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88 Cards in this Set

  • Front
  • Back
Osteoblast activity is needed for?
bone formation
What hormone is linked to calcium reuptake and building of bone tissue?
What is the production of red blood cells in bone marrow called?
What is the primary complication of osteoporosis?
What happens to the bones in osteoporosis?
Bones soften, and there's a DECREASE in bone matrix and remineralization
What are the causes of PRIMARY osteoporosis?
hormonal imbalance
faulty metabolism
poor dietary intake of
What are the causes of SECONDARY osteoporosis?
osteogenesis imperfecta
rheumatoid arthritis
liver disease
lactose intolerance
What does menopause (hormonal imbalance) put women at risk for?
A woman who has just had a total hysterectomy and has had her ovaries removed is no longer producing hormones and is at risk for?
What is the primary prevention of osteoporosis?
maintain optimal calcium intake, and use estrogen replacement therapy
The primary mechanism BELIEVED to cause gout is?
caused by a genetic defect in purine metabolism that causes OVERPRODUCTION of uric acid
Is gout related to calcium production?
In advanced gout, urate crystal deposits develop on the hands, knees, feet, forearms, ear, and Achilles tendon. These deposits are referred to as?
The usual pattern of nonchronic gout involves?
painful attacks with pain-free periods
Chronic gout may lead to?
frequent attacks with persistently painful joints
Which foods would a patient AVOID eating who has been prescribed a diet that limits its purine-rich foods?
Don't eat:
What is client teaching for a patient who is recovering from an attack of gout?
Lose weight as the loss will decrease stress on joints
A physician tells a client diagnosed with gout that his X-rays are normal. An appropriate response that the physician might make if the patient asks if he still has gout would be?
X-rays are normal in the early stages of gout and can be very valuable in diagnosing gout.
When x-ray changes occur in a gout patient, the changes are present during?
attacks AND remissions
Why is colchicine effective in the treatment of gout?
MOA for colchicine is that it DECREASES inflammation by reducing the migration of leukocytes to synovial fluid
What is the best explanation for why clients with gout are encouraged to increase fluid intake?
fluids promote the excretion of uric acid
Gout usually occurs in?
A client with gout is receiving indomethacin (NSAID) for pain. Client teaching for a patient on NSAIDs might include?
take with food because it can be irritating to the GI mucosa and lead to GI can cause drowsiness and potential bleeding complications
What is the most common form of arthritis?
osteoarthritis...can afflict people of any age, but mostly elderly
What causes primary osteoarthritis?
overuse of joints
What causes secondary osteoarthritis?
congenital abnormalities
diabetes mellitus
Which nodes are a common sign of osteoarthritis?
Where do Heberden's nodes appear?
distal interphalangeal joint on men and women
Where do Bouchard's nodes appear?
dorsolateral aspect of proximal interphalangeal joint
What is the common drug treatment for osteoarthritis?
Salicylates can be dangerous in older people because they can cause what adverse effect?
hearing loss
What symptoms can salicylates cause which is worrisome to older clients?
fluid retention
Salicylates DO NOT DECREASE____ absorption.
Salicylates DO NOT INCREASE ______ demineralization
Clients with osteoarthritis may be on bedrest for prolonged periods. What is a proper nursing intervention for these clients?
turn client every 2 hours, and encourage coughing and deep breathing
What is the difference between rheumatoid arthritis and osteoarthritis?
osteoarthritis is a LOCALIZED disease...not gender specific

rheumatoid arthritis is SYSTEMIC...gender specific

BOTH disorders have dislocations and subluxations
Which joint involvement assessment finding would indicate osteoarthritis?
asymmetrical joint involvement
What signs and symptoms are present in rheumatoid arthritis?
elevated sedementation rate
multiple subcutaneous nodules
inflammation (heat, fever,
What instruction would be considered primary prevention of injury from osteoarthritis?
"Warm up before exercise and avoid repetitive tasks"
What is a good description of osteoarthritis?
a noninflammatory joint disease, with degeneration and loss of articular cartilage in synovial joints
What is rheumatoid arthritis?
systemic inflammatory joint disease
What is arthrodesis?
fusion of joints
An osteoarthritic patient type of clothing that would help with ADLs is?
velcro clothing
slip on shoes
rubber grippers

avoid zippers, ties, and buttons
How can a nurse help a client who is refusing to perform her own daily care?
encourage her to perform as much care as her pain will allow...don't use pain medication as a bargaining tool
What term is used to describe the late stages of osteoarthritis?
Early stages of osteoarthritis may cause the following symptoms?
a dull ache and deep aching pain with or without relief with rest
What happens to cartilage as osteoarthritis develops?
the cartilage covering the ends of the bones is destroyed and bones rub against each other...osteophyties, or bone spurs, may also form on the ends of bones
When a client uses a cane for assistance in walking, the cane should be used on the _______ side.
What instruction about activity should be given to a client with osteoarthritis after he returns home?
should pace activities and avoid overexertion
What can overexertion in an osteoarthritic patient cause?
increased degeneration and pain
What can a sedentary lifestyle cause in an osteoarthritic patient?
A client was prescribed an anti-inflammatory drug for osteoarthritis 5 days ago. He says the pain has decreased some but not completely. What should the nurse tell him?
"continue the present dose" and offer other pain measures because anti-inflammatory meds may take 2 to 3 weeks for full benefits...other measures are rest, massage, heat, cold
Degenerative joint disease, also commonly known as osteoarthritis is caused by?
noninflammatory joint disease due to wear and tear on joints and often seen in athletes
What is client education about gout?
uric acid crystals collect in joint of great toe and causes inflammation...the kidney excretes uric acid, an end product of metabolism...a diet low in purines would be indicated
The nurse is assigned to care for a 70-year-old client with acute rheumatoid arthritis. What might she find during physical exam?
stiff joints
Osteoarthritis findings might include?
nodules on the dorsolateral aspects of the distal interphalangeal joints (Herbeden's nodules), flexion and deviation deformities, like radial deviation of the distal phalanges, and nodules on the proximal interphalangeal joints (Bouchard's nodes)
What can occur with long-term prednisone (Deltasone) therapy
diabetes mellitus
The hands of a patient with osteoarthritis may have Heberden's nodes where?
distal interphalangeal joints...these bony and cartilaginous enlargements are usually hard and painless and typically occur in middle-aged and elderly clients with osteoarthritis
A client is diagnosed with gout. Which foods should the nurse instruct the client to AVOID?
(these foods are high in purines)

also avoid anchovies, sweetbreads, lentils, alcoholic beverages, esp. beer and wine
Scoliosis is a common finding in which 2 clients?
pregnancy and abdominal obesity
What do these values indicate?
creatinine kinase 195 U/L
AST 20 U/L
serum calcium 10.2 mg/dL
serum phosphorus 3.6 mg/dL
muscle trauma
progression muscular
effects of electromyography
A 27 year old woman who is insulin-dependent since 3 years old complains of tingling in fingers with pain radiating up wrist and bilateral feet pain. Which assessment test is indicated?
What is a follow-up statement that shows good understanding for someone who
wants to know what to expect after musculoskeletal diagnostic testing?
"I may develop blood under my skin at the needle sites"
Someone needs arthroscopy surgery. What is a teaching intervention?
Teach the client straight leg raising exercises before the surgery so he can perform them after the surgery.
What is a statements that shows a client knows the difference between primary and secondary risk factors for osteoporosis?
"white female older than 60 who smokes and has a family history of osteoporosis is at risk for primary osteoporosis"
Clients on Prepro should have what 2 things checked?
blood pressure and cholesterol
What is indicative of osteomalacia?
demineralized bones
increased alkaline
phosphatase level
Common assessment findings for Paget's disease?
low back and sciatic nerve
Someone has osteomyelitis in right leg which may be acute or chronic. What are the symptoms for acute osteomyelitis?
erythema of affected area
tenderness to touch
What is the priority plan of care for a patient with osteomyelitis?
medicate for severe pain
Patient with osteosarcoma has pain and swelling in left shin. What is the priority nursing diagnosis?
acute pain related to physical injury
A patient has altered body image...nurse develops plan of care...what is expected outcome statement?
client will demonstrate adjustments to chnages in health status
A 57 year old diabetic carpal tunnel syndrome patient needs further education if she says?
Even though I have carpal tunnel syndrome, men are more likely than women to experience carpal tunnel syndrome
When carpal tunnel syndrome is confirmed, which treatment option is plausible?
use a splint to offer immobilization
Patient has fallen at work and twisted ankle....shakes off injury as nonemergent...over next couple of days, however, ankle injury and pain do not abate...a trip to local emergency department reveals a fracture over the top of talus bone. Which type of fracture is this?
incomplete fracture
A 68 year old female presents to emergency room with a back injury from a fall onto wet cement. What is an appropriate stage of bone healing?
within 48 to 72 hours after injury, a hematoma forms at the site of the fracture because bone is extremely vascular
Following diagnosis of a tallus fracture at right ankle...patient is cast even though right lower extremity is quite swollen...which symptoms should be monitored for as an indication of acute compartment syndrome?
pain with passive motion of extremity
8 year old male gets cast for broken arm due to fall from tree...nurse assesses frequently for neurovascular changes...which neurovascular change assessment would you expect nurse to do?
assess sensation with
Nurse is developing plan of care for 33 year old client admitted with fracture of pelvis following motor vehicle accident...which nusing diagnoses apply?
risk for infection r/t trauma
ineffective coping r/t
prolonged immobility
potential for ischemic
constipation r/t opioids and
prolonged immbolity
When caring for a client with a cast, Stephanie is told by her nursing instructor what intervention should be completed. Which nursing intervention by nursing student demonstrates a correct understanding of cast care?
a finger is inserted into the cast to check for snugness
A 17yo male admitted to pediatric hospital and placed in skeletal traction after humerus is fractured in tackle football game...which nursing intervention demonstrates need for further teaching regarding traction care?
if client in severe pain, lower amount of weight on the traction
Talus fracture causing excruciating pain...what is best intervention?
administer opioid mixture...antiinflammatory drugs, and muscle relaxants
Male was outside shoveling snow when he fell on ice...upon ER visit, it is noted that he has suffered from a hip fracture...he is scheduled to go to OR in morning to undergo open reduction with internal fixation (ORIF). Which nursing intervention should be performed first upon his return from OR?
assess vital signs
Female sustains pelvic fracture after MVA...what is the priority nursing action?
assess for presence of blood in urine
Elsie is suffering from a rare bone cancer affecting her entire left leg and pelvic bones. An amputation is scheduled in an effort to save her life. Which type of amputation will ensue?
hip disarticulation
After Elsie's amputation, nurse visits her...when Elsie responds with melancholy to the nurse's questions, the nurse recognizes her impending depression over her procedure...which response by the nurse is most appropriate?
How do you feel about your loss?
Amputee is discharged to go home after 6 week stay in rehab facility. Which statement, if made by her husband, demonstrates a good understanding of her followup care?
"We'll wrap the stump three times daily with an elastic bandage in a figure eight manner."
Ryan, a professional athlete, injures himself in a bad fall. MRI diagnosis a torn meniscus. He's casted initially for a locked knee, but later he undergoes surgery. Which nursing action by a graduate nurse would require intervention by his/her preceptor?
Begin range of motion exercises in immediate postop period.