Answer 24

Rest, steroids/anti-inflammatory/muscle relaxers, exercise/pt, hot/cold, quit smoking, lose wt

Question 25

What is the best position to sleep with lower back pain? (Spider-Man)

Answer 25

Williams position

Question 26

What is severe pain unrelated to original pain caused by long term use of opioids?

Answer 26

Opioid induced hyperalgesia

Question 27

What surgeries can be performed for back pain?

Answer 27

Kyphoplasty (balloon inserted to put cement between discs), spinal fusion, bone grafting, discectomy, laminectomy

Question 28

What is an allograft?

Answer 28

Cadaver bone

Question 29

How do you position a pt after back surgery?

Answer 29

Log-roll pt, pillow propping, NO trapeze, assess q2h

Question 30

What is an infection in the bone?

Answer 30

Osteomyelitis

Question 31

What is the direct way to get osteomyelitis?

Answer 31

Open fracture or surgery

Question 32

What is the indirect way of getting osteomyelitis?

Answer 32

Blood borne infection: teeth, tonsils, boils, diabetic ulcers

Question 33

What is the contiguous method of getting osteomyelitis?

Answer 33

Cellulitis

Question 34

What is the difference between acute and chronic osteomyelitis?

Answer 34

Acute lasts less than a month. Chronic lasts longer than 4 weeks.

Question 35

True of false: bone turns to pus due to bacterial growth in osteomyelitis

Answer 35

True

Question 36

True or false: clinical manifestations of osteomyelitis are similar to the flu

Answer 36

True

Question 37

What is the collaborative care for osteomyelitis?

Answer 37

Vigorous antibiotic, surgical debridement, suction/irrigation, hyperbaric 02 therapy

Question 38

What is the buergers test with amputations?

Answer 38

Pt lays supine, legs elevated, look for colors in feet

Question 39

What is disarticulation?

Answer 39

Amputation at joint

Question 40

How do you prevent flexion contractions?

Answer 40

Lie flat on back for 30 mins at a time 3-4 times a day