Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
43 Cards in this Set
- Front
- Back
- 3rd side (hint)
|
Teaching for x-ray
|
avoid excessive exposure of pt and self. Remove radiopaque objects that can interfere with results. Verify pt is not pregnant.
|
|
|
|
Teaching for CT scan
|
Inform pt that it is painless, and they should stay still. If contrast medium is used, assess allergy to shellfish.
|
|
|
|
Teaching and intervention for myelogram
|
Contrast medium is injected into sac arount nerve roots. Used for nerve impingement. Can detect subtle lesions and injuries. Inform of risk of spinal headache which should be resolved in 1-2 days, rest and fluids. Should be reported to doc. If oil contrast medium is used, lay the pt down after the procedure. If H2O is used, they can sit up. (Oil rises)
|
Stop anticonvulsants and BLOOD THINNERS before this procedure.
|
|
|
Nursing responsibilities: MRI
|
Inform pt who are claustrophobic they may experience symptoms. Administer antianxiety drugs.
|
|
|
|
Nursing responsibilities: Arthroscopy
|
Risk of infection!!
|
|
|
|
Bone density measurements (DEXA, Quantitative Ultrasound Study)
|
Measures bone mass.
|
|
|
|
Nursing responsibilities: bone scan
|
What is it?
Injection of radioisotope that is taken up by bone. Uniform uptake of isotope is normal. Increased uptake in osteomyelitis, osteoporosis, cancer and fractures. Decreased uptake in avascular necrosis. Nursing responsibilities: Radioisotope is given 2 hrs preprocedure. Ensure bladder is empty. Increase fluids after the scan. |
|
|
|
Nursing responsibilities: EMG (electromyogram)
|
What is it?
Needles are put in muscles. Machine records electrical activity of muscle. Provides info r/t lower motor neuron dysfunction and primary muscle disease Nursing responsibilities: Avoid administration of stimulants and caffiene 24 hours preprocedure. |
|
|
|
Nursing responsibilities: arthrocentesis
|
What is it?
Puncture of joint capsule to obtain sample of synovial fluid. What do I do? Apply a pressure dressing postprocedure and observe for lleakage of blood or fluid on the dressing. |
|
|
|
Rheuthmatoid factor
|
<1:17 or negative
Assess presence of autoantibody in serum. Factor is not specific for RA. Seen in many connective tissue diseases. |
|
|
|
Erythrocyte sedimentation rate (ESR)
|
Inflammation. Elevated in RA, osteomyelitis, etc
<30mm/hr |
|
|
|
Creatine kinase (CK)
|
Highest concentrations found in skeletal muscle, so it is raised in skeletal muscle injury.
25-250 |
|
|
|
Alkaline phosphotase
|
42-136
Has to do with osteoblast formation, so it will go up with healing. |
|
|
|
Musculoskeletal Ca connection
|
Ca moves out of the bones when we are immobile.
8.7-10 |
|
|
|
Musculoskeletal Ph connection
|
Ca and Ph have an inverse relationship. Decreased Ph may lead to stones.
2.7-4.5 |
|
|
|
Musculoskeletal K connection
|
Potassium level goes up with broken bones.
3.5-5.1 |
|
|
|
A contusion is...
|
a bruise. Usually healed up 3-6 weeks.
|
|
|
|
A sprain is...
|
an injury to the lagament by twisting. Usually in ankle and knee.
|
|
|
|
A strain is...
|
excessive stretching of the muscle. Usually in the lower back, calf, and hamstring.
|
|
|
|
Intervention for sprains and strains
|
In the acute phase (24-48hrs)
RICE Rest Ice (not to exceed 20-30 min) Compression (wrap distal to proximal to encourage fluid return. leave on 30 min) Elevation After that, apply heat for 30 min at a time and use the affected limb. |
|
|
|
Grades of sprains and strains
|
1: involves only a few fibers resulting in mild tenderness and min swelling
2: involves partial disruption of tissue with more selling and tenderness 3: complete tearing of the ligament or muscle. May be a visual gap. |
|
|
|
Primary nursing goal with musculoskeletal injuries...
|
PREVENT NEUROVASCULAR IMPAIRMENT!!!! CWMS!!!!
|
|
|
|
Avascular necrosis
|
Bone cell death due to inadequate blood supply (especially a concern with dislocations)
|
|
|
|
Compartment syndrome
|
a concern with fractures and dislocations...
|
|
|
|
Nursing care for a wet cast...
|
Handle with palms only until the cast is dry to avoid finger prints.
Support cast with pillows while drying. |
|
|
|
Cast care maintainance
|
Instruct pt not to scratch undercast.
Position cast on pillows. Pad rough cast edges and traction connections to prevent skin irritation. Instruct pt to direct cool air from hair dryer under cast to decrease itching. NEVER HOT! Ipply ice for first 24-36 hr to reduce swelling. |
|
|
|
Signs of a fractured hip (3)
|
Externally rotated.
The affected limb is shorter. MUSCLE SPASM!! |
|
|
|
Difference b/w fat embolism and venous thrombosis...
|
Petechaie on chest neck and arms with fat embolism.
|
|
|
|
Care for fat embolism...
|
O2!!!!
|
|
|
|
Care for venous thrombosis...
|
Position pt on rt side
|
|
|
|
Primary nursing dx for external fixators...
|
Risk for infection
|
|
|
|
If a compound fracture exists, what do you do first?
|
Splint the extremity and cover the wound with a sterile dressing.
|
|
|
|
6 P's
|
Pain, pulses, parathesias, paralysis, pressure, parishingly cold
|
|
|
|
Compartment syndrome...
|
Swelling causes the lymph not to be able to move out.
S/S: unrelieved pain by opiods Intervention: DON'T ELEVATE. Take the cast of compression bandage off to see if it helps. |
|
|
|
Vertebral fractures...
|
logroll
|
|
|
|
Pelvic fractures
|
May be on bedrest for 6 weeks. Turning is important. Think about internal damage like torn colon, ureters, etc.
|
|
|
|
When turning a pt with pelvic fracture...
|
Use abductor pillow. Also, use sandbags or pillows to prevent external rotation when pt is supine.
|
|
|
|
Teaching for hip surgery pts
|
Don't cross legs, internally roate, adduct. Don't put on your own shoes until 6 wks postop. Don't sit in chairs with no arms (you can't get up!) Use toilet seat elevator. Inform dentist of prosthesis before dental work so that he can prescribe prophylactic antibiotics.
|
|
|
|
Facial fractures
|
Don't use NG tube b/c you can poke their brain. Have wire cutters by bedside to cut wires if they aspirate. O2 status!!
|
|
|
|
Position of hip fracture pt
|
HOB <30 degrees. Position pt on unaffected side with abductor pillow b/w legs.
|
|
|
|
Primary concern with amputation
|
Risk of hemmorhage
|
|
|
|
Amputation interventions...
|
Compression bandage on at all times, watch for bleeding, monitor for infection, prevent external rotation and contracture.
|
|
|
|
First sign of fat embolism
|
Restlessness
|
|
