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124 Cards in this Set
- Front
- Back
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POTENTIAL COMPLICATION OF OPEN FRACTURE
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INFECTION
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6 PHASES OF FRACTURE HEALING AND WHEN THEY OCCUR
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HEMATOMA - IN 1ST 72 HOURS
GRANULATION - DAY 3-14 CALLUS FORMATION - BY END OF 2ND WEEK OSSIFICATION - 3WEEKS-6 MONTHS CONSOLIDATION REMODELING-UP TO A YEAR |
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WHEN IS SKIN TRACTION DONE, AND WHY IS IT DONE
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USED PREOPERATIVELY
IMMOBILIZES A JOINT DECREASES SWELLING AND SPASMS MAINTAINS ALIGNMENT |
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IF A PATIENT HAS TRACTION, WHAT ARE 3 IMPORTANT NURSING CARE CARE MEASURES
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MAINTAINING ALIGNMENT
PAIN MANAGEMENT NEUROVASCULAR CHECKS TO EXTREMITY |
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WEIGHT LIMITS FOR SKIN TRACTION
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5-10 LBS.
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WEIGHT LIMITS FOR SKELETAL TRACTION
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5-45 LBS.
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SKELETAL TRACTION - WHAT IS IT AND RISKS
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SURRGICAL PLACEMENT OF PINS INTO BONE (AKA EXTERNAL FIXATION).
RISK IS INFECTION |
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MOST IMPORTANT NURSING RESPONSIBILY FOR SKELETAL TRACTION
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PIN CARE: REMOVE EXUDATE WITH 1/2 STRENGTH PEROXIDE AND RINSE WITH STERILE SALINE. DRY WITH STERILE GAUZE
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WHAT ARE NEUROVASCULAR CHECKS
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CHECKS FOR:
COLOR TEMPERATURE CAP REFILL PERIPHERAL PULSES EDEMA SENSATION MOTOR FUNCTION PAIN A COOL/COLD EXTREMITY BELOW THE INJURY CAN INDICATE ARTERIAL INSUFFICIENCY A WARM,CYANOTIC EXTREMITY COULD INDICATE POOR VENUS RETURN |
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NURSING CONSIDERATIONS FOR CASTS
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PERFORM NEUROVASCULAR CHECKS:
ASSESS FOR HOT SPOTS, DRAINAGE, ODOR, SKIN BREAKDOWN, AND INCREASED PAIN. INSTRUCT PT. NOT TO PUT ANYTHING IN THE CAST EXERCISE JOINTS BELOW AND ABOVE CAST HANDLE DRYING CAST WITH PALM OF HAND TO AVOID INDENTION OF PLASTER CAST IS NOT STRONG ENOUGH FOR WEIGHT BEARING FOR 24-72 HR. |
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WHAT IS AN ORIF AND WHAT IS A MAJOR NURSING CONSIDERATION.
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HARDWARE IS USED TO REPLACE DAMAGED BALL AND SOCKET OF HIP. ITS NOT A HIP REPLACEMENT
EARLY ROM IS INDICATED. CPM MACHINES USED TO PREVENT ADHESIONS AND INCREASE HEALING. |
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COMPARTMENT SYNDROME
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A COMPLICATION OF A FRACTURE IN WHICH PRESSURE CONSTRICTS STRUCTURES AND CUTS OFF CIRCULATION TO THE AREA.
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S/S OF COMPARTMENT SYNDROME
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CAN BE SOME OR ALL OF THE 6 P'S
1. PARASTHESIAS-NUMBNESS OR TINGLING 2. PAIN-DISTAL TO THE INJURY NOT RELIEVED WITH ANALGESICS 3. PRESSURE 4. PALLOR - COOLNESS OR LOSS OF COLOR 5. PULSELESSNESS - DIMINISHED OR ABSENT PERIPHERAL PULSES **LATE AND OMINOUS SIGNS ARE PULSELESSNESS AND PARALYSIS |
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LABS THAT MAY INDICATE POTENTIAL COMPARTMENT SYNDROME
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INCREASED MYOGLOBIN WITH DARK REDDISH BROWN URINE (can lead to renal failure)
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NURSING CONSIDERATIONS FOR SUSPECTED COMPARTMENT SYNDROME
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DO NOT ELEVATE EXTREMITY ABOVE HEART
DO NOT USE ICE - INCREASED VASOCONSTRICTION CAN OCCUR |
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MEDICAL TX FOR COMPARTMENT SYNDROME
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FASCIOTOMY TO DECOMPRESS (INFECTION IS A POSSIBILITY THAT COULD LEAD TO AMPUTATION)
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FAT EMBOLISM AND WHEN DOES IT USUALLY OCCUR
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LIFE THREAT ER
GLOBS OF FAT ENTER PERIPHERAL CIRCULATION OR PULMONARY VASCULAR BED. USUALLY OCCUR 24-28 HR AFTER INJURY |
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WHAT SHOULD A NURSE ASSESS FOR WHEN FAT EMBOLIISM IS SUSPECTED?
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ASSESS FOR:
NEURO CHANGES (LOC,RESTLESSNESS,CONFUSION, HA) RESPIRATORY CHANGES (DYSPNEA, CYANOSIS,PETECHIAE OF BUCCAL MEMBRANES, SKIN,AND CONJUNCTIVAL SACS) |
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NURSING CARE FOR A CLIENT WITH FAT EMBOLISM
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O2 THERAPY WITH POSSIBLE INTUBATION
NOTIFY PHYSICIAN MAINTAIN FLUID BALANCE ADMINISTER STEROIDS, IF ORDERED IMMOBILIZE LONG BONE (TOO MUCH MOVEMENT WILL CAUSE MORE FAT TO DISLODGE) COUGH DEEP BREATH |
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HOW IS FAT EMBOLISM DX
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THERE IS NO DX TEST, BUT LABS COULD INDICATE:
FAT CELLS IN BLOOD,SPUTUM,URINE DECREASED PAO2 (LESS THAN60) CHANGE ON ECG DECREASED PLT, HCT INCREASED PT CXR MAY REVEAL PULM INFILTRATE (WHITE OUT EFFECT) |
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BUCK'S TRACTION
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USED TO RELIEVE MUSCLE SPASMS, IMMOBILIZE LEG AND RELIEVE PAIN PRIOR TO HIP SURGERY FOR A FRACTURED HIP.
USED FOR 24-48 HR MAXIMUM |
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PATIENT AND FAMILY TEACHING ON WHAT NOT TO DO FOR A PATIENT WITH A FEMORAL HEAD PROSTHESIS TO PREVENT DISLOCATION
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DO NOT:
FORCE HIP TO MORE THAN 90 DEGREES OF FLEXION,ADDUCTION,OR INTERNAL ROTATION CROSS LEGS PUT ON SHOES OR STOCKINGS WITHOUT ADAPTIVE DEVICE SIT ON CHAIRS WITHOUT ARMS TURN ON AFFECTED SIDE UNTIL APPROVED BY SURGEON |
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PATIENT AND FAMILY TEACHING ON WHAT TO DO FOR A PATIENT WITH A FEMORAL HEAD PROSTHESIS TO PREVENT DISLOCATION
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USE AN ELEVATOR ON A TOILET OR SEAT
PLACE CHIR INSIDE SHOWER USE PILLOW B/T LEGS FOR 1ST 8 WEEKS AFTER SURGERY (ESPECIALLY WHEN TURNING) KEEP HIP IN NEUTRAL STRAIGHT POSITION WHEN SITTING,WALKING,LYING |
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WHEN SHOULD A PT WITH A HIP PROSTHESIS NOTIFY THE SURGEON
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IF SEVERE PAIN,DEFORMITY, OR LOSS OF FUNCTION OCCURS
ALSO NOTIFY DENTIST BEFORE DENTAL WORK SO PROPHYLACTIC ANTIBIOTICS CAN BE GIVEN. |
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NURSING MANAGEMENT OF A PATIENT WITH HIP FRACTURE OR REPLACEMENT
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ORIF:
NEUROVASCULAR ASSESSMENT (ASSESS PAIN,PALLOR,PULSE,PARASHTESIA,PARALYSIS) TURN TO AFFECTED SIDE SAFETY REPLACEMENT: ALL OF THE ABOVE AND ELEVATED TOILET SEAT DO NOT FLEX HIP MORE THAN 90 DEGREES ABDUCTOR PILLOW BT LEGS DO NOT CROSS ANKLES OR LEGS. |
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POST OP CARE FOR A PATIENT WITH A MANDIBLE FRACTURE FOCUSES ON WHAT?
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AIRWAY
ORAL HYGIENE COMMUNICATION PAIN MANAGEMENT NUTRITION |
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2 MAJOR PROBLEMS IMMEDIATE POST OP FOR MANDIBLE FRACTURE. WHAT SHOULD THE NURSE DO TO PREVENT?
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AIRWAY OBSTRUCTION
ASPIRATION OF VOMITUS OBSERVE FOR S/S OF RESP. DISTRESS (DYSPNEA,ALTERATION IN RATE, QUALITY, AND DEPTH OF RESP.) PLACE PT ON SIDE W/ HEAD SLIGHTLY ELEVATED WIRE CUTTER OR SCISSORS TAPED TO HOB |
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WIRE CUTTERS,SCISSORS MAY BE USED TO CUT WIRES OR BANDS IN EMERGENCY (ONLY AS A LAST RESORT). WHEN MIGHT THIS BE NECESSARY
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RESP OR CARDIAC ARREST REQUIRING ACCESS TO PHARYNX OR LUNGS.
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IF A PT BEGINS TO CHOKE WHEN MOUTH IS WIRED SHUT, WHAT SHOULD THE NURSE DO?
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TRY TO CLEAR MUTH AND AIRWAY BY SUCTIONING NASOPHARYNGEAL OR ORAL ROUTE.
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WHY MIGHT AN NG TUBE BE USED FOR A MANDIBLE FX WITH WIRES
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TO DECOMPRESS AND REMOVE FLUIDS AND GAS FROM STOMACH TO PREVENT ASPIRATON AND VOMITING
AS A FEEDING TUBE |
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NURSING CARE AND TEACHING FOR THE PT. WITH A MANDIBLE FX
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RINSE MOUTH FREQUENTLY WITH NS, WATER, OR ALKALINE MOUTHWASH (ALSO A SOFT WATER PIC OR CATHETER CAN BE USED)
INSPECT MOUTH SEV.TIMES A DAY COMMUNICATION (ESTABLISH PRE-OP) LIQUID DIET TEACH PT HOW TO CLEAR SECRETIONS AND VOMITUS HOW TO USE WIRECUTTERS ENCOURAGE PT TO VERBALIZE FEELINGS ABOUT ALTERED IMAGE |
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WHEN PT HAS A CLAVICLE FX, THEY ARE INSTRUCTED NOT TO WHAT?
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RAISE ARMS ABOVE SHOULDER LEVEL
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RESPIRATORY COMPRIMISE AND OR FLAIL CHEST IS A COMPLICATION OF FRACTURED RIBS. WHAT SHOULD THE NURSE TEACH TO PROMOTE ADEQUATE RESP. FUNCTION?
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TURN,COUGH,DEEP BREATH
USE INCINTIVE SPIROMETER |
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MOST COMMON NON-TRAUMA RELATED CAUSE OF AMUPTATIONS IS?
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DIABETES
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COMPLICATIONS OF AMPUTATION
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INFECTION
DELAYED HEALING CONTRACTURES PSYCHOLOGICAL EFFECTS HEMORRHAGE |
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HOW CAN CONTRACTURES CAN BE PREVENTED?
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LIYING PRONE FOR PERIODS OF TIME UNLESS CONTRAINDICATED DUE TO COPD
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NURSING RESPONSIBLITIES REGARDING PREVENTION OF COMMPLICATIONS FOLLOWING AMPUTATION
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MONITOR VS AND DSG FOR S/S OF HEMORRHAGE
STERILE TCHNIQUE FOR DSG CHANGES |
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PATIENT TEACHING ON AMPUTATION. WHEN THE PT GETS HOME, HOW SHOULD HE/SHE CARE FOR THE AMPUTATION
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INSPECT FOR S/S OF IRRITATION (ERYTHEMIA,EXCORIATION,ODOR)
D/C PROSTHESIS IF IRRITATION DEVELOPS WASH LIMB Q NIGHT WITH WARM WATER AND BACTERIOSTATIC SOAP, DRY THOROUGHLY AND EXPOSE TO AIR FOR 20 MINS NO LOTIONS,ALCOHOL,POWDERS, OR OIL CHANGE LIMB SOCK Q DAY USE RX PAIN MEDS ROM ON ALL JOINTS DAILY DO NOT ELEVATE LIMB ON PILLOW LIE PRONE WITH HIP EXTENSION FOR 30 MINS 3-4X/DAY |
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NURSING CARE FOR PT WITH AMPUTATION IS AIMED AT WHAT
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ALLEVIATING PAIN
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TYPES OF SOFT TISSUE TRAUMA
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CONTUSION-BLEEDING INTO SOFT TISSUES
SPRAIN-INJURY TO A LIGAMENT STRAIN-TEARING OF A MUSCLE |
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RICE WHAT DOES IT STAND FOR AND WHEN IS IT INDICATED?
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REST
ICE COMPRESSION ELEVATION INDICATED IN SOFT TISSUE TRAUMA (CONTUSION,SPRAIN,STRAIN) |
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TX FOR SOFT TISSUE TRAUMA
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RICE
MOTRIN (OR OTHER ANTI-INFLAMMATORY) 24-48 HR. POST-INJURY APPLY ICE FOR 20 MINS AND OFF FOR 15 MINS AFTER 48-72 HOURS, APPLY WARMTH WITH A HEATING PAD COMPRESSION WITH ACE BANDAGE (REMOVE SEVERAL X/DAY FOR 15 MIN INTERVALS) ELEVATION |
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JOINT DISLOCATION
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TOTAL SEPERATION OF CONTACT BT TWO BONES
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SUBLUXATION
HOW DOES IT OCCUR |
PARTIAL SEPERATION BETWEEN TWO BONES (COMMONLY THE VERTEBRAE).
THEY CAN OCCUR WITH IMPROPER POSITIONING OF A CLIENT OR FROM MOTOR VEHICLE ACCIDENTS. |
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TX FOR SUBLUXATION
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PAIN MANAGEMENT
REPAIR PREVENTION OF COMPLICATION SUCH AS AVASCULAR NECROSIS |
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TESTS TO DETECT POSSIBLE CARPEL TUNNEL SYNDROME
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PHALEN'S TEST - HOLD WRISTS FOR 60 SECONDS. IF NUMBNESS OR TINGLING OCCURS OVER THE MEDIAN NERVE, PALAR SURFACE OF THE THUMB, INDEX FINGER, MIDDLE FINGER, OR PART OF THE RING FINGER, IT'S POSITIVE.
TINEL'S SIGN-PARASTHESIA PRODUCED BY TAPPING GENTLY OVER THE VOLAL ASPECT OF THE WRIST. |
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COLLABORATIVE CARE FOR A PT WITH CARPEL TUNNEL
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RELIEVE NERVE COMPRESSION
INJECTION OF CORTICOSTEROID (FOR S/T RELIEF) AVOID HEAT AND COLD SURGERY - OUTPATIENT UNDER LOCAL,REGIONAL,OR GENERAL ANESTHESIA |
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BURSITIS AND TX
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INFLAMMATION OF THE BURSA FROM FRICTION BT THE BURSA AND MUSCULOSKELETAL TISSUE.
TX: ICE TO DECREASE PAIN AND INFLAMMATION IMMOBILIZE AFFECTED PART IN COMPRESSION DRESSING OR SPLINT NSAIDS TO REDUCE INFLAMMATION AND PAIN ASPIRATION OF BURSAL FLUID AND INJECT A CORTICOSTEROID BURSECTOMY IF SEPTIC BURSAE OCCURS, SURGICAL INCISION AND DRAINAGE IS DONE. |
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EPICONDYLITIS
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TENNIS ELBOW RESULTING FROM INFLAMMATION TO THE TENDON AT ITS POINT OF ORIGIN
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ROTATOR CUFF INJURY
TX |
TEAR WITHIN MUSCLE OR TENDON OF SHOULDER
COMMON IN BASEBALL PLAYERS BUT MAY BE ASSOCIATED WITH DEGENERATIVE CHANGES ASSOC. WITH NORMAL AGING TX: REST SHOULDER NSAIDS GRADUAL MOBILIZTION WITH ROM AND STRENGTHENING EX IF MAJOR, SURGERY |
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AFTER DX ROTATOR CUFF INJURY, HOW IS IT CONFIRMED
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MRI TO CONFIRM
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MANIFESTATIONS OF ROTATOR CUFF INJURY
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SHOULDER WEAKNESS
PAIN DECREASED ROM DROP ARM TEST (ARM DROPS QUICKLY AFTER PT ASKED TO SLOWLY LOWER IT TO THE SIDE AFTER ABDUCTION OF 90 DEGREES) |
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POST-OP FOR ROTATOR CUFF SURGERY
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IMMOBILIZER
DO NOT IMMOBILIZE FOR TOO LONG BECAUSE FROZEN SHOULDER OR ARTHROFIBROSIS MAY OCCUR PENDULUM EXERCISES AND PT BEGIN THE 1ST POST-OP DAY |
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MENISCUS INJURY
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INJURY TO THE KNEE WHEN A PERSON CHANGES DIRECTIONS QUICKLY. FOOTBALL PLAYERS MOST AT RISK.
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DX FOR TORN MENISCUS
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ARTHROGRAM
ARTHROSCOPY MRI TO CONFIRM (USUALLY BEFORE ARTHROSCOPY) |
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PREVENTION FOR MENISCUS INJURIES
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WARM UP
PROPER STRETCHING |
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INITIAL CARE FOR TORN MINISCUS
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ICE
NSAIDS IMMOBILIZATION PARTIAL WEIGHT BEARING WITH CRUTCHES |
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TYPE OF SURGERY AND POST-OP TX FOR MENISCUS INJURY
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SURGERY IS ARTHROSCOPY
NSAIDS OR OTHER ANALGESICS REHAB ROM |
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OSTEOPEROSIS - PATHOPHYSIOLOGY
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METABOLIC DO CHARACTERIZED BY LOSS OF BONE MASS, INCREASED BONE FRAGILITY, AND INCREASED RISK OF BONE FRACTURES
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OSTEOPEROSIS IS MORE COMMON IN WHO
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WOMEN, ESPECIALLY EUROPEAN DESCENT
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COMPLICATIONS OF OSTEOPEROSIS
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DOWAGER'S HUMP
COMPRESION FACTORS |
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UNMODIFIABLE RISK FACTORS FOR DEVELOPING OSTEOPEROSIS
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OLDER AGE
FEMALE RACE (EUROPEAN AND ASIAN) GENETICS ENDOCRINE (LOW ESTROGEN) HYPERTHYROIDISM CUSHING'S DISEASE DIABETES |
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WHAT MEDS CAN CONTRIBUTE TO OSTEOPEROSIS
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STEROIDS
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NURSING IMPLICATIONS FOR PATIENTS TAKING BONE REAPSORPTION INHIBITORS(BIOPHOSPHONATES) SUCH AS FOSAMAX AND BONIVA
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TAKE ON EMPTY STOMACH
TAKE FIRST THING IN AM TAKE WITH 8 OZ WATER (NO OTHER LIQUID) TAKE 30-60 MINS BEFORE EATING OR DRINKING REMAIN UPRIGHT FOR 30-60 MINUTES AFTER TAKING |
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WHAT TWO SUPPLEMENTS SHOULD PEOPLE AT RISK FOR OSTEOPOROSIS TAKE TO DECREASE THEIR RISKS
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CALCIUM
VITAMIN D TAKE TURNS |
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ESTROGENS ROLE IN BONE
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INCREASES BONE DENSITY
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PATIENTS AT RISK FOR OSTEOPEROSIS SHOULD AVOID WHAT
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SMOKING
ALCOHOL |
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CLIENTS AT RISK FOR OSTEOPEROSIS NEED TO PARTICIPATE IN WHAT TYPE OF EXERCISE
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WEIGHT BEARING ACTIVITIES SUCH AS WALKING
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TEST TO DETERMINE OSTEOPEROSIS AND PURPOSE OF THE TEST
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BONE DENSITY TEST
DETERMINES MINERAL CONTENT AND DENSITY |
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NURSING CONSIDERATIONS FOR PRE-BONE DENSITY TEST
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EXPLAIN PROCEEDURE
NO FASTING OR SEDATION REMOVE METALLIC OBJECTS |
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TERIPARATIDE
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A NEW FORM OF PARATHYROID HORMONE AND A NEW OSTEOPOROSIS MEDICATION THAT INCREASES THE RATE OF BONE FORMATION IN THE BONE REMODELING CYCLE.
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INDICATIONS FOR BONIVA,FOSOMAX, AND ACTONEL
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PREVENTION AND TREATMENT OF POSTMENOPAUSAL OSTEOPOROSIS
TX OF GLUCOCORTICOID INDUCED OSTEOPEROSIS IN WOMEN AND MEN AS A RESULT OF LONG TERM USE OF MEDICATIONS SUCH AS PREDNISONE AND CORTICONE |
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S/E OF BIOPHOSPHONATES
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GI PROBLEMS
ADB OR MS PAIN NAUSEA HEARTBURN IRRITATION OF ESOPHAGUS OSTEONECROSIS OF THE JAW AND VISUAL DISTURBANCES (RARE) |
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CALCITONIN INDICATIONS AND USE
side effects for both |
USED FOR OSTEOPEROSIS
SQ INJECTION OR NASAL SPRAY SE'S FOR INJECTIBLE: MAY CAUSE ALLERGIC REACTION SUCH AS FLUSHING OF THE FACE AND HANDS MAY CAUSE URINARY FREQUENCY NAUSEA SKIN RASH SE'S FOR NASAL: NASAL IRRITATION BACKACHE BLOODY NOSE HEADACHES |
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ESTROGEN THERAPY (ET) HORMONE THERAPY (HT)INDICATIONS AND SE'S
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PREVENTION OF OSTEOPOROSIS
RELIEF OF MENOPAUSE SYMPTOMS BENEFICIAL EFFECT ON BONE HEALTH SE'S: VAG BLEEDING,BREAST TENDERNESS,MOOD DISTURBANCE,INCREASED RISK OF BREAST CANCER,DVT,STROKES,HEART ATTACK,GALLBLADDER DISEASE |
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OSTEOMALACIA
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AKA ADULT RICKETS
CAUSED BY INSUFFICIENT CALCIUM ABSORPTION AND /OR INCREASED LOSS OF PHOSPHOROUS. |
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PEOPLE AT RISK FOR OSTEOMALACIA
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RENAL FAILURE
MALABSORPTION DISORDERS SUCH AS GASTRECTOMY OR CROHN'S |
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LABS MAY REVEAL WHAT IN A PATIENT WITH OSTEOMALACIA
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LOW SERUM CALCIUM AND/OR PHOSPHOROUS
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S/S OF OSTEOMALACIA
TX |
BONE PAIN (USUALLY WHAT CAUSES PT TO SEEK HELP)
MUSCLE WEAKNESS WADDLING GAIT CREPITATION (GRATING SENSATION) **NO SYSTEMIC MANIFESTATIONS PRESENT LIKE IN RHEUMATOID TX: VIT D SUNLIGHT CALCIUM PHOSPHORUS SUPPLEMENT |
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OSTEOARTHRITIS
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RESULTS FROM CARTILAGE DAMAGE. DESTRUCTION HAPPENS AT A FASTER RATE THAN THE BODY CAN REPAIR. FISSURING AND EROSION OCCUR AND BONE SPURS FORM
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S/S OF OSTEOARTHRITIS
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PAIN THAT WORSENS WITH JOINT USE
EARLY AM STIFFNESS LOSS OF ROM PAIN WILL NO LONGER BE RELIEVED WITH REST AS IT PROGRESSES |
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DIAGNOSTIC STUDIES FOR OSTEOARTHRITIS
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CT SCAN OR MRI TO DETECT EARLY OA
XRAY TO CONFIRM |
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PAGET'S DISEASE
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INITIAL INCREASE IN BONE TISSUE BREAKDOWN FOLLOWED BY ABNORMAL BONE FORMATION.
CAUSE UNKNOWN |
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COMPLICATIONS OF PIAGET'S DISEASE
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SPONTANEOUS FRACTURES
A SMALL PORTION WILL DEVELOP OSTEOGENIC SARCOMA, A CANCER OF THE BONE. |
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TX FOR PIAGET'S DISEASE
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SUPPLEMENT WITH CALCIUM, VIT D, AND CALCITONIN
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OSTEOMYELITIS
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INFECTION OF BONE.
CAN FOLLOW WOUND,TRAUMA,OR SURGERY **BROTHER EXAMPLE |
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ACUTE OSTEOMYELITIS AND MANIFESTATION
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LASTS LESS THAN 1 MONTH
MANIFESTATIONS ARE SYSTEMIC AND LOCAL: FEVER NIGHT SWEATS CHILLS RESTLESSNESS NAUSEA MALAISE PAIN SWELLING WARMTH TENDERNESS RESTRICTED MVT AT INFECT SITE LATER SIGNS: DRAINAGE FROM SINUS TRACTS TO THE SKIN AND/OR FRACTURE SITE. |
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SUBACUTE OR CHRONIC OSTEOMYLITIS
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SYMPTOMS HAVE CONTINUED FOR MORE THAN A MONTH
SYSTEMIC SIGNS ARE DIMINISHED AND LOCAL BONE PAIN,SWELLING,TENDERNESS, AND WARMTH AT INFECTION SITE MORE COMMON |
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DX OSTEOMYELITIS
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BONE OR SOFT TISSUE BIOPSY TO DETERMINE MICROORGANISM
WOUND CULTURE BLOOD CULTURE ELEVATED WBC ELEVATED ESR BONE SCAN MRI CT (S/S WILL NOT BE DETECTED UNTIL AROUND 10 DAYS AFTER THE CLINICAL SYMPTOMS HAVE APPEARED AND THE DISEASE HAS PROGRESSED) |
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TX OSTEOMYELITIS
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IV ANTIBIOTIC THERAPY
SURGICAL DEBRIEDMENT DECOMPRESSION HYPERBARIC O2 |
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CHILDREN ARE SCREENED FOR SCOLIOSIS. THEY ARE REFERRED TO AN ORTHOPEDIC SPECIALIST IF?
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IF THE SHOULDER BLADE HEIGHT IS ASYMMETRICAL, AND OR A METER READING OF GREATER THAN 10 DEGREES.
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KYPHOSIS
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HUNCHBACK OR DOWAGER'S HUMP APPEARANCE.
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TX FOR SCOLIOSIS AND KYPHOSIS
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RANGE FROM:
PHYSICAL THERAPY MASSAGE CHIROPRACTIC AND EXERCISE TO BRACES OR SURGERY SUCH AS SPINL FUSION WITH HARRINGTON RODS |
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BUNION
TX |
AKA HALLUX VLGUS
CAUSED BY WEARING HIGH HEELS FOR PROLONGED PERIODS OF TIME TX: WEARING SHOES WITH A BUNION POCKET BUNION PADS SURGERY TO REMOVE BURSAL SAC AND CORRECTION |
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HAMMERTOE
TX |
DORSIFLEXION OF THE FIRST TOE WITH PLANTAR FLEXION OF THE SECOND AND THIRD
TX: STRETCHING SURGERY TO STREIGHTEN TOES |
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MORTONS NEUROMA
TX |
MASS OR THICKENING FORMED WITHIN THE NEUROVASCULAR BUNDLE OF THE METATARSAL SPACES THAT CAUSES BURNING SENSATION, ESP WHEN STANDING.
THERE IS INCREASED INCIDENCE IN THOSE WHO WEAR TIGHT SHOES TX: PROPER FITTING SHOES ORTHOTICS SURGICAL EXCISION |
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MANIFESTATIONS OF BONE TUMORS
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PAIN
MASS IMPAIRED FUNCTION |
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HOW IS A BONE TUMOR DX
|
H&P
XRAY CT MRI NEEDLE BX |
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SARCOMAS ARE BONE CANCERS. WHAT IS OSTEOGENIC SARCOMA
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BONE TUMOR INVOLVING THE LONGER BONES. USUALLY OCCURS IN MALE ADOLESCENTS. IT IS AGGRESSIVE AND RAPIDLY METS.
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OSTEOGENIC SARCOMA IS A BONE TUMOR INVOLVING THE LONG BONES. IT IS USUALLY SEEN IN WHO
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MALE ADOLESCENTS 10-25; MOST OFTEN IN BONES OF ARMS,LEGS, OR PELVIS
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OSTEOGENIC SARCOMA TX
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PREOP CHEMO
SURGICAL RESECTION AMPUTATION |
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MULTIPLE MYELOMA
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BONE CANCER IN ADULTS THAT CAUSES INFILTRATION AND DESTRUCTION OF BONE MARROW
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MANIFESTATIONS OF MULTIPLE MYELOMA
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INFECTION
ANOREXIA FATIGUE WT LOSS BACK PAIN ANEMIA THROMBOCYTOPENIA BLEEDING TENDENCIES |
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WHY SHOULD WOMEN WITH BREAST CANCER NOT TAKE ESTROGEN?
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ESTROGEN WILL FEED THE CANCER
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WHAT EFFECT DO STEROIDS HAVE ON BONES
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DESTROYS BONE
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WHAT CAN A PERSON WITH OSTEOPOROSIS DO TO HELP THE SPINE STAY ERECT?
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DRINK LOTS OF WATER
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#1 AND #2 CAUSE OF OSTEOMALACIA
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#1-LACK OF SUN
#2-PATHOLOGY |
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WHAT IS MOST IMPT IN THE NURSING MANAGEMENT OF A PT WITH KNEE REPLACEMENT
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FLEXIBILITY
NOT MOBILITY - BEING MOBILE IS NOT THE SAME AS BEING FLEXIBLE. |
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CAST CARE
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IF APPLYING ICE,PUT ICE IN PLATIC BAG AND PROTECT CAST WITH CLOTH
DRY CAST IF EXPOSED TO WATER (BLOT DRY,HAIRDRYER) ELEVATE EXTREM ABOVE HEART FOR FIRST 48 HR MOVE JOINTS ABOVE AND BELOW CAST REGULARLY |
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PATIENTS WITH CASTS SHOULD REPORT WHAT TO PHYSICIAN
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INCREASING PAIN
SWELLING ASSOCIATED WITH PAIN AND DISCOLORATION OF TOES OR FINGERS PAIN DURING MOVEMENT BURNING OR TINGLING UNDER CAST SORES OR FOUL ODOR UNDER CAST |
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STANDARD X-RAY
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TO DETERMINE DENSITY OF BONE AND EVALUATES STRUCTURAL OR FUNCTIONAL CHANGES OF BONES AND JOINTS.
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DISKOGRAM
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CONTRAST DYE
X-RAY OF LUMBAR OR CERVICAL INTERVERTEBRAL DISK ASSESS FOR ALLERGY TO CONTRAST DYE |
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CT SCAN
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3-D TO ID SOFT TISSUE OR BONE ABNORMALITIES AND MUSCULOSKELETAL TRAUMA
SHELLFISH ALLERGY |
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MRI
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SOFT TISSUE
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BONE SCAN- how it's done, indicates what?
preproceedure and postproceedure instructions |
RADIOISOTOPE USED
IF INCREASED UPTAKE OF ISOTOPE IS SEEN, OSTEOMYELITIS,OSTEOPOROSIS, AND PRIMARY AND METASTIC MALIGNANT LESIONS IN BONE COULD BE PRESENT. BLADDER SHOULD BE EMPTIED BEFORE SCAN INCREASE FLUIDS AFTER EXAM |
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ENDOSCOPY (ARTHROSCOPY)
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INSERTION OF ATHROSCOPE INTO JOINT(USUALLY KNEE). USED FOR EXPLORATORY PURPOSES AND FOR DX OF MENISCUS,ARTICULAR CARTILAGE,LIGAMENTS,OR JOINT CAPSULE
OUTPATIENT ASEPSIS LOCAL OR GENERAL STERILE DSG |
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ALKALINE PHOSPHATASE
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ELEVATED IN HEALING FX, BONE CANCER,OSTEOPOROSIS,OSTEOMALACIA,AND PAGETS
NORMAL 30-120 |
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CALCIUM
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DECREASED IN OSTEOMALACIA,RENAL DISEASE
NORMAL 9-11 |
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PHOSPHOROUS
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DECREASED IN OSTEOMALACIA
INCREASED IN RENAL FAILURE, HEALING FX, OSTEOLYTIC METASTIC TUMOR NORMAL 2.8-4.5 |
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RHEUMATOID FACTOR
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PRESENCE OF AUTOANTIBODY IN SERUM. NOT SPECIFIC FOR RHEUMATOID ARTH. AND IS SEEN IN OTHER CONN. TISSUE DO'S
NORMAL: NEGATIVE OR TITER<1:20 |
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ESR
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ELEVATED IN INFLAMMATOR CONDITIONS
NORMAL: <20MM/HR |
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URIC ACID
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END PRODUCT OF PROT METABOLISM
ELEVATE IN GOUT NORMAL: MEN 4.5-6.5 WOMEN 2.5-5.5 |
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CRP
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USED TO DX INFLAMMATORY DISEASE, INFECTION, AND MALIGNANCY
NORMAL: NEGATIVE |
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CREATINE KINASE
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INCREASED IN MUSCULAR DYSTROPHY, POLYMYOSITIS, TRAUMATIC INJURY
NORMAL MEN: 15-105 WOMEN: 10-80 |
