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127 Cards in this Set
- Front
- Back
what is arthroplasy
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surgical repair of a joint
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what is arthritis
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inflammation of a joint
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aaa
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bbb
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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
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Impact fx
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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
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carpal tunnel syndrome
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carpal tunnel syndrome results from pressure on the median nerve on the wrist symptoms of
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paresthesia (sensation of pins and needles) and hypoesthesia (decrease in sensation)
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there is a higher incidence of this in
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women who are obese, middle aged women involving repetitious motions of hte fingers and hands
women in there last trimester |
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the affected hand has alterred ability to
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grasp or hold small objects
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subjective data includes
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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
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objective data includes
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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
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dx tests for carpal tunnel syndrome are
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physical exam
electromyogram MRI handheld electroneurometer |
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medical management for carpal tunnel syndrome is
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splint if you have mild symptoms
hydrocortisone acetate suspension injections - mild sx surgery for severe sx |
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if surgery is required the post op intervetions are as follows
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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 |
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amputation can be done for
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trauma, diabetes, tumors, impaired circulation
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if replantation takes place the severed limb should be kept sterile and placed in a
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moist plastic bag filled with ice water. keep away from ice, do not use dry ice
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subjective data in an amputation includes
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assessment of pain
level of orientation neuro impairment |
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objective data include what in an amputation
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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 |
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dx tests include
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cbc, bun, K levels, ECG
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post op care of pt w/amputation includes noting subjective data such as
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phantome pain
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collection of objective data after amputation includes
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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 |
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nursing intervetions are aimed at preventing
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deformities
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flexion hip contractures can be prevented postop by
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raising the foot of the bed slightly to elevate the residual eextremity (do not elevate the stump on a pillow)
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pt should be placed in what position twice a day
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prone
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what are duodenal ulcers caused by
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when acid secretions exceeds the buffering factors
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what are the risk factors for duodenal ulcers
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H. pylori infection, NSAIDS, cigarette smoking, and coffee
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what is the characteristic symptoms of duodenal ulcers
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pain, symptom are described as dull, burning, burning, and gnawing, it is located in the midline of the epigstric region
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subjective data for gastric ulcers
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pain at night, nausea, eructation, distention - dyspepsia
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objective data includes looking for
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hemorrhage
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what bleeds more duoenal ulcers or gastric ulcers
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gastric ulcers
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duodenal ulcers are more apt to have
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chronic bleeding, and more prone to perforate than gastric ulcers
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when GI bleeding occurs one sign is
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vomiting blood ( hematemesis) looks like coffee grounds there may also be a presence of melena (tarlike, fetid smelling stool containing undigeste blood).
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in severe cases in duodenal ulcers what happens
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there may be bright red blood rectal bleeding
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what can aggravate bleeding in pts with a hx of peptic ulcers
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salicylates and alcohol
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bleeding from a__________ ulcer is more difficult to control then from a ______ ulcer
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gastric, duodenal
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what is considered the most lethal complications of peptic ulcers
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perforation
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what is a complication of peptic ulcer disease that can ccur at any time
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gastric outlet obstruction
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what is the tx for gastric outlet obstruction
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relief may be achieved by constant NG aspiration of stomach contents.
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fiberoptc endoscopy can detect both gastric and duodenal ulcers. this is called
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esophagogastroduodenoscopy
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what might be ordered to treat duodenal ulcers
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NG tube, to remove gastric content and blood
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sugery is indicated only when
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the pt is no longer responding to medical management
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what is the primary tx of peptic ulcers
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decrease signs and symptoms by decreasing gastric acidity with drug therapy.
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surgery is usually indicated for complications of ulcers. one type of surgery is the vagotomy
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removal of the vagal innervation to the fundus, ecreasing acid produced by by the parietal cells of the stomach.
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bleeding may occur up to ___ days after gastric surgery
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7
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what are possible indications of postop bleeding
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abdominal rigidity, abdominal pain, restlessness,elevated temp, increase pulse, increased bp , leukocytosis
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an endoscopic exam that enables direct visualization of a joint
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arthroscopy
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what can you accomplish with arthhroscopy
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removal of fluid
see if there are any diseases remove damaged tissue or foreing bodies |
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after an arthrsocpy what should a pt do
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limit activities
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what do you look for after an athroscopy
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inflammation, redness, edema, blood clots , bleeding
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endoscopic exam that enables direct visualization of a joint
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arthroscopy
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type of disease were there is an inflammation of a joint
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arthritis
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what is the most serious form of arthitis
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RA
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who does it affect
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75 % are women
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RA is thought to be an ________ disorder
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autoimmune
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RA can affect
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many organ systems
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RA is characterized by
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chronic inflammation of the synovial membrane in the diathrodial joints
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the 4 classics symptoms of RA are
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morning stiffness, muscle weakness, joint pain, fatigue
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lab tests performed for RA are
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ESR , RF, Latex agglutination, RBC, synovial fluid aspiration
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medical management of RA is directed toward achieveing the following goals
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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 |
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rest is important for an RA pt they should get how much a night
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8 - 10 w/2hour naps
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what type of exercise should the RA pt have
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quiet exercise 2 - 3 times a day for 10 - 15 min.
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RA is marked by periods of
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emission and exacerbations
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stage 1 of RA is
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early effects
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stage 4 is
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terminal, marked joint deformity, extensive muscle atrophy, soft tissue lesions, bone and cartilage detruction, and fibrous or bony ankylosis
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djd is known as
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osteoarthritis
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OA is an inevitable consequence of
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aging
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what are the two forms of OA
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primary - cause is unkown
secondary - caused by trauma, infections, previous fx, obesity |
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OA is a
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nonsystemic, noninflammatory disorder that progressively causes bones and joint to dgenerate
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OA affects the joints of the
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hip, knee, vertebra, hands,
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who does OA affect
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nearly all people older than 60 women are affected more than men
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women are affected more in the _____ with OA
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hands
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men are affected more in the ___ with OA
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pelvis
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objective data for OA includes
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edema, tenderness, deformity
heberdens nodes and bouchards nodes |
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dx test for OA
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there is no specific dx test Xrays
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what will the dr order
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medications, rest periods balanced with exercise, PT ,gait enhancers, NSAIDs
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what are some alteratives to medications for OA
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massage therapy, imagry, therapeutic touch,
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what surgical procedures might help a pt with OA
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osteotomy, arthroplasty (the most common)
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what is the nursing intervention for a pt with Oa
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making sure they perform some ADL
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what is the most important aspect of the nursing interventions
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teaching the pt about the disease process
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metabolic disorder resulting from n accumulation of uric acid in the blood. it is an acute inflammatory condition associated with ineffectrivge metabolisms of purines
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gout
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who does gout affect
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men more than women
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what joint is affected the most
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the big toe
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what other disorder is associated with gout
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tophi - which is an accumulation of calculi containing sodium urate deposits that develop in periarticular fibrous tissues
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where is tophi mostly located
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earslobes, fingers, toes, hands
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what is the CM
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usually onset at night affects big toe, very painful. it can last a short duration or 5 - 10 days
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you should ask the pt about there
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food consumptions, foods high in purine and alcohol
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what are some foods high in purines
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organ meats (liver, heart, kidney, brain) scallops, mackeral, yeast, anchovies , herring,
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you should assess the pt for
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pain in joint, esp the big toe (can be purple or red), there will be limited movement. can have hypertension, tachypnea, tachycardia
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what are the dx test for gout
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serum and urinary uric
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what is done for gout
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use of several drugs
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what is the nursing intervention for gout
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giveing meds , increasing the fluids to 2000 ml daily helps eliminate the excess urinary urates. you should carefully docuent I & O
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incompete fracture in which the fracture line extends only partially through the bone. the bone is broken but still secured on one side.
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greenstick fracture
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who is the greenstick fracture more likely to occur in
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children - bones are much softer
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fracture line extends entirely through the one with the periosteum disrupted on both sides of the bone
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complete fracture
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bone is splintered in three or more fragments at the site of the break.. there is more than one fracture line
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comminuted fracture
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sometimes called a telescope fracture because one bone fragment is forcibly wedged into another bone fragment. creating a shortening of the extremity
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impacted fx
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break runs directly accross the bone. it is at a right angle of hte bone axis
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transverse fx
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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
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obique x
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break cils around the bone it is sometimes called a torsion f and will result from a twising force
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spiral fx
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when does the spiral fx occur
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usually seen in childre who are abused
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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
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colles fx
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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
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potts fx
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fractures are sometimes reffered to as a joint fx if they are close to a
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joint
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articular fx involves the surface of a
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joint
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extracapsular fx involves a fx near the joint but one that has not entered the
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joint capsule
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intracapsular fx is a fx within the
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joint capsule
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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
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vagotomy
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surgical formation of an opening of hte ileum onto the surface of the abdomen, through which fecal matter is emptied
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ileostomy
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an accumulation of fluid and albumin in the peritoneal cavity
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ascite
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arthroscopy
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direct visualization of a joint, usually performed on the knee
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what can you accomplish with an athroscopy
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you can remove fluid
fix ligaments remove debris |
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after arthroscopy what should a pt do
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limit activities for several days
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what do you look for after athroscopy
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swelling, bleeding, blood clot
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inflammation of a joint
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arthritis
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the most serious form of arthritis is
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RA
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who does RA affect
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mostly women about 75%
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RA is considered to be
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systemic - affecting many organ systems
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RA is characterized by
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chronic inflammation of the synovial membrane of the diathrosis joints
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RA is thought to be an
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autoimmune disease
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joints that are mostly affected are
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wrists, knees, vertebrae, hands
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what does the pt c/o
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weakness, joint pain and stiffness, fatigue
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what is the objective data of RA
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subcutaneous nodules, wt loss, morning stiffness, fever, limited ROM
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four classic sx of RA are
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malaise, fatigue, weakness, morning stiffness
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lab tests that are used to confirm RA are
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esr, latex agglutination, rbc,
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what is the med txof RA directed at
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controlling the disease progression, pain relief, prolong joint function,
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what is the most imp. nursing intervention
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pt teaching about the disease
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what is the major problem with RA
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fatigue pt should get 8 - 10 hours a sleep a night
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pt should excercise how
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quiet excercise 2 to 3 times a day for 10 - 15 min
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