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118 Cards in this Set

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