Term
| nursing management of spraisn and strains |
|
Definition
RICE
Apply cold immediately after injury |
|
|
Term
dislocation and subluxation
clinical manifestation |
|
Definition
local pain and tenderness
shortened limb
loss of function
swelling |
|
|
Term
assessment of
dislocation and subluxation |
|
Definition
|
|
Term
| other causes of repetitive strain injury |
|
Definition
poor posture
poor workspace ergonomics
(badly designed keyboard)
(repetitive lifting) |
|
|
Term
rotator cuff injury
treatment |
|
Definition
rest, ice, heat
NSAIDS
surgical repair
immobilization -- not too long or frozen shoulder can occur |
|
|
Term
fracture immobilization
collaborative care
casts |
|
Definition
| during drying period, cast should be kept dry and clean and direct pressure should be avoided - use palms |
|
|
Term
fracture immobilization
collaborative care
cast syndrome - body jacket |
|
Definition
compresses superior mesenteric artery against duodenum
patient complains of abdominal pain, abdominal pressure, nausea, vomiting
treatment: gastric decompression with NG tube and suction or cast may need to be removed or split |
|
|
Term
| side effects of muscle relaxants |
|
Definition
drowsiness
lassitude
HA
weakness and fatigue
blurred vision
ataxia
GI upset |
|
|
Term
compartment syndrome
clinical manifestations
Six P's |
|
Definition
paresthesia
pain
pressure
pallor
paralysis
pulselessness |
|
|
Term
compartment syndrome
clinical manifestations
Six P's: paraesthesia |
|
Definition
|
|
Term
compartment syndrome
clinical manifestations
Six P's: pain |
|
Definition
| distal to injury that is not relieved by opioid analgesics and pain on passive stretch of muscle traveling through compartment |
|
|
Term
compartment syndrome
clinical manifestations
Six P's: pressure |
|
Definition
|
|
Term
compartment syndrome
clinical manifestations
Six P's: pallor |
|
Definition
| coolness, and loss of normal color of extremity |
|
|
Term
compartment syndrome
clinical manifestations
Six P's: paralysis |
|
Definition
|
|
Term
compartment syndrome
clinical manifestations
Six P's: pulselessness |
|
Definition
| diminished/absent peripheral pulses |
|
|
Term
complications of fractures
fracture of the pelvis |
|
Definition
paralytic ileus
hemorrhage
laceration of urethra, bladder, or colon
sepsis
FES or DVT |
|
|
Term
collaborative care of fractures
Buck's traction |
|
Definition
relieves muscle spasms
used 24-48 hours max |
|
|
Term
nursing management pt/caregiver teaching for femoral head prosthesis
DO NOT |
|
Definition
- force hip into greater than 90 degrees of flexion
- force hip into adduction
- force hip into internal rotation
- cross legs at knees
- put on own shoes ore stockings until 6 weeks after surgery without adaptive device
- sit on chairs with out arms (they are needed to aid rising to a standing position) |
|
|
Term
nursing management pt/caregiver teaching for femoral head prosthesis
Do: |
|
Definition
- use an elevated toilet seat
- place chair inside shower or tub and remain seated while waiting
- use pillow between legs for first 6 weeks after surgery when lying on nonoperative side or when supine
- keep hip in neutral, straight position when sitting, walking or lying
- notify surgeon if severe pain, deformity or loss of function occurs
- inform dentist of presence of prosthesis before dental work so the prophylactic antibiotics can be given if indicated |
|
|
Term
Amputation
phantom limb sensation |
|
Definition
- occurs in 80% of amputees
- coldness, heaviness, cramping, shooting, burning or crushing pain
- usually subsides with time but may become chronic
- good nursing care consists of managing this type of pain |
|
|
Term
finger joint arthroplasty
Goal |
|
Definition
| to restore function to fingers and hands and reduce pain |
|
|
Term
osteomyelitis
most commonly caused by ____ bacteria |
|
Definition
|
|
Term
osteomyelitis
sequestrum forms |
|
Definition
| devitalized bone separates from living bone |
|
|
Term
osteomyelitis: direct entry
sequestrum may |
|
Definition
| be surgically removed through debridement of necrotic bone |
|
|
Term
clinical manifestations of
acute osteomyelitis
systemic |
|
Definition
fever
night sweats
chills
restlessness
nausea |
|
|
Term
clinical manifestations of
acute osteomyelitis
local |
|
Definition
constant bone pain that worsens with activity
swelling, tenderness, warmth at infection site
restricted movement of affected part
later signs: drainage from sinus tracts |
|
|
Term
collaborative care for osteomyelitis
surgical treatment for chronic osteomyelitis |
|
Definition
- removal of poorly vascularized tissue and dead bone
- extended use of antibiotics
- antibiotic-impregnated polymethyl methacrylate bead chains may also be implanted |
|
|
Term
| diagnostic study for osteomyelitis |
|
Definition
bone or soft tissue biopsy
Patient's blood and/or wound culture
positive for presence of microorganism
elevated WBC
*erythrocyte sedimentation rate (ESR) |
|
|
Term
osteomyelitis:
acute intervention |
|
Definition
- prevent complications associated with immobility
- flexion contracture: common sequela of osteomyelitis |
|
|
Term
metatstatic bone cancer
mets from primary site |
|
Definition
| bone pain and past hx of cancer suspected |
|
|
Term
low back pain
etiology
several risk foactors |
|
Definition
lack of muscle tone
excess body weight
poor posture
cigarette smoking
stress |
|
|
Term
low back pain
associated with low back pain |
|
Definition
| prolonged periods of sitting |
|
|
Term
acute low back pain
collaborative care |
|
Definition
| alternating of heat and cold compressess |
|
|
Term
acute low back pain
nursing assessment
subjective data |
|
Definition
| occupation requiring heavy lifting, vibrations, or extended driving |
|
|
Term
nursing implementation health promotion
DOs
for low back pain |
|
Definition
- prevent low back from straining forward by placing a foot on a step or stool during prolnged standing
- sleep in a side lying position with knees and hips bent
- sleep on back with a lift under knees and legs or with a 10 inch high pillow under knees to flex hips and knees |
|
|
Term
nursing implementation health promotion
DONTs
for low back pain |
|
Definition
- lean forward without bending knees
- lift anything above level of elbows
- stand in one position for prolonged time
- sleep on abdomen or on back or side with legs out straight
- exercise without consulting health care provider if having severe pain |
|
|
Term
nursing implentation
acute intervention
back pain |
|
Definition
|
|
Term
spinal surgery: postoperative
movement of patient |
|
Definition
logroll patient when turning
maintain proper allignment of spine
bed rest may be maintained for 1-2 days |
|
|
Term
| spinal surgery: postoperative |
|
Definition
parasthesias and/or pain may not be immediately relieved after surgery
note NEW muscle weakness or paresthesias and report to surgeon |
|
|
Term
|
Definition
caused by ill-fitting shoes
teach importance of proper shoes -- Jimmy Choo surgery |
|
|
Term
|
Definition
female gender
increasing age
family history
white or asian
small stature
early menopause
excess alcohol
cigarettes
anorexia
oophorectomy
sedentary lifestyle
insufficient calcium
low testosterone levels in men |
|
|
Term
osteoporosis
diagnostic studies |
|
Definition
| dual energy x-ray absorptiometry (DEXA) |
|
|
Term
osteoarthritis
what decreases risk |
|
Definition
| regular moderate exercise |
|
|
Term
osteoarthritis
clinical manifestations |
|
Definition
systemic manifestations not present
JOINT PAIN-- which worsens with use
affects joints asymmetrically |
|
|
Term
osteoarthritis
collaborative care focuses on |
|
Definition
managing pain and inflammation
preventing disability
maintaining adn improving joint function |
|
|
Term
osteoarthritis
foundation for OA management is |
|
Definition
| nonpharmacologic interventions |
|
|
Term
osteoarthritis
nutritional therapy and exercise |
|
Definition
| weight-reduction program is critical for overweight patient |
|
|
Term
osteoarthritis
drug therapy |
|
Definition
based on symptoms:
mild to moderate: topical agent (capsaicin cream, ZOSTRIX)
Tylenol
moderate to severe joint pain: NSAID |
|
|
Term
osteoarthritis
community education should focus on |
|
Definition
| alteration of modifiable risk factors -- weight loss; occupational and recreational hazards |
|
|
Term
osteoarthritis
acute intervention |
|
Definition
drugs administered for relief of pain and inflammation
-- acetaminophen (Tylenol) is first line therapy |
|
|
Term
rheumatoid arthritis
extraarticular manifestations
3 most common |
|
Definition
rheumatoid nodules
sjogren's syndrome
felty syndrome -- splenomegaly & blood dyscrasias |
|
|
Term
rheumatoid arthritis
extraarticular manifestations
nodules |
|
Definition
** can easily break and become infected
appear subcutaneously as firm, nontender, granuloma-type masses
- usually loacted over extensor surface of joints
- nodules at bas of spine or back of head are common in older adults
- develop insidiously and can persist or regress spontaneously
- usually not removed because of high probability of recurrence
- may also appear on sclera or lungs |
|
|
Term
rheumatoid arthritis
extraarticular manifestations
sjogren's syndrome |
|
Definition
|
|
Term
rheumatoid arthritis
complications |
|
Definition
| joint destruction begins as early as first year of disease without treatment |
|
|
Term
rheumatoid arthritis
complications
nodules |
|
Definition
| on the skin they can ulcerate, similar to pressure ulcers |
|
|
Term
rheumatoid arthritis
diagnostic studies
have 4 of following seven |
|
Definition
** symetrical joint swelling
morning stiffness that lasts > 1 hour
swelling in 3 or more joints
swelling in hand joints
erosions or decalcification see on hand x-rays
rheumatoid nodules
presence of serum RF |
|
|
Term
rheumatoid arthritis
callaborative care |
|
Definition
| a caring, long-term relationship with an arthritis health care team can increase patient's self-esteem and positive coping |
|
|
Term
rheumatoid arthritis
Drug therapy |
|
Definition
- disease modifying antirheumatic drugs (DMARDS): lessen permanent effects of RA -- sulfasalazine (azulfidine) & hydroxychloroquine (antimalarial drug)
- Methotrexate (rheumatrex) is drug of choice |
|
|
Term
rheumatoid arthritis
drug therapy
methotrexate |
|
Definition
immunosuppresive agent
teratogenic
rapid antiinfammatory effect decreases clinical symptoms in days to weeks
inexpensive
lower toxicity compared to other drugs |
|
|
Term
rheumatoid arthritis
drug therapy
corticosteroid intraarticular injections |
|
Definition
MOA: antiinflammatory, anaanalgesic, act by inhibiting synthesis and/or release of mediators of inflammation
Side effects: local osteoporosis, tendon rupture, neuropathic arthropathy from frequent injections,
dermal/subdermal changes
possibility of local infection |
|
|
Term
rheumatoid arthritis
drug therapy
corticosteroid intraarticular injections
Nursing consideration |
|
Definition
| use strict aseptic technique for joint fluid aspiration or corticosteroid injection. Inform patient that joint may feel worse immediately after injection. Inform patient that improvement lasts weeks to months after injection. Advise patient to avoid overusing affected joint after injection |
|
|
Term
rheumatoid arthritis
drug therapy
DMARDS |
|
Definition
methotrexate
sulfasalazine (Azulfidine, Salazopyrin)
leflunomide (Arava)
penicillamine (Cuprimine, Depen) |
|
|
Term
rheumatoid arthritis
drug therapy
DMARDS
methotrexate - nursing considerations |
|
Definition
monitor CBC and hepatic and renal function
advise pt to report signs of anemia
keep patient well hydrated
teratogenic effects
contraception should be used during and 3 mo after tx |
|
|
Term
rheumatoid arthritis
drug therapy
DMARDS
sulfasalazine (Azulfidine) - nursing consideratios |
|
Definition
| advise patient that drug may cause orange-yellow discoloration of urine or skin. space doses evenly around teh clock, taking drug after food with 8 oz of water. treatment may be continued even after symptoms are relieved. Monitor CBC |
|
|
Term
rheumatoid arthritis
drug therapy
DMARDS
leflunomide (Arava) - nursing consideration |
|
Definition
monitor hepatic function.
Evaluate for relief of pain, swelling, stiffness; increase in joing mobility. Advise women of childbearing age to avoid pregnancy |
|
|
Term
rheumatoid arthritis
drug therapy
DMARDS
penicillamine (Cuprimine, Depen) - nursing considerations |
|
Definition
monitor WBC count, platelets, urinalysis.
advise patient to take medicaiton 1 hr before or 2 hr after meals or at least 1 hr from any other drug, food or milk |
|
|
Term
rheumatoid arthritis
drug therapy
systemic corticosteroids -- hydrocortison sodium succinate (Solu-Cortef) |
|
Definition
| use only in life threatening exacerbation or when symptoms persist after treatment with less potent antiinflammatory drugs. administer for limited time only, tapering dose slowly. be aware that exacerbation of symptoms occurs with abrupt withdrawal of drug. Monitor BP, weight, CBC and potassium level. Limit Na intake. report signs of infection |
|
|
Term
rheumatoid arthritis
drug therapy
NSAIDs -- nursing considerations
ibuprofen |
|
Definition
administer drug with food, milk or antacids as prescribed
report signs of bleeding (tarry stools, bruising, petechiae, nosebleeds) edema, skin rashes, persistent HA, visual disturbances, monitor BP for elevations related to fluid retention. needs to be used regularly for maximal effect |
|
|
Term
rheumatoid arthritis
drug therapy
corticosteroid: c-reactive ___________________ |
|
Definition
| protein level to determine effectiveness |
|
|
Term
rheumatoid arthritis
nursing implementation |
|
Definition
Rest
alternate scheduled rest periods with activity throughout day
avoid flexion positions (encourage extension)
pillows should not be placed under knees
Ice: especially beneficial during periods of dz exacerbation
should not exceed 10-15 min at one time |
|
|
Term
|
Definition
lupus nephritis
-- ranging from mild prteinuria to glomerulonephritis
-- primary goal in treatment is slowing the progression |
|
|
Term
|
Definition
** lukopenia
** thrombocytopenia
formation of antibodies against blood cells
anemia
coagulopathy
anti-phsopholipid antibody syndrome |
|
|
Term
|
Definition
increased susceptibility to infections
fever should be considered serious |
|
|
Term
|
Definition
no specific test BUT
the most specific test for sLE is the anti-smith |
|
|
Term
SLE
planning
overall goals |
|
Definition
have satisfactory pain relief
comply with therapeutic regimen to achieve max symptom management
demonstrate awareness of and avoid activities that cause, dz exacerbation
maintain optimal role function and a positive self-image |
|
|
Term
SLE
nursing implementation
psychosocial issues |
|
Definition
| physical effects can lead to isolation, self-esteem and body image disturbances |
|
|
Term
|
Definition
disease process
names of drugs, actions, side effects, dosage, administration
pain management strategies
energy conservation and pacing techniques
therapeutic exercise, use of heat therapy
avoidance of physical and emotional stress
avoidance of exposure to individuals with infection
use of unscreen protection and protective clothing
regular medical and lab follow-up
marital and pregnancy counseling as needed
community resources and health care agencies |
|
|
