Msk

Front 1

common complication of osteoporosis?

Back 1

fracture of hip, wrist, shoulder, spine

Front 2

What are risk factors for osteoporosis/

Back 2

oral steroids, hormonal contraception, women, age, family hx, malabsorption disorders (crohn's), hyperparathroidism, osteopenia, early menopause, a lot of alcohol or smoking

Front 3

Why are women more likely to get osteoporosis than men?

Back 3

smaller frames,pregnancy and breast feeding may deplete ca, less ca intake, bone reabsorption begins earlier and accelerates at menopause, women live longers

Front 4

What factors impact bone mass?

Back 4

heredity, exercise, diet, hormone function

Front 5

prevention of osteoporosis

Back 5

weight bearing exercise, calcium and vit D. secreening,

Front 6

What nutrients determine bone mass?

Back 6

high calcium, vit D, protein good. high phosphate bad, inadequate calories

Front 7

HOw would you screen for risk factors for osteoporosis?

Back 7

diet, exercise, family hx, smoking, excessive alcohol, inactivity, poor nutrition, premature menopause

Front 8

On physical examination, what might indicate osteoporosis?

Back 8

kyphosis, chronic lower back pain, loss of height, decreased rib pelvic distance, decreased activity

Front 9

What are daily calcium requirements/

Back 9

1000mg until 50. then 1200mg

Front 10

fracture prevention strategies

Back 10

calcium vit D, exercise, fall prevention strategies, avoid excess alcohol and smoking

Front 11

fall prevention strategies

Back 11

have home assessed, de-clutter (beware of pets), low heeled shoes with good support, hand rails, be aware of effects of some meds

Front 12

alcohol and bones

Back 12

excess alcohol kills osteoblasts

Front 13

Assessing a limb

Back 13

CTSM 7Ps: pulse pallor pain puffiness, poikilothermia, paralysis, parathesia.

Front 14

s/s of sprain

Back 14

pain, edema, bruising, decreased function

Front 15

interventions for sprain

Back 15

RICE: rest, ice, compression, elevation

Front 16

s/s of fractures

Back 16

edema, ecchymosis, loss of function of extremity, crepitation (audible crunching), muscle spasm, pain/tenderness, deformity

Front 17

nursing care for someone with traction for fracture

Back 17

inspect exposed skin, pin care, CAROL. continuous (traction must not be interrupted), A (alignment pt must be in centre of bed); R (resistance - not present weights must hang free); O (opposing traction - body weight patient high in bed); L (line of pull - unobstructed, ropes do not touch pulleys)

Front 18

Cast care

Back 18

apply ice over fracture site for first 24h, dry cast after exposure to water, elevate limb above level of the heart for the first 48h, move joints below and above cast regularly, do not get cast wet or remove padding, do not insert any objects in the cast, do not cover with plastic for a long time

Front 19

complications of fractures

Back 19

compartment syndrome, DVT, fat emoblism, bone infection, nerve damage, bone malunion

Front 20

compartment syndrome

Back 20

develops when swelling and pressure occur within a confined space or compartment. the pressure causes perfusion to the muscle to be compromised. ischemia to the muscle and nerve damage result if enough pressure builds. early recognition is essential to avoid permanent damange

Front 21

common causes of compartment syndrome

Back 21

Common causes of compartment syndrome include tibial or forearmfractures, ischemic reperfusion following injury, hemorrhage, vascular puncture, intravenous drug injection, casts, prolonged limb compression,crush injuries and burns. long surgeries

Front 22

s/s of compartment syndrome

Back 22

pain that increases in severity, especially with passive stretching of the muscle and that is unrelieved with narcotics. paresthesia (tingling), decreased/absent pulses, cyanosis, cold, slow cap refill, tense skin over lib, paralysis

Front 23

nursing actions if suspected compartment syndrome

Back 23

elevate extremity to heart level, release restrictive devices

Front 24

fat embolism syndrome

Back 24

presence of systemic fat globules from fracture that are distributed into tissues and organs after a traumatic skeletal injury.

Front 25

complications of fat embolism syndrome

Back 25

Pulmonary fat embolism. Widespread obstruction causes sudden death.Systemic fat embolism. These may get lodged in capillaries of organs like brain, kidney, skin etc., causing minute hemorrhage and microinfarcts

Front 26

What are the metabolic effects of immobility?

Back 26

decreased Ca, decreased BMR, anorexia, negative nitrogen balance (BUN), delayed wound healing (reduced protein intake)

Front 27

What are TNP directives for immobility?

Back 27

weigh patient qMon and Thursday before breakfast, ensure adequate caloric intake, check lab values qTuesday, advise MD if albumin low

Front 28

Factors contributing to pressure ulcers

Back 28

malnutrition, immobility, dehydration, chronic illness, impaired sensation, decreased LOC, infection, age, steroid use. external: pressure, friction, shear, moisture

Front 29

pressure ulcer stages

Back 29

Stage 1 Pressure Injury: Non-blanchable erythema of intact skin. Stage 2 Pressure Injury: Partial-thickness skin loss with exposed dermisPartial-thickness loss of skin with exposed dermis. The wound bed is viable, pink or red, moist, and may also present as an intact or ruptured serum-filled blister. Adipose (fat) is not visible and deeper tissues are not visible. Granulation tissue, slough and eschar are not present. Stage 3 Pressure Injury: Full-thickness skin lossFull-thickness loss of skin, in which adipose (fat) is visible in the ulcer and granulation tissue and epibole (rolled wound edges) are often present. Slough and/or eschar may be visible. Stage 4 Pressure Injury: Full-thickness skin and tissue lossFull-thickness skin and tissue loss with exposed or directly palpable fascia, muscle, tendon, ligament, cartilage or bone in the ulcer. Slough and/or eschar may be visible. Epibole (rolled edges), undermining and/or tunneling often occur. Unstageable Pressure Injury: Obscured full-thickness skin and tissue lossFull-thickness skin and tissue loss in which the extent of tissue damage within the ulcer cannot be confirmed because it is obscured by slough or eschar. Deep Tissue Pressure Injury: Persistent non-blanchable deep red, maroon or purple discolorationIntact or non-intact skin with localized area of persistent non-blanchable deep red, maroon, purple discoloration or epidermal separation revealing a dark wound bed or blood filled blister.

Front 30

treatment of early stages of PU

Back 30

hydrocolloids (duoderm)

Front 31

Assessments/interventions for pressure ulcers

Back 31

assess for skin breakdown, t &p, evaluate risk with braden scale, skin care qshift, high protein diet, prevent shear when moving patient, increase fluid intake to 2L/day.