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127 Cards in this Set

  • Front
  • Back
what is arthroplasy
surgical repair of a joint
what is arthritis
inflammation of a joint
this is sometimes called a telescope fx because one bone fragment is forcibly wedged into another bone fragment. in long bones this can create a shortening of the extremity
Impact fx
painful disorder of the wrist or hand, induced by compression on the median nerve between the inelastic carpal ligament and other structures in the carpal tunnel
carpal tunnel syndrome
carpal tunnel syndrome results from pressure on the median nerve on the wrist symptoms of
paresthesia (sensation of pins and needles) and hypoesthesia (decrease in sensation)
there is a higher incidence of this in
women who are obese, middle aged women involving repetitious motions of hte fingers and hands
women in there last trimester
the affected hand has alterred ability to
grasp or hold small objects
subjective data includes
c/o burning pain or tingling in the hands relieved with vigoruos shaking or exercising of hte hands, numbness, inability to grasp or hold objects
objective data includes
assessment of the hand, wrist, or fingers for edema, muscle atrophy or a depressed appearance of hte soft tissue at the base of hte thumb onthe palmar surface
dx tests for carpal tunnel syndrome are
physical exam
handheld electroneurometer
medical management for carpal tunnel syndrome is
splint if you have mild symptoms
hydrocortisone acetate suspension injections - mild sx
surgery for severe sx
if surgery is required the post op intervetions are as follows
1. elevate hand and arm for 24 hours
2. implementing and evaluating active thumb and finger motion
3. administer meds
4. monitor v/s
5. check fingers for circulation, sensation, movement every 1 - 2 hours for 24 hours
amputation can be done for
trauma, diabetes, tumors, impaired circulation
if replantation takes place the severed limb should be kept sterile and placed in a
moist plastic bag filled with ice water. keep away from ice, do not use dry ice
subjective data in an amputation includes
assessment of pain
level of orientation
neuro impairment
objective data include what in an amputation
assess v/s
assess bilateral pedal pulses and doppler pressure measurements
assess wound drainage for color, amount and presence of odor
evaluate upper body strenght and nutritional status
dx tests include
cbc, bun, K levels, ECG
post op care of pt w/amputation includes noting subjective data such as
phantome pain
collection of objective data after amputation includes
observing for hemorrhage
monitoring suction drainage and documenting
assesing and protecting the remaining extremety
observe for nero impairent - done hourly in the immediate post period
nursing intervetions are aimed at preventing
flexion hip contractures can be prevented postop by
raising the foot of the bed slightly to elevate the residual eextremity (do not elevate the stump on a pillow)
pt should be placed in what position twice a day
what are duodenal ulcers caused by
when acid secretions exceeds the buffering factors
what are the risk factors for duodenal ulcers
H. pylori infection, NSAIDS, cigarette smoking, and coffee
what is the characteristic symptoms of duodenal ulcers
pain, symptom are described as dull, burning, burning, and gnawing, it is located in the midline of the epigstric region
subjective data for gastric ulcers
pain at night, nausea, eructation, distention - dyspepsia
objective data includes looking for
what bleeds more duoenal ulcers or gastric ulcers
gastric ulcers
duodenal ulcers are more apt to have
chronic bleeding, and more prone to perforate than gastric ulcers
when GI bleeding occurs one sign is
vomiting blood ( hematemesis) looks like coffee grounds there may also be a presence of melena (tarlike, fetid smelling stool containing undigeste blood).
in severe cases in duodenal ulcers what happens
there may be bright red blood rectal bleeding
what can aggravate bleeding in pts with a hx of peptic ulcers
salicylates and alcohol
bleeding from a__________ ulcer is more difficult to control then from a ______ ulcer
gastric, duodenal
what is considered the most lethal complications of peptic ulcers
what is a complication of peptic ulcer disease that can ccur at any time
gastric outlet obstruction
what is the tx for gastric outlet obstruction
relief may be achieved by constant NG aspiration of stomach contents.
fiberoptc endoscopy can detect both gastric and duodenal ulcers. this is called
what might be ordered to treat duodenal ulcers
NG tube, to remove gastric content and blood
sugery is indicated only when
the pt is no longer responding to medical management
what is the primary tx of peptic ulcers
decrease signs and symptoms by decreasing gastric acidity with drug therapy.
surgery is usually indicated for complications of ulcers. one type of surgery is the vagotomy
removal of the vagal innervation to the fundus, ecreasing acid produced by by the parietal cells of the stomach.
bleeding may occur up to ___ days after gastric surgery
what are possible indications of postop bleeding
abdominal rigidity, abdominal pain, restlessness,elevated temp, increase pulse, increased bp , leukocytosis
an endoscopic exam that enables direct visualization of a joint
what can you accomplish with arthhroscopy
removal of fluid
see if there are any diseases
remove damaged tissue or foreing bodies
after an arthrsocpy what should a pt do
limit activities
what do you look for after an athroscopy
inflammation, redness, edema, blood clots , bleeding
endoscopic exam that enables direct visualization of a joint
type of disease were there is an inflammation of a joint
what is the most serious form of arthitis
who does it affect
75 % are women
RA is thought to be an ________ disorder
RA can affect
many organ systems
RA is characterized by
chronic inflammation of the synovial membrane in the diathrodial joints
the 4 classics symptoms of RA are
morning stiffness, muscle weakness, joint pain, fatigue
lab tests performed for RA are
ESR , RF, Latex agglutination, RBC, synovial fluid aspiration
medical management of RA is directed toward achieveing the following goals
controlling the disease by adminstering antiinflammatory drugs
- pain relief
-prolonging the joint function with PT and splints
-slowing the progression of joint damage by promoting ADL, exercise and wt management
rest is important for an RA pt they should get how much a night
8 - 10 w/2hour naps
what type of exercise should the RA pt have
quiet exercise 2 - 3 times a day for 10 - 15 min.
RA is marked by periods of
emission and exacerbations
stage 1 of RA is
early effects
stage 4 is
terminal, marked joint deformity, extensive muscle atrophy, soft tissue lesions, bone and cartilage detruction, and fibrous or bony ankylosis
djd is known as
OA is an inevitable consequence of
what are the two forms of OA
primary - cause is unkown
secondary - caused by trauma, infections, previous fx, obesity
OA is a
nonsystemic, noninflammatory disorder that progressively causes bones and joint to dgenerate
OA affects the joints of the
hip, knee, vertebra, hands,
who does OA affect
nearly all people older than 60 women are affected more than men
women are affected more in the _____ with OA
men are affected more in the ___ with OA
objective data for OA includes
edema, tenderness, deformity
heberdens nodes and bouchards nodes
dx test for OA
there is no specific dx test Xrays
what will the dr order
medications, rest periods balanced with exercise, PT ,gait enhancers, NSAIDs
what are some alteratives to medications for OA
massage therapy, imagry, therapeutic touch,
what surgical procedures might help a pt with OA
osteotomy, arthroplasty (the most common)
what is the nursing intervention for a pt with Oa
making sure they perform some ADL
what is the most important aspect of the nursing interventions
teaching the pt about the disease process
metabolic disorder resulting from n accumulation of uric acid in the blood. it is an acute inflammatory condition associated with ineffectrivge metabolisms of purines
who does gout affect
men more than women
what joint is affected the most
the big toe
what other disorder is associated with gout
tophi - which is an accumulation of calculi containing sodium urate deposits that develop in periarticular fibrous tissues
where is tophi mostly located
earslobes, fingers, toes, hands
what is the CM
usually onset at night affects big toe, very painful. it can last a short duration or 5 - 10 days
you should ask the pt about there
food consumptions, foods high in purine and alcohol
what are some foods high in purines
organ meats (liver, heart, kidney, brain) scallops, mackeral, yeast, anchovies , herring,
you should assess the pt for
pain in joint, esp the big toe (can be purple or red), there will be limited movement. can have hypertension, tachypnea, tachycardia
what are the dx test for gout
serum and urinary uric
what is done for gout
use of several drugs
what is the nursing intervention for gout
giveing meds , increasing the fluids to 2000 ml daily helps eliminate the excess urinary urates. you should carefully docuent I & O
incompete fracture in which the fracture line extends only partially through the bone. the bone is broken but still secured on one side.
greenstick fracture
who is the greenstick fracture more likely to occur in
children - bones are much softer
fracture line extends entirely through the one with the periosteum disrupted on both sides of the bone
complete fracture
bone is splintered in three or more fragments at the site of the break.. there is more than one fracture line
comminuted fracture
sometimes called a telescope fracture because one bone fragment is forcibly wedged into another bone fragment. creating a shortening of the extremity
impacted fx
break runs directly accross the bone. it is at a right angle of hte bone axis
transverse fx
break runs along a slant to the length of the bone, it is at approx a 45 degree angle to the shaft of the bone
obique x
break cils around the bone it is sometimes called a torsion f and will result from a twising force
spiral fx
when does the spiral fx occur
usually seen in childre who are abused
fracture of the distal portion of the rdius within 1 inch of the joint of the wrist that commonly occurs when a person attempts to break a fall by putting the hands down
colles fx
occurs at hte distal end of hte fibula andis characterized by chipping off of a piece of the medial malleolus with a displacement of the foot outward
potts fx
fractures are sometimes reffered to as a joint fx if they are close to a
articular fx involves the surface of a
extracapsular fx involves a fx near the joint but one that has not entered the
joint capsule
intracapsular fx is a fx within the
joint capsule
removal of the vagal innervatoin to the fundus, decreains acid produced by the parietal cells of hte stomach is usually done with a billroth I or II procedure
surgical formation of an opening of hte ileum onto the surface of the abdomen, through which fecal matter is emptied
an accumulation of fluid and albumin in the peritoneal cavity
direct visualization of a joint, usually performed on the knee
what can you accomplish with an athroscopy
you can remove fluid
fix ligaments
remove debris
after arthroscopy what should a pt do
limit activities for several days
what do you look for after athroscopy
swelling, bleeding, blood clot
inflammation of a joint
the most serious form of arthritis is
who does RA affect
mostly women about 75%
RA is considered to be
systemic - affecting many organ systems
RA is characterized by
chronic inflammation of the synovial membrane of the diathrosis joints
RA is thought to be an
autoimmune disease
joints that are mostly affected are
wrists, knees, vertebrae, hands
what does the pt c/o
weakness, joint pain and stiffness, fatigue
what is the objective data of RA
subcutaneous nodules, wt loss, morning stiffness, fever, limited ROM
four classic sx of RA are
malaise, fatigue, weakness, morning stiffness
lab tests that are used to confirm RA are
esr, latex agglutination, rbc,
what is the med txof RA directed at
controlling the disease progression, pain relief, prolong joint function,
what is the most imp. nursing intervention
pt teaching about the disease
what is the major problem with RA
fatigue pt should get 8 - 10 hours a sleep a night
pt should excercise how
quiet excercise 2 to 3 times a day for 10 - 15 min