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118 Cards in this Set
- Front
- Back
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Name two radiological procedures
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X-rays and CAT scans
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X-rays
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determine density, alignment, texture, integrity of bone
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CAT scans
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Scans soft tissue and bones and are used w/bone tumors and spinal problems
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MRI
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Nonivasive procedure that uses magnetic energy
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Arthroscopies
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Surgical procedure usd to view interior of a joint
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Bone biopsy
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determine presence of cancer in bone
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Arthrocentesis
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Surgical puncture of joint to obtain a specimen
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Bone Densitometry
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Estimate bone mineral density
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How would a nurse provide psychosocial support for a preoperative pt.
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discuss the procedure, pain managment recovery plan and other concerns the pt. may have
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What types of physical care might a nurse do for a preoperative pt.
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controlling infection, adequate hydration, anticoagulant therapy, bed preparation, autologous blood donor
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What are the main concerns with postoperative care
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vascular/neurologic Integrity (CMS/NVS)
Pain control, Activity Limitations, Prevention of DVTs, |
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What does CMS mean
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Circulation, motion, sensation
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What are the types of activity limitations
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FWB, PWB, NWB
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Name some devices to help set physical limits w/postop pt.
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abduction pllows, toilet seat extender
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What are the five Ps to assess
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pain, pulses, paresthesia, pallor, paralysis
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Name some devices to assist mobility w/postop pt.
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Crutches, walkers, canes, Immobilizers/braces
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Types of exercise rgimens
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Physical therapy, Occupaitonal therapy
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What are ways to prevent DVTs w/postop pt.
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Anticoagulants, TED hose/ antithrombic pumps, ambulation
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What are the types of facilities for rehabilitation
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Rehabilitation Centers, Skilled Nursing Facility (SNF), Trans Care Unit (TCU), Home Health Care (HHC)
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What other factors help with Pt. recovery from orthopedic surgery
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Attitude, hope, and family support
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How long dose it take for a fracture to fully heal
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1 year
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Fracture
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break in continuity of bone
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complete fracture
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bone is broken into at least two parts
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closed fracture
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when skin is not periferated
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open (compound) fracture
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a fracture in which damage also involves the skin or mucous membranes
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greenstick fracture
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a fracture where one side of the bone is broken and the other is bent
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impacted (compressed) fracture
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a fracture where one bone is driven into another
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Comminuted fracture
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complete fractures that breaks into many fragments
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pathologic fractures
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fracture that occurs through an area of diseased bone that occurs without trama or fall
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avulsion fracture
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a fracture that occurs when there is a pulling away of a fragment of bone by a ligament or tendon and its attachment
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What are the S&S of fractures
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Pain, swelling, loss of function, deformity- out of alignment, spasms of muscles, crepitus
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reduction
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correcting a bone fracture or dislocation by open or closed technique
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closed technique reduction
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manually pulling and realigning the bones
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Open technique reduction
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requires surgical incision (ORIF) and screws, nails, plates and pins are used
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Cast
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plaster or fiberglass that hold bone in alignment to promote healing
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What is included in the assessment of a cast
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CMS-distal part, handle carefully, check for odor and itching
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What is a bivalve cast
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a cast split in half to reduce pressure
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What is are the types of traction
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Skin and skeletal
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What is the purpose of traction
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to decease muscle spasms, immobility after reduciton, realignment
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Skin traction
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adhesive material applied to skin via wrap
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Skelatal traction
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steel pin through bone, ends protrude from skin
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What is used to clean skin pins with
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Saline and ointment as ordered
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What are the different external fixation devices
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Hoffman, halo brace
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What are the nursing implications for external fixation devices
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elevate part, NVS/CMS- q1-4 hours or w/VS, exercise the part, teach adaptations mobility limitaions, drain care
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What are the major complications of fractures
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Nonunion, malunion, infection, fat embolus, DVT, and compartment syndrome
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Nonunion
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no firm union of bone
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Malunion
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deforminty of the union of bone
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Infection of bone
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osteomyelitis
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What are the S&S of a fat embolus
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Restlessness, dyspnea, increase in P/R, Cyanosis, hypoxia, petechiae
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What are the S&S of a DVT
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fever, pain, swelling, and tenderness
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What are the nursing implicaitons to prevent a DVT
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Anticoagulant, early ambulation, TED hose, Antithrombic pumps
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What are the S&S of compartment syndrome
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increase of pain, paresthesia, skin stretch
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Rheumatoid Arthritis
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Autoimmune disorder of inflammation of the synovial membrane and thickening of atricular cartilage
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Osteoarthritis
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progressive waring out of a joint
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Gout
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Chronic metabolic disorder that causes inflammation of a joint due to the increase of uric acid deposit because of the inablity to matabolize purines
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Osteoporosis
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decrease of bone desity by increasing porosity and brittleness of bone
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Psoriasis
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Chronic inflammatory disorder of the skin because of increase of poliferation of keratinocytes causing scaly patches
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Contact Dermatitis
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inflammation of the skin by contact with an antigenic
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Lupus Erythematosus
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Collagen disease that causes inflammaion and slow distruction of collagen
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Verrucae
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warts
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Pigmented Nevi
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Moles
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Angiomas
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a knot of distended blood vessels
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Keloids
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a sharply elevated irregular shaped, progressivly enlarged scar
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What are the S&S of Rheumatoid Arthritis
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Muscle aches, feveer, malaise, inflamed swollen red hot joints, stiffness in the morning, and eventual ankylosis
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What are the S&S of Osteoarthritis
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Stiffness in the AM, increase pain w/exercise, limitaion of movement, joint enlargement
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What are the S&S of Gout
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sudden onset of tophi formation occurance in big toe, hands, ankles, knees
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What are the S&S of Osteoporosis
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no S&S until 30% of bone loss occures, loss of height, curvature of spine, pain, and fractures
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What are the S&S Psoriasis
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elevated patches that are covered with dry, silvery scales
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What are the S&S of contact dermatitis
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Pruritis, burning erythrmia, vesciculation, and edema, weeping and crust formaiton followed by peeling
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What are the S&S of Lupus Erythematosus
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exacervations and remissions, polyartritis, glumervlonephritis, endocarditis, vaculitis, and bone marrow involvment, and butterfly rash
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What are the nursing implications for Rheumatoid Arthritis
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Balance and rest, maintain mobility, surgery, pain control, medications
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What are the types of surgerys for Rheumatoid Arthritis
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Arthroplasty, Snovectomy, Total Joint Arthroplasty
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What are the medicaitons that are used for Rheumatoid Arthritis
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Salicylates, Ibuprofen, COX-2 Inhibitors, Steroids
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What are the nursing implications for Osteoarthritis
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ADL's, moderate exercise, weight loss, heat and massage, T.J. replacement
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What are the nursing implications for Gout
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Diet, Care for affected part, medications, Check for S&S of kidney stones
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What is the diet for a pt. w/Gout
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Low in purines, fats and an increase in CHO, no shellfish, mushrooms, organ meat, and avoid ETOH
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What are the medications for a pt. w/ Gout
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Urocosuric drugs- block the reabsorption of uric acid,
Benemid, Anturane, allopurinaol (Zyloprim) NO ASA |
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What are the nursing implications for Osteoporosis
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Pt. teaching of Calcium intake, medications, ERT, weight baring exercise, diet, no smoking, and vitamin D
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What are the nursing implications for Psoriasis
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to slow mitotic activity, stress management
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What are the nursing implications for contact dermatitis
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avoid cause, soothing solutions- Burow's, calamine, oatmeal bath, antibiotics
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What are the nursing implications for Lupus Erythematosus
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Glucocortiocoids, salicylates, NSAIDS, stress managment, avoid ultraviolet light, severe cases- cytotoxic drugs
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What is compartment syndrome
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Build up of pressure within muscles surronded by fascia
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What are the S&S of compartment syndrome
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increase of pain, paresthesia, positive stretch test
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What are the nursing implications for compartment syndrome
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Prevention- rest, ice elevation, contact MD, fasciotomy
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What is the mobility for a hip fracture
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NWB with pinning and PWB with prosthesis
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Total hip
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socket and femur head is replaced
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What are the assistive devices for a total hip
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abduction pillow, toilet seat extender, walker/crutches, cane
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What is the position of pt. with a total hip
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abduction pillow, no greater flexion then 90 degrees, turn on opposite side
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How offten dose the drain need to be empty
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q8h and record
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Total Knee
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replacement of the distal femur epiphysis and proximal tibial epiphysis
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What is the position of pt. with a toal knee
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in CPM machine while in bed and heel care with transfers
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What are the S&S of bone tumors
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triad of pain, disability, and swelling
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What is the treatment for bone tumors
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surgery, radiation, chemotherapy
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What are some of the causes for amputations
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trauma, disease, tumors, congenital
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What are the preoperative preparation for a pt. that is getting an amputation
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Psych support, explain surgery
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What are the postoperative preparations for a pt. that had an amputation
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assess for hemorrhage, prevent contractures, compression/shrinkage of stump, rehabilitation
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What is the nursing implications for assessing hemorrhage of a pt. with an amputation
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pressure dressing-wrap stump, JP drain, and elevation
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What are the nursing implications for preventing contractures with a pt. with an amputation
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good positioning and early ambulation
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What are the nursing implications for rehabilitaion with a pt. with an amputation
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stump exercise, meet mobility needs, prosthetic devices, emotional support, phantom limb
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What are the complications for immobility...9
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muscle atrophy, contractures, osteoporosis, atelectasis/pneumonia, orthostatic hypotension, DVT/thrombophlibitis, constipation, renal calculi, pressure sores/decubitus
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What are the things to assess with a pt. with skin problems
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type of lesion and area involved, sensations, current medications food and clothing
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macule
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non raised reddened spot, freckles
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papule
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solid elevation of reddened spot, wart
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vesicle
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elevated, round, filled with serum, blister
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pustule
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small elevation containing pus, boil
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wheal
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elevated, irregular border, no free fluid, hives
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urticaria
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usually caused by an allergic reaction, characterised by pale or reddened irregular, elevated patches and severe itching
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scales
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shedding, dead epithelial cells
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crusts
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dried exudate
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excoriations
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loss of epidermis, abrasions
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What are the uses for plastic surgery
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repair defects and malformations, aesthetic and cosmetic improvement
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split thickness
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epidermis and part of the dermis
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full thickness
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epidermis and all dermis
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pedicle graft
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skin and subcutaneous tissue with one end still attached to donor site
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dermabrasion
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scraping, sandpapering of superficial skin
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What are the nursing implicaitons for plastic surgery
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avoid pressure to surgical area, protect from injury and sun exposure, no washing/shaving until crusts falls off
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Rhinoplasty
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plastic surgery of the nose
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Blepharolplasty
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plastic surgery that removes fat deposits on eyelids and under the eyes
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