Shared Flashcard Set

Details

Musculoskeletal System
Exam 2 Musculoskeletal System
50
Nursing
Not Applicable
12/09/2012

Additional Nursing Flashcards

 


 

Cards

Term
What happens to the vessesl with a dislocation (subluxation)
Definition
Bone may press on the vessels occluding circulation
Term
What are the s/s of a dislocation/subluxation
Definition
deformity of the dislocated area
Term
tx: of dislocation/subluxation
Definition
external manual manipulation (setting)
Term
nursing considerations of dislocation/subluxation
Definition
check CMST above and below affected area
Term
what is a pathalogical fracture
Definition
bones that break spontaneously
Term
what are we looking for in assessing dislocation
Definition

asymmetry

ROM

pain

Term
open (compound) fracture
Definition
through the skin
Term

what is a pt with a compound / open fracture

(through the skin) at risk for

Definition

at risk for infection

needs IV antibiotics

Term
Definition
when a pt has an open/compound fracture
Term
tx: of a fracture
Definition
immobilization
Term

nursing considerations for fracture

name 4

Definition
  1. if you suspect a fracture immobilize the affected part do not attempt to reduce
  2. monitor CMST
  3. monitor 7 p's
  4. after casting or surgery elevate limb to reduce pain and edema 
Term
7 P's
Definition
  1. Pain
  2. Pallor
  3. paresthesia
  4. paralysis
  5. polar temperature
  6. puffiness
  7. pulselessness 
Term
Plaster casts - what is done to protect the skin from the edges
Definition
petaling - brining the stockinette over the edge of the cast
Term
Plaster Cast: nursing considerations
Definition
  1. support cast with pillows to preserve original shape
  2. keep cast uncovered
  3. handle wet cast with palms only (finger pressure can dent a cast and create pressure points)
  4. Cover rought edges with tape (petaling
  5. monitor CMST and 7 P's
  6. Instruct client not to put anything inside of cast
  7. monitor for infection - odor and hot spot 
Term
external fixation
Definition

a device used to manage complex fractures that are associated either with soft tissue damage or open wounds in the fracture area - holds pins in place and maintains immobilization

Term
External fixation - nursing considerations
Definition
  1. monitor CMST and infection
  2. provide care of pin sites
  3. Sterile dressing changes
  4. gently pull skin away from pin sites
  5. monitor for rejection of metal alloy
Term
pin site care
Definition
use a sterile cotton-tipped applicator to apply sterile hydrogen peroxide, rinse with normal saline
Term
CMST
Definition

Color / Circulation

  • Pale - impaired circulation
  • Prolonged capillary refill - impaired circulation

Movement

  • Should be able to wiggle the toes

Sensation

  • Should not have numbness and tingling

Temperature

  • Cold - impaired circulation, hot - infection
Term

what do we need to monitor for with a fracture of the pelvis?

Definition

Hematuria

Risk for hemorrhage, very vascular

Term
what kind of cast is used with a pelvis fracture
Definition
spica or body cast
Term

Spica cast - nursing considerations

name 2

Definition
  1. pay special attention to elimination and the area near the buttocks for skin breakdown
  2. monitor for constipation 
Term
s/s for shock
Definition
  • ↓ b/p
  • ↑ pulse
  • pallor / pale
  • ↓ neuro status, ↓ LOC
  • cool, clammy
  • diaphoretic
  • restless

 

Term
skeletal traction
Definition
to a bone
Term
Russells's Traction (balanced)
Definition

a type of skin traction - knee is suspended in a sling creating upward pull from the knee with lower leg in horizontal traction in hip and knee fractures

[image]

Term
important nursing considerations with Russell's traction
Definition

monitor popliteal area for:

  • pressure
  • swelling
  • damage to nerves and blood vessels
Term
Buck's Traction (simple)
Definition

a type of skin traction -provides a straight pull on extended extremity in hip fractures

[image]

Term
Bryant's Traction
Definition

for small children with unstable hjip or femur fractures - legs suspended in air at a 90° angle from hips, knees slightly flexed, buttocks off bed

[image]

Term
Traction nursing considerations
Definition
  • assess, document and report neurovascular impairment
  • ensure correct weight of weights used
  • observed skin: elbow in Dunlop's and popliteal in Russell's traction
  • assess distal pulses for circulatory integrity
  • inspect for loss of sensation  
  • assess pin sites in skeletal traction and cleanse as ordered
Term
ORIF
Definition
open reduction and internal fixation - hip replacement surgery
Term
Definition

RA - rheumatoid arthritis

SLE - systemic Lupus Erythematosus

Term

what kind of machine is used to increase extension and flexion of the joint after knee surgery

Definition
CPM machine - provides passive flexion
Term
nursing considerations with knee surgery
Definition
  • ↑ leg for 24 hours to enhance venous return
  • turn every 2 hours
  • monitor for infection
  • CPM machine - passive flexion
  • pain management
  • progressive leg exercises to obtain 90° flexion and quadriceps for leg lifts
  • leg immobilizer when out of bed 
Term
which people would not be a candidate for surgery
Definition
  • Obese
  • Infection
Term
who is at the highest risk for a hip fracture
Definition
postmenopausal women - due to osteoporosis
Term

Hip surgery nursing considerations:

name 10

Definition
  1. keep affected leg abducted at all times to keep hip in socket (abductor pillow)
  2. use trochanter roll to prevent external rotation of limb
  3. monitor for bleeding under the client 
  4. prevent hip flexion by elevating HOB 20-30 degrees only for meals
  5. turn on non-operative side
Term
hip surgery - pt teaching
Definition
  • teach quadriceps exercise
  • use a raised toilet seat - prevent hip flexion
  • no bending, no crossing legs
  • do no sit in low chairs
  • flex and dorsiflex foot and use antiembolic hose to prevent DVT

 

Term
what is important to do for the lungs and to prevent pneumonia after hip surgery
Definition
turn, cough, deep breath, incentive spirometer
Term
s/s of fat embolism
Definition
dyspnea, tachypnea, abnormal lung sounds
Term
s/s of post op complication - neurovascular pressure
Definition
  • numbness
  • tingling
  • loss of sensation
  • inability to move extremities
  • pallor
  • cool skin
  • edema

 

Term

Complications of Fracture or bone surgery:

osteoyelitis - serious bone infection

s/s:

tx:

Definition

s/s:

  • pain
  • fever
  • flushed apperance
  • ↑ WBC
  • ↑ ESR
  • positive wound cultures

tx:

  • IV ANTIBIOTICS
Term
where does a fat embolisim most commonly cause an obstruction?
Definition
in the lungs
Term
why Buck's extension traction is being applied before surgery
Definition
provides comfort by reducing muscle spasms and provides fracture immobilization
Term
A client with diabetes mellitus has had a R BKA (right below knee amputation). The nurse should monitor for what?
Definition
separtion of wound edges. Client's with diabetes mellitus are more prone to wound infection and delayed healing because of the disease
Term
what is the typical area for intervertebral disk disease
Definition
cervical or lumbar areas
Term

s/s of intervertebral disk disease

also known as heriniated disk, slipped disk or sciatica

Definition
  • back, shoulder, neck or leg pain
  • numbness
  • pain most often occuring on the side and radiation over buttock and down leg (sciatica)
  • numbness and tingling that is worse when coughing, sneezing, bending, or lifting
  • muscle spasam
Term

tx for intervertebral disk disease

(sciatica, slipped disk, herniated disk)

Definition
TENS therapy
Term
laminectomy
Definition
removal of the bone between the spinal process to remove tissue and releive compression
Term
spinal fusion
Definition
attachment of a steel rod or grafting piece of bone from the tibia or iliac crest to the weakened vertebra to fuse the bones together for stability
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