Nurs 128 Test #2

Front 1

What are the 5 p's

Back 1

Pain
Pallor
Pulselessness
Paresthesia
Paralysis

Front 2

Loss of bone density, leaving the bone
porous and easily fractured, especially
the wrist, hip, and vertebrae

Back 2

Osteoporosis

Front 3

causes of __________________:
drop in estrogen levels
aging
genetic influences- stature, race
diet- chronic low Ca, caffeine,smoking
and alcohol
sedentary lifestyle
medications- steriods

Back 3

Osteoporosis

Front 4

manifestations of __________:
-back pain with movement& muscle spasm
-Dowagers hump
-loss of height (2-3 in)
-wrist fracture (colles fracture)
-hip fracture (75%)

Back 4

Osteoporosis

Front 5

Management of _____________-
-dx early- bone mineral density
-estrogen replacement
-dietary supplemental Ca, Vit D
-calcitonin injections, nasal spray
-fosimax- inhibit bone resorption
-evista- decreased cholesterol
-diet, exercise -falls prevention
-prophylaxis- best approach

Back 5

osteoporosis

Front 6

revisible metabolic bone disease with softening and deformity of bone marked increased in abnormal bone.

Back 6

osteomalacia

Front 7

Causes of ___________:
-lack of minerals-phosphorous, Vit D
-poor dietary intake,decreased sunlight
-GI problems that hinder absorption
-many pregnancies
-excessive excretion of Phosporous
by the kidneys
-long term med use of dilantin, phenobarb, steriods

Back 7

Osteomalacia

Front 8

Manifestations of ______________:
-bone pain, muscle weakness, fractures
-skeletal deformitites

Back 8

Osteomalacia

Front 9

Chronic bone disease of the elderly.
2%-4% of people over 60
characterized by excessive bone resorption and deposition, softening , enlargement and severe deformity of the skeleton.
-affects all bones of the skeleton
caused by viral infection, biochemical defect, precancerous

Back 9

Paget's disease

Front 10

symptoms of ________________:
-bone pain, back pain, headache, fractures, skull enlargement, impinge on nerves causing deafness, blindness, paralysis, flushed warm skin.
diagnosed by elevated serum alkaline phosphatase, hyperuricemia, X-Ray, CT, MRI

Back 10

Paget's disease

Front 11

infection of bone
symptoms include: fever, swelling, tenderness, redness, pain
treatment is with antibiotics and surgical management

Back 11

osteomyelitis

Front 12

compression of median nerve in wrist, causing pain, numbness.
seen more at night

Back 12

Carpal tunnel syndrome

Front 13

break in the continuity of the bone

Back 13

fractures

Front 14

cause of fracture -
break at point of contact is called ___

Back 14

direct force

Front 15

break distant from point of contact is called__________

Back 15

shear force

Front 16

uneven pull, weakened muscle called_____

Back 16

muscle fatigue

Front 17

a type of fracture where the skin is intact

Back 17

simple

Front 18

a type of fracture where the skin is broken

Back 18

compound

Front 19

a type of fracture where it effects only one side of the bone

Back 19

Incomplete

Front 20

a type of fracture that goes through the bone

Back 20

complete

Front 21

a type of fracture where one part is driven into another

Back 21

telescoped

Front 22

a type of fracture where the fracture site is separated

Back 22

displaced

Front 23

a type of fracture where injury is from bone to body organ

Back 23

complicated

Front 24

a type of fracture where you have a thin break line

Back 24

hairline

Front 25

a type of fracture where the bone is pulled away from the tendon

Back 25

Avulsion

Front 26

a type of fracture where it breaks in several pieces

Back 26

comminuted

Front 27

a type of fracture that goes straight across

Back 27

transverse

Front 28

a longitudinal fracture

Back 28

Linear

Front 29

an angled fracture

Back 29

Oblique

Front 30

fracture of the distal radius

Back 30

Colles fracture

Front 31

a type of fracture where one leg is shortened and externally rotated. different types include femoral head, intertrochanter, sub-trochanteric

Back 31

Hip fracture

Front 32

pre-op management of _________fracture:
-Bucks traction
-Bucks care (turn toward fracture side)

Back 32

hip fracture

Front 33

The following will you do or not do?
-force hip into more than 90 of flexion
-force hip into adduction
-force hip into internal rotation
-cross legs
-put on own shoes or stockings until 8 weeks after surgery
-sit on chairs without arms to aid rising to a standing position

Back 33

DO NOT

Front 34

The following will you do or not do for hip fx care:
-use toilet elevator on toilet seat
-place chair inside shower and remain seated while washing
-use pillow between legs when supine or laying on good side
-keep hip in neutral position
-notify dr with increased pain, loss of function, or deformity occurs

Back 34

DO

Front 35

Sign of a fracture that causes disruption of soft tissues or bleeding into the surrounding tissues

Back 35

Edema and swelling

Front 36

signs of a fracture that you have muscle spasm due to involuntary reflex action of muscle; direct tissue trauma; increased pressure to sensory nerve; movement of fracture parts

Back 36

pain and swelling

Front 37

signs of a fracture where you have a protective response to injury and fracture

Back 37

muscle spasm

Front 38

signs of a fracture where you have abnormal position of bone caused by original forces of injury and by action of muscles pulling fragment into abnormal position

Back 38

deformity

Front 39

signs of a fracture where you have discoloration of skin due to extravasation of blood in subcutaneous tissues

Back 39

ecchymosis

Front 40

signs of a fracture where you have disruption of bone that prevents functional use

Back 40

Loss of function

Front 41

sign of a fracture where you have grating or crunching together of bony fragments producing palpable or audible crunching sensation.

Back 41

crepitation

Front 42

for healing of a fracture what is necessary?

Back 42

immobilization

Front 43

heals by regeneration of fibers

Back 43

muscle

Front 44

heal by creating new bone

Back 44

bone

Front 45

a blood clot provides a structure upon which a fibrin network can build (48 to 72 hours)

Back 45

hematoma

Front 46

cells at the torn ends multiply and form a soft tissue bridge

Back 46

cellular proliferation

Front 47

loosely worn cartilage and bone matrix 6-21 days

Back 47

callus formation

Front 48

calcium deposits- bone become rigid and healed in 2-6 weeks

Back 48

ossification

Front 49

bone returned to its normal shape and contour one to several years

Back 49

remodeling

Front 50

Length of time it takes to _____ depends on:
-type of fracture
-good immobilization
-age (younger are faster)
-general health (good nutrition increases this)

Back 50

heal

Front 51

restore bone's normal alignment, position, length

Back 51

reduction

Front 52

manuel manipulation of fracture without surgery (bandage, splint, cast, traction)

Back 52

closed reduction

Front 53

type of reduction that requires surgery

Back 53

open

Front 54

a type of reduction where a surgical incision with the application of pins, nails, plates, screws to the bone

Back 54

Open reduction with internal fixation
ORIF

Front 55

a type of reduction whare a metallic device to compress fractures and to immobilize.
attached to the bones by percutaneous pins

Back 55

external fixation

Front 56

Complication of fracture where you have a long bone or pelvis fracture that releases yellow bone marrow into the blood stream

Back 56

fat embolism

Front 57

this complication occurs within the first 12-72 hours
-lodge in the lung, causing hemorrhagic interstitial pneumonitis that produce symptoms of acute Resp distress syndrome
-serum lipase will be elevated
-will see peteciae

Back 57

fat embolism

Front 58

complication of a fracture that has increased tissue pressure within a closed space that compromises the circulation to the area

Back 58

compartment syndrome

Front 59

______________:
-sheaths of fascia surround muscle and do not allow for expansion
-muscles are injured and swell and bleed
-seen in leg and arm
-onset 2 hrs to 6 days after trauma
-early sx- increasing pain
later sx- numbness, tingling,,pallor, coolness, loss of movement and pulse

Back 59

compartment syndrome

Front 60

bone death due to a lack of supply of blood

Back 60

avascular necrosis

Front 61

complication of fracture where you have failure to heal

Back 61

delayed and nonunion

Front 62

complication of fracture where it heals in an abnormal position that predisposes to degenerative arthritis, angulation

Back 62

Malunion

Front 63

infection of the bone that is direct or indirect route and treated with long term IV antibiotics, or for chronic treated with surgical debridement and IV antibiotics

Back 63

osteomyelitis

Front 64

RICE stands for:

Back 64

R- rest
I- ice
C- compression
E- elevation

Front 65

amputation where in the surgical procedure there is a drain left in because of ______

Back 65

Infection
An open (guillotine)

Front 66

amputation where in the surgical procedure there is a flap

Back 66

closed

Front 67

another name for real pain felt where you no longer have a limb or digit. still feel the discomfort, hard for the patient to explain

Back 67

phantom limb pain

Front 68

__________ disorders involve muscle, bones , joints, and if systemic other body organs often related to immunological problems (rheumatology)

Back 68

Connective tissue disorders

Front 69

disease to weight bearing joints (hips, knees, vertebrae and hands)
cause is unknown but age, genetics, obesity, trauma, lack of exercise, congenital, metabolic diseases predispose
The cartilage thins, joint space narrows, bone grates against bone, bony enlargement of joint, deformity and pain

Back 69

DJD
Degenerative joint disease

Front 70

immobilize the joint

Back 70

arthrodesis

Front 71

surgically reconstructed

Back 71

arthroplasty

Front 72

a chronic progressive systemic disease characterized by inflammation and destruction of synovial tissue in joints.
occurs in 20-40 age group 3:1 females
periods of remission and exacerbations
is an autoimmune disease

Back 72

rheumatoid arthritis

Front 73

symptoms include:
-morning stiffness,fatigue,weakness, anorexia, fever
symmetrical joint inflammation often beginning in both hands
-synovitis- edema,warmth,redness,and pain on joint movement-destroys the synovium
systemic sx- vasculitis, myositis, ocular changes, cardiac dysfunction

Back 73

Rheumatoid arthritis

Front 74

chronic multi-system autoimmune disease with remissions and exacerbations. it is an inflammatory disease of connective tissue involving the skin, joints, heart, kidneys, blood and central nervous system. Females 5:1 prevalence occurring in ages 20-40

Back 74

Systemic Lupus Erythematosus
(SLE or LUPUS)

Front 75

sx include:
red, raised rash, alopecia, polyarthritis, fever, fatigue, anorexia, nephritis (leading cause of death), pulmonary changes, pericarditis, Raynauds, CNS effects, GI, psychosocial

Back 75

Lupus

Front 76

inflammatory disorder resulting from deposition of uric acid crystals in the joints usually the great toe

Back 76

GOUT

Front 77

____________-
uric acid is the end product of purine (a type of protein) metabolism. Purine comes from the diet and is also made by the body.
crystal deposition- nodules called tophi (ear, arms, fingers)

Back 77

GOUT

Front 78

a progressive systemic disorder caused by excessive collagen deposition characterized by inflammation, fibrosis, sclerosis of skin and with organs
-mask like face and finger and toes become thinned.

Back 78

Systemic sclerosis (scleroderma)

Front 79

symptoms indicating poorer prognosis in systemic sclerosis:
C
R
E
S
T
S

Back 79

C- calcinosis
R- raynauds syndrome
E- esophagal motility changes
S- sclerodactyly-fingers and toes
T- Telegiectasia- permanent dilation of blood vessels

Front 80

chronic musculoskeletal pain disorder or unknown cause, found in 2% of the population mainly girls and young women.
Sx include fatigue, morning stiffness, sleep difficulties, muscle pain. often associated with irritable bowel syndrome, depression, sleep disturbances

Back 80

Fibromyalgia

Front 81

Type of drug used to decrease inflammation and pain.
Does not stop underlying disease
-contraindicated in GI ulcer
-take with food, milk, antacids
Examples: trilisate, dilsalcid, naprosyn, motrin, ASA, indocin, toradol,
celebrex, vioxx, zantac, pepcid

Back 81

NSAID's
Non steriodal anti-inflammatory drugs

Front 82

Type of drug used to decrease inflammation, suppress immunological response and reduce pain.
-take with food, decrease salt, don't stop drug abruptly.
Ex: Prednisone, Depo-medrol, Kenalog, ACTH, Decadron, Aristocort, Celestone

Back 82

Steriods

Front 83

Type of drug that suppresses the Immune system which is causing the damage to the body.
Example:
Imuran
Cytoxan
Methotrexate Remicade
Remicade

Back 83

Cytotoxic Drugs

Front 84

Type of drug used for treatment of GOUT, decrease the formation of uric acid
-instruct in low purine diet
Examples:
Allopurinol
Zyloprim

Back 84

Uricosurics

Front 85

Type of drug that increases uric acid excretion.
-used in long term managment of arthritis- not used during acute attack
-ck for allergies to sulfa drugs
Examples:
Benemid
Anturane

Back 85

Probenecid

Front 86

Type of drug used for osteoporosis and Paget's disease
Example:
Calcimar

Back 86

Calcitonin

Front 87

Type of drug used to relax muscle spasms associated with acute painful musculoskeletal condition.
Example:
Flexeril, Robaxin, Valium, Paraflex, Soma, Dantrium, Lioresal

Back 87

Muscle relaxants

Front 88

Type of drug that decreases pain signal to the brain. Used for acute strong pain.
-not good for chronic pain
Example:
Ultram

Back 88

Non-Narcotic Analgesic

Front 89

Type of drug that binds to receptor sites in the CNS and blocks pain transmission.
Examples: Darvon, Darvocet, Codeine, Morphine, Percodan, Percocet, Demeral, Talwin, Dilaudid, Vicodan, Duragesic Patch, Roxanol, MS Contin
-may need to give antiemetics and laxatives

Back 89

Narcotic analgesic

Front 90

Type of drug that reduces pain by blocking pain.
-give in the evening
Examples:
Elavil
Tofranil
Sinequan

Back 90

Serotonin Blockers

Front 91

Type of drug that reduces bone loss and increases bone mass.
-for use with women after menopause
-take once a day on empty stomach with full glass of water

Back 91

Fosimax

Front 92

Type of drug that prevents osteoporosis.
-non-hormonal
-decreases cholesterol

Back 92

Evista