skin/bone

Question 1

How does impaired circulation happen w casts

Answer 1

exothermic reaction from plaster= vasodilation= edema= impaired circulation

Question 2

Whys osteomyelitis hard to treat

Answer 2

a capsule (sequestrum) forms which is a ring of dead tissue w/o blood flow  
WBC and ESR elevated

Question 3

2point gait
3 point
4 point
swing

Answer 3

2-crutch opposite of leg
3- both crutches w non weight bearing leg
4- r crutch, l foot, l crutch, R foot
swing- both crutches forward, swing foot past crutches

Question 4

Whats Lupus

Answer 4

inflammatory autoimmune disease affecting JOINTS, BUTTERFLY RASH, renal, seizures, arrythmias, peri neuropathy

Question 5

LUPUS dx

Answer 5

ANA 99%, RF 15-35, ^ESR, gamma globulin, decreased WBCs and PLTs

Question 6

LUPUS meds

Answer 6

nsaids for arthalgia
antimalarials for inflammation
steroids for exacerbations
Immunosuppressive ctoxan, immuran

Question 7

Osteoarthritis

Answer 7

MEN{NONinflammatory decrease in weight bearing cartilage

Question 8

Osteoarthritis S/s

Answer 8

pain releived w rest, worse w activity, assymetric, herbeden (distal), bouchard ( prox), bow legged, one leg shorter

Question 9

Osteoarthritis dx

Answer 9

synovial fluid has bone chips, cartilage is yellow

Question 10

Osteoarthritis treatment

Answer 10

apply heat or cold to help pain/stiffness, intraarticular injections of corticosteroids for pain w effusion, hylauronic acid

Question 11

Rheumatoid arthritis

Answer 11

WOMEN{systemic autoimmune inflammatory, worse in morning

Question 12

RA comps

Answer 12

ulnar deviation, swan neck, joint subluxulation, subq nodules

Question 13

RA dx

Answer 13

^esr, rf, ana (inflammatory),

Question 14

RA treatment

Answer 14

heat/cold for pain stiffness NOT in acute flares, antiinflammatory, antirheumatics (antimalarial, gold, penicillamine, sulfasalazine) if aggressive w erosions=dmards (immunosuppressant), systemic steroids to counteract flares, inject into problem joints

Question 15

Knee replacement activity, Drainage,

Answer 15

more active than hip, cpm machine, 200ml 1st 8hrs, decrease to less than 25 ml 48hrs

Question 16

Carpal tunnel phalen test

Answer 16

wrists together one minute

Question 17

Carpal tunnel tinels test

Answer 17

tap on medial nerve

Question 18

Incomplete fracture

Answer 18

bending/crushing

Question 19

Simple fracture

Answer 19

closed reduction

Question 20

comminuted

Answer 20

multiple pieces (open reduction)

Question 21

Open/ compound fracture

Answer 21

surgical debridement

Question 22

early movement with

Answer 22

open reduction w/ internal fixation

Question 23

skin traction, bucks

Answer 23

48-72 hrs until skeltal traction, bucks stops hip flexion, decreases muscle spasms

Question 24

Skeletal traction

Answer 24

long term keeps bones aligned w pins, wire

Question 25

Hip fracture s/s

Answer 25

external rotation, muscle spasms, shortening of leg, displaced femoral head=necrosis

Question 26

hip fracture post op

Answer 26

OOB day one, assess sense/function, keep pillow between legs 6 wks, anterior more stable post op; 350 ml drain 1st 24hrs

Question 27

After Hip replacement do NOT

Answer 27

``` climb stairs (3mo) flex hips>90 degrees (low chairs) adduct, internal rotation, cross legs ```

Question 28

S/s of hip prosthesis dislocation

Answer 28

sudden pain, lump in butt, limb shortening, external rotation

Question 29

Osteoporosis

Answer 29

imbalance between osteoclasts &blasts, secondary to long term steroid therapy

Question 30

osteoporosis DX

Answer 30

DXA measures hip &spine density (accurate), Bone sonometer measures heel and peripheral sites (easy)

Question 31

Osteoporosis drugs

Answer 31

biphosphanates ( slow clasts,^bone mass), fosamax (empty stomach, upright 30min), calcitonin IM SQ Nasal, SERMS mimick estrogen in decreasing bone reasborption=hot flash, leg cramps

Question 32

repositioning chair vs bed

Answer 32

2hrs bed, 1hr chair

Question 33

stage two pressure ulcer

Answer 33

partial thickness, shallow pink wound bed OR intact/open blister w serum in it

Question 34

stage 3 pressure ulcer

Answer 34

full thickness tissue loss, subq fat, undermining, and tunneling

Question 35

stage 4 pressure ulcer

Answer 35

full thickness loss w exposed bone, tendon, or muscle, undermining, tunneling

Question 36

What to use to clean pressure ulcers

Answer 36

noncytoxics bc they dont damage fibroblasts