Scc Basic Medsurg Exam 4

Front 1

What is often the first sign that a person might have osteoperosis?

Back 1

a fracture

Front 2

Describe generalized osteoperosis?

Back 2

involves multiple bone structures either primary or secondary

Front 3

Describe regional osteoperosis?

Back 3

seen when a bone is immobilized due to a fracture, injury, paralysis, etc. Also seen when people spend time in a weightless environment

Front 4

What is a "classic" clinical manifestation of osteoporosis?

Back 4

Kyphosis (dowager's hump)

Front 5

What are the clinical manifestations of osteoporosis?

Back 5

kyphosis (dowager's hump), shorter height, back pain, compression vertebral fracture

Front 6

What type of testing is used to diagnose osteoporosis?

Back 6

radiographic testing

Front 7

What treatment is the primary prevention strategy for reducing bone loss in women?

Back 7

Hormone replacement therapy

Front 8

What should the patient be monitored for when they are receiving parathyroid hormones?

Back 8

hypercalcemia

Front 9

What is important for early prevention of osteoporosis?

Back 9

calcium

Front 10

Why should Vitamin D be taken?

Back 10

it is needed for calcium to be absorbed.

Front 11

What are Bisphosphonates used for?

Back 11

the prevention and management of osteoporosis and hypercalcemia associated with cancer by inhibiting bone resorption

Front 12

What are some examples of Bisphosphonates?

Back 12

Alendronate (fosamox)
ibandronate (Boniva)
resedronate (actonel)

Front 13

What are some side effects of Bisphosphonates?

Back 13

esophagitis/esophageal ulcers

Front 14

What do selective estrogen receptor modulators do?

Back 14

increases BMD, reduces bone resorption and lowers serum cholesterol

Front 15

What does calcitonin do?

Back 15

inhibits osteopclastic activity and decreases bone loss

Front 16

What is calcitonin used in the treatment of?

Back 16

Osteoporosis, Paget's disease and hypercalcemia with cancer

Front 17

What should be monitored if your patient is on selective estrogen receptor modulators?

Back 17

s/s of a DVT

Front 18

What should be included when educating your patient who has osteoporosis?

Back 18

Diet: increased amts of calcium and vit.D
fall prevention: hazard free environment
Exercise: weight bearing
pain management: analgesics during the acute phase, NSAIDS/muscle relaxants

Front 19

What is osteomyelitis?

Back 19

acute or chronic infection of the bone usually caused by the staphlococcus aureus organism

Front 20

What are the different ways that a pt. can acquire osteomyelitis?

Back 20

Exogenous: infection enter from outside the body (open would)
Endogenous: infection is carried to the bone through the blood stream
Contiguous: infection occurs as a result of skin infection in the adjacent tissue (gum infection)

Front 21

What happens during the acute phase of osteomyelitis?

Back 21

infection spreads to other parts of the bone. Pus forms, edema occurs and the vascular supply is compromised.

Front 22

What happens during the chronic phase of osteomyelitis?

Back 22

the necrotic bone separates, a new layer of bone forms around the necrotic bone and a sinus develops to allow the wound to drain

Front 23

What are some clinical manifestations of osteomyelitis?

Back 23

bone pain, fever, swelling/tenderness at site, erythema/warmth, elevated WBC/ESR, poor circulation, draining ulcers, s/s of septic shock

Front 24

What are some diagnostic test that are done for osteomyelitis?

Back 24

blood/wound cultures, bone scan, MRI's and bone biopsy's

Front 25

What type of drug therapy is given for osteomyelitis?

Back 25

antibiotic therapy

Front 26

Describe Hyperbaric oxygen therapy?

Back 26

large concentrations of oxygen diffused into the tissues to promote healing

Front 27

What type of surgical interventions are performed for osteomyelitis?

Back 27

debridement, bone grafts, bone segment transfers, muscle flaps,amputation

Front 28

What usually causes a fracture?

Back 28

trauma

Front 29

What is a pathologic fracture?

Back 29

occurs when the muscles around the bone are unable to absorb energy as they should

Front 30

What is a compression fracture?

Back 30

fracture that occurs due to a loading force applied to the long axis of the bone, common in vertebrae of patients with osteoporosis

Front 31

Name and describe the different types of fractures.

Back 31

complete: complete seperation of the bone producing two fragments
incomplete: only part of the bone is broken
simple or closed-skin: skin over the broken bone is intact
Compound or open: opening between the skin wound and fracture
proximal: part of the bone that is closest to the center of the body
Distal: part of the bone that is most distant to the body
non-displaced: when two bone fragments are in good alignment
Displaced: when bone fragments are separated at the point of fracture
Greenstick: splintering on one side on the bone
Transverse: break in the bone is straight across
Oblique: line of bread is at an oblique angle to the bone shaft
Spiral: fracture line partially encircles the bone
Telescoped or impacted: when the bone fragment is forcibly pushed against and into the adjacent fragments
Comminuted: when there are several bone fragments

Front 32

What are some treatments for a fracture?

Back 32

maintain patent airway, spling/immobilize fracture, elevate the ext. if that does not cause pain, apply ice, perform neurovascular checks

Front 33

What are some pain management techniques for a patient with a fracture?

Back 33

narcotics or nonnarcotics, administer valium, apply ice, immobilize, use relaxation techniques

Front 34

How often are neurovascular checks performed on a pt. with a fracture?

Back 34

every hour

Front 35

What is checked when we do our neurovascular checks?

Back 35

checking for warmth, color, capillary refill, pain relief, sensation, ability to move part

Front 36

What are some ways to help promote good skin integrity?

Back 36

early identification of those at risk, inspect skin freq., turn every 2 hours, good patient transfer, special beds, good hygiene

Front 37

What are some complication of a fracture?

Back 37

fat embolism syndrome and Compartment syndrome

Front 38

What are some clinical manifestations of Fat embolism syndrome?

Back 38

change in LOC, hypoxemia, tachypnea, tachycardia, petechiae, chest pain, fever, lipuria

Front 39

What are the clinical manifestations of compartment syndrome?

Back 39

pain which is severe, unrelenting, unrelieved with pain meds and which increases with elevation, numbness, paresthesia, muscular weakness, paralysis

Front 40

What is used to maintain immobilization?

Back 40

casts and traction

Front 41

What are the two different types of traction?

Back 41

skin traction and skeletal traction

Front 42

What is the most common site of a ligament injury?

Back 42

knee

Front 43

What is the most common site of a tendon injury?

Back 43

achilles tendon

Front 44

What are the clinical manifestations of ligament/tendon injuries?

Back 44

tenderness, swelling, pain, effusion, hematoma, c/o 'knee gave way",abnormal motion at site

Front 45

What is the treatment for a moderate tendon/ligament injury?

Back 45

rest, aspiration of extra fluid, compression, support with splint or brace, strengthening exercises

Front 46

What is the treatment for a severe tendon/ligament injury?

Back 46

surgery, compression, immobilization, strengthening

Front 47

What are some clinical manifestations of a muscle trauma?

Back 47

mild aching to severe pain, disability, swelling tenderness

Front 48

what type of treatment is done from a muscle trauma?

Back 48

ice initially, rest, heat after 24 -48 hours, surgery

Front 49

What are the different types of joint injuries and describe them?

Back 49

sprains: pain, limitation of motion, edema, superficial bruising, tenderness
Meniscus tears: pain, edema, decrease in motion, locking aor slipping of joint
Dislocation: pain, loss of function, deformity, decrease neurovascular status, evidence of dislocaiton on x-ray

Front 50

What are some complications of an amputation?

Back 50

hemorrhage, infection, phantom limb pain, problems associated with immobility, neuroma, flexion contractures

Front 51

How are seizures catagorized?

Back 51

generalized, partial and unclassified

Front 52

What is epilepsy?

Back 52

a chronic disorder characterized by recurrent, unprovoked seizure activity

Front 53

What four catagories are generalized seizures divided into?

Back 53

tonic-clonic, absence, myoclonic, and atonic

Front 54

What is a complex partial seizure?

Back 54

loss of consciousness fro a few minutes, automatisms characteristic, amnesia postictal, often involves the temporal lobe

Front 55

What is a simple parital seizure?

Back 55

no loss of consciousness has an aura, may have unilateral movement, may have unusual sensations, may have autonomic or psychic symptoms

Front 56

What is an unclassified seizure?

Back 56

a seizure that occus for no known reason

Front 57

What are some seizure precautions?

Back 57

protect the patient, once the seizure has started DO NOT force anything into the mouth, turn pt. to the side if poss., do not restrain the pt., have airway equipment/suctioning ready, lossen clothing

Front 58

What is Status Epilepticus?

Back 58

Prolonged seizure lasting more than 5 minutes or repeated seizures lasting over 30 min.

Front 59

What medications would be administered during a Status Epilepticus?

Back 59

Lorazepam (ativan) or diazepam (valium)

Front 60

What is tegretol (carbamazepine)used for?

Back 60

the treatment of partial and generalized tonic/clonic seizures

Front 61

What medication might be given to a pt. with status epilipticus?

Back 61

Diazepam (valium), Lorazepam (ativan)

Front 62

What would you monitor your patient for after administering valium?

Back 62

respiratory depression/hypotension

Front 63

What is the goal for all patients with degenerative diseases?

Back 63

maintain quality of life, manage symptoms, help pt. be independent as long as possible, support family as roles change

Front 64

When do the symptoms of MS usually begin?

Back 64

between 20 -40 years of age

Front 65

Describe MS

Back 65

the demyelination of the white matter of the CNS

Front 66

What are some early signs of MS?

Back 66

double vision, spots before the eyes, blindness, tremors, weakness, fatigue, susceptibility of URI, emotional instability-depression, problems with bowel and bladder, numbness and tingling

Front 67

What are some later symptoms of MS?

Back 67

nystagmus, disorders of speech (scanning), urinary freq. and urgency, contipation, change in muscle coordination and gait

Front 68

When does parkinsons disease usually affect people?

Back 68

in their middle to later years of life (50 - 60)

Front 69

What are some of the drug therapies that are used for pt. with parkinsons disease?

Back 69

anticholinergic alkaloids (cogentin, Artane), Levodopa, antiviral agents, sinement, dopamine agonists-parlodel, monoamine oxidase B inhibitors, COMT inhibitors

Front 70

What are some interventions for Parkinsons disease?

Back 70

surgery, activity, nutrition, control of the environment, patient teaching

Front 71

What is Myastenia Graves?

Back 71

the nerve impulse fails to pass to the muscle at the myoneural junction

Front 72

What test could be done for a pt. with Myastenia Graves?

Back 72

Tensilon test

Front 73

What type of drugs should a pt. with Myastenia Graves avoid?

Back 73

any drugs that cause muscle relaxation, barbituates, tranquilizers, morphine

Front 74

What is an otoscope?

Back 74

instrument used to examine the ear

Front 75

What is conductive hearing loss?

Back 75

occurs due to something physically blocking the sound wave transmission

Front 76

What is sensorineural hearing loss?

Back 76

occurs due to a defect in the cochlea, the eighth cranial nerve or the brain (hearing loss from loud noises)

Front 77

What is mixed conductive-sensorineural hearing loss?

Back 77

profound hearing loss

Front 78

What are the different types of hearing tests?

Back 78

voice test, watch test, audioscopy, tuning fork test

Front 79

What is external otitis?

Back 79

a painful condition caused by irritating or infective agents coming in contact with the external ear

Front 80

What is acute otitis media?

Back 80

ear infection that happens suddenly and is of short duration

Front 81

What is chronic otitis media?

Back 81

ear infection that occurs as a result of acute otitis media and lasts longer.

Front 82

What are some clinical manifestations of otitis media?

Back 82

ear pain, pressure/fullness sensation of ear, distorted/decreased hearing, tinnitus, headaches, malaise, fever, N/V, dizziness/vertigo

Front 83

What is some treatment for otitis media?

Back 83

medical: antibiotics, heat/cold, analgesics, antihistamines, decongestants

Front 84

What is mastoiditis?

Back 84

an infection of the mastoid air cells due to otitis media

Front 85

What is tinnitus?

Back 85

continuous ringing in the ear

Front 86

What is labyrinthitis?

Back 86

infection of the labyrinth

Front 87

What is Meniere's disease?

Back 87

a chronic disorder of the inner ear that is characterized by tinnitus, one sided sensorineural hearing loss and vertigo

Front 88

What is dysmenorrhea?

Back 88

Painful menstrual flow