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Fundamentals of Nursing > Musculoskeletal System > Flashcards

Flashcards in Musculoskeletal System Deck (67)
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1
Q

Functions of musculo-skeletal system

A

Protection of vital organs (heart, brain, lungs)
Provides framework to support body structure
Makes mobility possible
Production of blood cells (hematopoiesis)
Reservoir for immature blood cells/vital minerals
Facilitate return of blood to the heart

2
Q

What is atrophy?

A

Shrinkage like decrease in the size of the muscle

3
Q

RICE

A

Rest
Ice
Compress
Elevate

4
Q

Ligaments

A

bone to bone

5
Q

Tendons

A

muscle to bone

6
Q

Assessment of the MS system includes

A

ADL’s, ability to perform, any problems related to mobility

7
Q

Physical assessment of the musculoskeletal system includes

A
Posture
Gait
Bone integrity
Joint function
Muscle size and strength
8
Q

CT scans determine

A

used to visualize tumors, soft tissue, severe trauma to the chest, and or pelvis

9
Q

MRI’s help assess

A

bone and soft tissues, muscle ligaments and cartilage, herniated disks

10
Q

What is a cast?

A

Immobilizing device used to specifically immobilize a reduced fracture, correct/prevent deformities, support or stabilize weak joints

11
Q

What should you teach the pt when a cast is being placed?

A

Explain condition needing of cast. Keep dry, do not cover with plastic. With fiberglass explain that heat is given off while cast is applied.

12
Q

Splints

A

More commonly used in outpt settings. Often used for simple/stable fractures, sprains, tendon injuries

13
Q

Splints do not compromise

A

Circulation

14
Q

Braces are used to

A

Provide support, control movement, and prevent additional injury

15
Q

Assessments for casts, splints, and braces are performed

A

every hour the first 24 hours and then every 1-4 hours thereafter

16
Q

When assessing for peripheral circulation of a pt with a cast, splint or brace you check

A

Peripheral pulses
Capillary refill
Edema
Color and temp of skin

17
Q

What are indications of neurovascular compromise (5-P’s)

A
Pain
Pallor
Pulselessness
Paresthesia 
Paralysis
18
Q

What is compartment syndrome?

A

Occurs when increased pressure within a confined space compromises blood flow

19
Q

External fixation devices

A

Used for complicated fractures of humerus, forearm, femur,tibia, and pelvis.

20
Q

For external fixation device, monitor neurovascular status

A

every 2-4hrs, assess each pin site at least every 8-12hrs

21
Q

What is traction?

A

A pulling force to promote and maintain alignment of injured body part. Goal is to reduce muscle spasms and pain.

22
Q

Bucks extension traction is used for

A

to immobilize fractures of the proximal femur and hip before surgical fixation (skin traction)

23
Q

Nursing management for Bucks traction

A

Auscultate lungs every 4-8hrs
Reduced GI motility results in contstipation, needs a diet high in fiber and fluids. Monitor fluid I&O. Educate pt on how to perform foot and ankle exercises ever 1-2 hrs to prevent DVT

24
Q

Low back pain patho

A

Disk degeneration is a common cause
Obesity
Postural problems
Overstretching of spinal support

25
Q

Medication for low back pain

A
Tylenol (acetaminophen)
NSAIDS
Flexeril (muscle relaxant)
Cymbalta 
Neurontin (radiculapathy pain)
26
Q

Non pharmacologic interventions for low back pain

A
Hot/cold therapy
Spinal manipulation
Physical therapy
Massage
Acupuncture
Exercise and yoga
27
Q

Pt with low back pain should avoid

A
Twisting
Lifting
Bending
Reaching 
Sitting for more than 20-50min
28
Q

Treatment for tendonitis

A

Hot/cold therapy
NSAIDS
Corticosteroid injections (most effective)

29
Q

Carpal tunnel syndrome is caused by

A

Repetitive hand-wrist movements

30
Q

Treatment for carpal tunnel includes

A

Open nerve release
Endoscopic laser surgery
Corticoisteroid injections
Wrist splints

31
Q

Osteoporosis patho

A

Calcitonin and estrogen decrease. Bones become brittle and pourous. Bone resorption is greater than bone formation

32
Q

Risk factors for osteoporosis

A

Small framed Asian/Caucasian women.
Obesity, imobility
Patients that underwent bariatric surgery

33
Q

Why is a patient with a hx of bariatric surgery at risk for osteoporosis?

A

The duodenum is bypassed. The duodenum is the site of calcium absorption

34
Q

Medical management of osteoporosis

A

Calcium and vitamin D rich diet
20-30 min of aerobic exercise
Calcium and vitamin D supplements
Biophosphates

35
Q

What is osteomalcia?

A

Metabolic bone disease characterized by inadequate mineralization of bone. Softening of the bones

36
Q

Patho of osteomalacia

A

Deficiency of activated vitamin D, may result from failed Ca+ absorption or excessive Ca+ loss.
Severe renal insufficiency results in acidosis,
prolonged use of antiseizure meds
malnutrition
GI disorders where fats are inadequately absorbed

37
Q

What is osteomyelitis

A

Infection of the bone

38
Q

What pt’s are at risk for osteomyelitis

A
Older adults
Poorly nourished
Obese
Pt's w/ diabetes
Rheumatoid arthritis 
IV drug users
39
Q

Patho of osteomyelitis

A

MRSA
Gram + organisms
Soft tissue infection

40
Q

S/S of osteomyelitis

A

Fever/chills
Rapid pulse, mailase
Infected area becomes painful, swollen, and extremely tender
Bone necrosis

41
Q

Medical management of osteomyelitis

A
Hydration
Diet high in vitamins/proteins
Correction of anemia
Antibiotics
Surgical debridement (if infection is chronic and does not respond to antibiotics)
42
Q

Contusion

A

Soft tissue injury produced by blunt force (kicking, falling etc) causing small blood vessels to rupture and bleed into soft tissues

43
Q

Sx of contusion

A

Pain, swelling, and discoloration

44
Q

How to treat a contusion

A

Applying cold packs, and elevation of extremity

45
Q

Strain

A

Injury to a muscle or tendon from overuse, overstretching or excessive stretch

46
Q

Sprain

A

Injury to the ligaments and tendons that surround a joint

47
Q

What causes a sprain

A

Twisting motion or hyperextension of a joint

48
Q

RICE
R stands for
What is the reason for it?

A

Rest, prevents additional injury

49
Q

RICE
I stands for?
What is the reason for it?

A

Ice, applying cold packs during the first 72 hrs produces vasoconstriction (decreases bleeding/edema)

50
Q

RICE
C stands for?
What is the reason for it?

A

Compress, elastic compression bandage controls bleeding and reduces edema

51
Q

RICE
E stands for?
What is the reason for it?

A

Elevate. Elevation at or above heart level controls the swelling

52
Q

Types of fractures

A
Complete
Incomplete (greenstick)
Comminuted
Closed (simple)
Open
53
Q

What is a complete fracture?

A

Break across entire cross section of bone, frequently displaced

54
Q

What is a incomplete fracture?

A

Break thru only part of the cross section of bone. Commonly occurs in children

55
Q

What is a comminuted fracture?

A

Produces several bone fragments

56
Q

What is a closed fracture?

A

A fracture where there is no break in the skin

57
Q

What is a open fracture?

A

Compound or complex.

Skin or mucous membrane wound extend to the bone

58
Q

What is a grade 1 open fracture?

A

Clean wound, less than 1cm long

59
Q

What is a grade 2 open fracture?

A

Larger wound w/o soft tissue damage

60
Q

What is a grade 3 open fracture?

A

Highly contaminated, extensive soft tissue damage

61
Q

Manifestations of fractures

A
Pain
Loss of function
Deformity
Shortening
Crepitus
62
Q

What is crepitus?

A

A crumbling sensation that may be felt or heard

63
Q

Emergency management of a fracture

A

Immediately immobilize before pt is moved. Adequate splinting is essential

64
Q

Patients with open fractures are at risk for

A

Osteomyelitis
Tetanus
Gas gangrene

65
Q

Complications of fractures

A

Shock

Fat embolism

66
Q

On assessment, a patient with osteomalacia may have

A

Kyphosis and bowed legs

67
Q

Treatment for osteomalacia is mainly

A

Dietary. Supplementation

increase vitamin D, treat underlying cause.