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101 LEC > TEST 4 > Flashcards

TEST 4 Flashcards

(74 cards)

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1
Q

What subjective data do we ask for musculoskeletal?

A

Joint: Pain, stiffness, ROM
Muscles: Pain, cramping, weakness
Bones: Pain, deformity, accident/trauma
*Do you have any limitations in movement

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2
Q

What are you inspecting for on musculoskeletal?

A

Color (fracture- may see brusing)
Swelling
Masses
Deformities

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3
Q

What are you inspecting for on musculoskeletal?

A

Color (fracture- may see brusing)
Swelling
Masses
Deformities

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4
Q

What are you palpating for on musculoskeletal?

A

Extremities - crepitous
Joints - tenderness
Temp (hot = autoimmune disorder)

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5
Q

What is AROM and PROM?

A

ActiveROM - Patient is able to do themselves
PassiveROM - patient is being assisted

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6
Q

What is ROM checking?

A

Joint mobility
Should not cause pain

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7
Q

What is the muscle strength grading scale?

A

5 - FULL ROM/ FULL RESISTANCE
4 - FULL ROM/ LIGHT RESISTANCE
3 - FULL ROM / gravity/no resistance from nurse
2 - FULL ROM / gravity eliminated /only horizontal but not vertical
1 - Slight contraction
0 - no contraction

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8
Q

What is osteoporosis?

A

Loss of bone mass/density resulting in decreased ability to maintain structural integrity of skeleton

Kyphosis present / aging / etiology unknown

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9
Q

What are the treatments for osteoporosis?

A

Biphosphonates - inhibit bone resorption
(fosamax, boniva, actonel) side effect - esophageal ulcers / give 8oz water

Calcitonin - inhibit bone resportion
(Miacalcin, Fortical)

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10
Q

What is Osteomalacia

A

Softening of bone tissue due to inadequate mineralization of osteoid - *calcification does not occur

Caused by Vit D deficiency (lack of sun, dietary, malabsorption - crohns)

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11
Q

What is Osteomyelitis?

A

Infection of the bone
- caused by invasion of microorganisms that stim inflam response in bone tissue

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12
Q

What is definition of a fracture?

A

A break or disruption in the continuity of bone
(not in 2 separate parts)

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13
Q

What is a simple fracture and a compound fracture?

A

Simple - Break but not exposed to the atmosphere // skin intact
Compound - bone sticking out of body - even if skin is broken but bone is not out//still compound

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14
Q

What are these types of fractures?
Comminuted
Displaced
Spiral
Impacted
Greenstick

A

Comminuted - Bone is in several fragments
Displaced - fracture in 2 parts but they are misaligned
Spiral - goes down in spiral
Impacted - bone against bone, (jump off cliff - impact)
Greenstick - bones are not fully formed and it is bowed or bent

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15
Q

Define a strain.

A

Excessive stretching of a muscle or tendon

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16
Q

Define Sprain

A

Excessive stretching of a ligament

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17
Q

What are the classifications of strains and sprains?

A

1st degree - stretched too much
2nd degree - stretched or pulls and tears
3rd degree - big tears, complete disruption, ripped apart

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18
Q

How do you manage strains and sprains?

A

Cold & heat
Activity limitations
Anti inflam drugs
Muscle relaxants
Surgery

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19
Q

How do you manage the different degrees of strains and sprains?

A

1st - Rest, Ice for 24-48, Compression bandage, Elevation

2nd - immobilization, partial weight bearing

3rd - longer immobilization, possible surgery

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20
Q

Sprains or strains are what part of body?

A

Muscle
Tendon
ligament

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21
Q

Define osteoarthritis

A

-Most common type of arthritis
(weight-bearing joints and hands)
-Joint pain and loss of function
-Progressive deterioration

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22
Q

What are Heberdens nodes and Bouchards nodes?

A

Heberdens nodes - enlargement of distal joint
Bouchards nodes - enlargment of proximal joint

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23
Q

What are the clinical manifestation of Osteoarthritis?

A

Pain worsens with activity / better with rest
Hypertrophy of bone joints
50% of hand have heb or bouc nodes

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24
Q

Define Rheumatoid arthritis

A

Chronic progressive systemic inflam autoimmune disease primarily affecting joints

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25
How does rheumatoid arthritis work?
Autoantibodies attack healthy tissue (RFacotrs) Affects synovial tissue of any organ or body system - thickened inflam cells (erode cartilage and bone) Starts in upper extremities & works down Not genetic
26
What are the clinical manifestation of rheumatoid arthritis?
Joint deformity Bilateral and symmertric 25% have subQ nodules - soft tissue growth pop up and go away **hyper extension of thumb always present
27
What is the treatment for rheumatoid arthritis?
Pain management Plasmapheresis - take blood out from remove RF and put blood back in Assistive devices
28
What is a comparison of Osteo and Rheumatoid?
Osteo - Assymetric, pain with movement, hypertrophy - not warm or red Rheumatoid - symmetric, pain when touched, warm and red
29
ALtruism
Wanting to care for others/help others
30
Autonomy
Ability to make own decisions
31
Human dignity
Respect all human life
32
Integrity
Follow standards
33
Social justice
Treating everyone equal / fairly
34
What are laws vs ethics?
Laws - rules establishing society's behavior, created and enforced by the government, breaking results in a penalty Ethics - Standards of behavior, based on morals, may or may not be penalized
35
Autonomy
Patients choice to make decisions
36
Beneficence
do good for patients/prevent harm
37
Fidelity
Keeping your word/ promise to care for them
38
Justice
Treat fairly
39
Nonmaleficence
Do no harm to patient
40
Veracity
Tell truth at all times
41
TORTS what are the 2 main categories?
Unintentional - negligence/malpractice Intentional -
42
What are the types of intentional torts?
Defamation - ruining someone's character False imprisonment - restrict patients freedom of movement Invasion of privacy - look up info that's not assigned Fraud - don't ID yourself correctly Assault - verbally threaten to touch someone Battery - physically touch someone/ doing a procedure w/o consent for invasive procedure such as surgery
43
What are the 2 types of defamation?
Slander - verbal Liable - typing it
44
Informed consent includes
-Explanation of treatment -anticipated risk -potential benefits -possible alternatives -answers to questions -a statement that consent can be withdrawn at any time
45
Emergency medical treatment and active labor law?
Make sure every hospital gives emergency care and stabilizes before kicking out regardless of insurance status
46
Patient safety and quality improvement act?
All care provided is of quality and its safe. Protects nurse when report on safe acts or quality and no retaliation
47
americans with disabilities act
Everyone gets treated the same - provides accommodations
48
Child abuse and prevention and treatment act
Mandatory reporter and protects against retaliation
49
Common incident reports
Med errors Complications from treatment/procedure Failure to report change in condition Falls Break is aseptic technique Patient refuses treatment/consent
50
HIPAA
Health insurance portability and accountability act of 1996 Protects the privacy of pt info / health info can be released for treatment, payment, routine health care operations
51
Nurse practice acts
Delegation to LPN/CNA - Delegate tasks not in nursing process
52
What are the 5 rights of delegation?
Right person Right task Right circumstance Right directions Right supervision
53
What is an advanced directive?
to communicate wishes regarding to end of life care should patient become unable to do so
54
What is the patient self-determination act (PSDA)
Requires that all patients be asked if they have advanced directives
55
What is a living will?
A list of all thing you want or don't want done. YES OR NO. Does not kick in until the person cannot advocate for self
56
Durable power of attorney for health care
name of person who will make health care decisions if patient cannot make own decisions
57
If there is no DNR order what does nurse do
Do CPR when a patient has no pulse or respirations
58
What is the food samaritan law?
Nurses are held to a different standard, bc your always a nurse - IF you walk up to someone and tell them your a nurse, it auto creates a nurse/patient relationship
59
What are some purpose of records?
Communication Care plan Financial reimbursement Auditing/monitoring legal documentation
60
What 3 things should always be on my nurses note?
What did I observe/assessments findings? What did I do about the findings? How did the patient respond?
61
HIPAA violation can result in
$250,000 fine 10 years in prison
62
What are 5 guidelines for quality documentation?
Factual Accurate Complete Current/timeliness organized
63
Documenting guidelines for paper charting
Pen Date and Time Mistakes - no whiteout, no scribbling only 1 line through mistake with error and signature with credentials no blank lines
64
When do you document? when you are writing or time of event
When you are writing note
65
Initial nursing assessment includes
Baseline Sample narrative note date time age, admitted for AAoX3, assessments in head to toe format name and credentials
66
What is PIE documentation
Problem Intervention Evaluation
67
What is DAR documentation
Data Action Response
68
What is SOAP documentation
Subjective Objective Assessment/analysis Plan
69
What is SOAPIE documentation?
Subjective Objective Analysis - nursing diagnosis Plan/goal Intervention / what did you do Evaluation / how did the patient respond
70
What is ISBARR
Introduction/introduce self and patient Situation Background Assessment Recommendation Read back and verify order from provider
71
What are the aims of patient education
Promote health prevent illness/injury Restore health facilitate coping how to develop self care abilities -knowledge, skills attitudes
72
What are the 3 learning domains
Cognitive - knowledge Psychomotor - skills Affective - attitudes
73
What are some factors that affect learning?
Age & development level Support & resources Culture and language literacy
74
What is the teaching-learning process?
Assess Identify actual learning needs Develop - plan Implement teaching plan Evaluate the learning

101 LEC (15 decks)

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