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MS2 Exam 4 Musculoskeletal with precise detailed answers
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What |! are |! some |! of |! the |! changes |! that |! occur |! in |! the |! musculoskeletal |! system |! related |! to |! aging? |! - |! Correct |! answer |! ✔-Decreased |! bone |! density -Increased |! bone |! prominence -Kyphosis -Widened |! gait -Shift |! in |! center |! of |! gravity -Cartilage |! degeneration -Decreased |! ROM -Muscle |! atrophy -Decreased |! strength -Slowed |! movement What |! does |! a |! complete |! neurovascular |! assessment |! include? |! - |! Correct |! answer |! ✔Palpation |! of |! pulses |! in |! the |! extremities |! below |! the |! level |! of |! injury |! and |! assessment |! of |! sensation, |! movement, |! color, |! temperature, |! and |! pain |! in |! the |! injured |! part. |! If |! pulses |! are |! not |! palpable, |! use |! a |! Doppler |! to |! find |! pulses |! in |! the |! extremities.
What |! is |! arthroscopy? |! - |! Correct |! answer |! ✔A |! fiberoptic |! tube |! inserted |! into |! a |! joint |! for |! direct |! visualization |! of |! the |! ligaments, |! menisci |! and |! articular |! surface |! of |! the |! joint What |! is |! the |! priority |! for |! postprocedure |! care |! after |! an |! arthroscopy? |! - |! Correct |! answer |! ✔To |! assess |! the |! neurovascular |! status |! of |! the |! patient's |! affected |! limb |! every |! hour. |! Monitor |! and |! document |! distal |! pulses, |! warmth, |! color, |! capillary |! refill, |! pain, |! movement, |! and |! sensation |! of |! the |! affected |! extremity. What |! is |! osteoporosis? |! - |! Correct |! answer |! ✔A |! chronic |! disease |! of |! cellular |! regulation |! in |! which |! bone |! loss' |! causes |! significant |! decreased |! density |! and |! possible |! fracture Why |! is |! osteoporosis |! often |! referred |! to |! as |! a |! silent |! disease? |! - |! Correct |! answer |! ✔Because |! the |! first |! sign |! of |! osteoporosis |! in |! most |! people |! follows |! some |! kind |! of |! a |! fracture. "bone |! attack" What |! is |! a |! fragility |! fracture? |! - |! Correct |! answer |! ✔A |! fracture |! caused |! by |! osteoporosis what |! fracture |! is |! most |! important |! to |! watch |! for? |! - |! Correct |! answer |! ✔hip |! fracture |! - |! mortality |! rate |! is |! high
How |! does |! inadequate |! vitamin |! D |! levels |! affect |! the |! musculoskeletal |! system? |! - |! Correct |! answer |! ✔Activated |! vitamin |! D |! is |! needed |! for |! calcium |! uptake |! in |! the |! body. What |! pt |! teaching |! should |! be |! provided |! regarding |! osteoporosis |! prevention? |! - |! Correct |! answer |! ✔Teach |! patients |! who |! do |! not |! include |! enough |! dietary |! calcium |! which |! foods |! to |! eat, |! such |! as |! dairy |! products |! and |! dark |! green |! leafy |! vegetables. |! Teach |! them |! to |! read |! food |! labels |! for |! sources |! of |! calcium |! content. |! Explain |! the |! importance |! of |! sun |! exposure |! and |! adequate |! vitamin |! D |! in |! the |! diet. |! Teach |! people |! at |! high |! risk |! for |! bone |! loss |! the |! importance |! of |! smoking |! cessation, |! weight |! loss, |! and |! avoidance |! of |! excessive |! alcohol |! use. |! Teach |! them |! the |! need |! to, |! limit |! the |! number |! of |! carbonated |! beverages |! consumed |! each |! day. |! Remind |! patients |! who |! have |! sedentary |! lifestyles |! about |! the |! importance |! of |! exercise |! and |! which |! types |! of |! exercise |! build |! bone |! tissue. |! Weight-bearing |! exercises, |! such |! as |! regularly |! scheduled |! walking, |! are |! preferred. |! Teach |! people |! at |! high |! risk |! to |! avoid |! activities |! that |! cause |! jarring What |! is |! the |! most |! promising |! imaging |! test |! for |! diagnosing |! bone |! disease? |! - |! Correct |! answer |! ✔The |! use |! of |! magnetic |! resonance |! imaging |! (MRI) |! to |! assess |! bone |! marrow |! composition What |! are |! the |! nutritional |! changes |! used |! as |! part |! of |! the |! management |! of |! osteoporosis? |! - |! Correct |! answer |! ✔Teach |! patients |! about |! the |! need |! for |! adequate |! amounts |! of |! calcium |! and |! vitamin |! D |! for |! bone |! remodeling. Describe |! the |! nutrition |! plan |! for |! a |! pt |! with |! osteoporosis |! - |! Correct |! answer |! ✔The |! plan |! should |! emphasize |! fruits |! and |! vegetables, |! low-fat |! dairy |! and |! protein |! sources, |! increased |! fiber, |! and |! moderation |! in |! alcohol |! and |! caffeine
Is |! calcium |! ever |! used |! as |! a |! lone |! treatment |! for |! osteoporosis? |! - |! Correct |! answer |! ✔Intake |! of |! calcium |! alone |! is |! not |! a |! treatment |! for |! osteoporosis What |! is |! the |! drug |! of |! choice |! for |! osteoporosis? |! - |! Correct |! answer |! ✔Alendronate |! (Fosamax) What |! pt |! teaching |! do |! we |! need |! to |! include |! when |! giving |! a |! pt |! alendronate |! for |! osteoporosis? |! - |! Correct |! answer |! ✔Make |! sure |! you |! teach |! them |! to |! take |! it |! on |! an |! empty |! stomach |! with |! a |! full |! glass |! of |! water |! They |! should |! also |! wait |! 30 |! minutes |! before |! eating, |! drinking |! or |! taking |! anything |! else |! and |! they |! should |! also |! remain |! upright/sitting |! for |! at |! least |! 30 |! minutes |! after |! taking |! it what |! ate |! healthcare |! resources |! for |! osteoporosis? |! - |! Correct |! answer |! ✔national |! osteoporosis |! foundation, |! osteoporosis |! society |! of |! Canada, |! and |! larger |! facilities |! that |! have |! outpatient |! clinics |! (to |! go |! over |! education |! & |! support |! them) What |! is |! osteomyelitis? |! - |! Correct |! answer |! ✔Infection |! in |! bony |! tissue What |! are |! the |! general |! signs |! and |! symptoms |! of |! osteomyelitis? |! - |! Correct |! answer |! ✔Bone |! pain, |! with |! or |! without |! other |! signs |! and |! symptoms, |! is |! a |! common |! concern |! of |! patients |! with |! osteomyelitis. |! The |! pain |! is |! often |! described |! as |! a |! constant, |! localized, |! pulsating |! sensation |! that |! worsens |! with |! movement. What |! are |! our |! nursing |! interventions |! for |! a |! pt |! who |! has |! just |! had |! surgery |! for |! osteomyelitis? |! - |! Correct |! answer |! ✔Neurovascular |! assessments |! must |! be |! done |! frequently |! because |! the |! patient |! experiences |! increased |! swelling |! after |! the |!
How |! are |! primary |! malignant |! bone |! tumors |! are |! usually |! surgically |! treated? |! - |! Correct |! answer |! ✔They |! are |! usually |! reduced |! or |! removed |! with |! surgery, |! and |! surgery |! may |! be |! combined |! with |! radiation |! or |! chemotherapy. Large |! bone |! defects |! that |! result |! from |! tumor |! removal |! may |! require |! what? |! - |! Correct |! answer |! ✔• |! Total |! joint |! replacements
normal |! value |! for |! PTT? |! - |! Correct |! answer |! ✔20-30 |! seconds normal |! value |! for |! INR? |! - |! Correct |! answer |! ✔0.8-1. What |! is |! gout? |! - |! Correct |! answer |! ✔Gout |! is |! a |! systemic |! disease |! in |! which |! urate |! crystals |! (the |! result |! of |! errors |! in |! purine |! metabolism) |! deposit |! in |! joints, |! causing |! severe |! joint |! inflammation. How |! is |! gout |! controlled? |! - |! Correct |! answer |! ✔This |! type |! of |! arthritis |! is |! well |! controlled |! with |! drug |! therapy. What |! drug |! is |! used |! for |! the |! management |! of |! gouty |! arthritis? |! - |! Correct |! answer |! ✔Allopurinol, |! it |! blocks |! uric |! acid |! production |! in |! the |! body What |! is |! osteoarthritis? |! - |! Correct |! answer |! ✔Osteoarthritis |! is |! the |! most |! common |! arthritis, |! it |! is |! the |! progressive |! deterioration |! and |! loss |! of |! articular |! (joint) |! cartilage |! and |! bone |! in |! one |! or |! more |! joints What |! is |! primary |! osteoarthritis? |! - |! Correct |! answer |! ✔When |! the |! disease |! is |! caused |! by |! aging |! and |! genetic |! factors What |! is |! secondary |! osteoarthritis? |! - |! Correct |! answer |! ✔Secondary |! OA |! occurs |! less |! often |! than |! primary |! disease |! and |! can, |! result |! from |! joint |! injury |! and |! obesity. |! Injury |! to |! the |! joints |! from |! excessive |! use, |! trauma, |! or |! other |! joint |! disease |! (e.g, |! rheumatoid |! arthritis) |! predisposes |! a |! person |! to |! OA.
Can |! drugs |! be |! used |! to |! cure |! osteoarthritis? |! - |! Correct |! answer |! ✔No |! drug |! therapy |! can |! influence |! the |! course |! of |! OA. |! The |! purpose |! of |! drug |! therapy |! is |! to |! reduce |! pain |! and |! inflammation |! caused |! by |! cartilage |! destruction, |! muscle |! spasm, |! and/or |! synovitis. What |! should |! we |! do |! before |! and |! after |! implementing |! interventions |! for |! pts |! with |! osteoarthritis |! pain? |! - |! Correct |! answer |! ✔Perform |! a |! pain |! assessment |! before |! and |! after |! implementing |! interventions What |! is |! the |! first |! choice |! drug |! for |! pain |! R/T |! osteoarthritis? |! - |! Correct |! answer |! ✔Regular |! acetaminophen |! is |! the |! primary |! drug |! of |! choice What |! can |! be |! added |! to |! the |! regimen |! for |! a |! pt |! taking |! acetaminophen |! for |! osteoarthritis |! if |! the |! acetaminophen |! alone |! is |! not |! treating |! the |! pain? |! - |! Correct |! answer |! ✔Topical |! drugs |! may |! help |! with |! temporary |! relief |! of |! mild |! pain, |! prescription |! lidocaine |! 5% |! patches |! are |! commonly |! used What |! joint |! positioning |! can |! we |! teach |! pts |! to |! aid |! in |! their |! discomfort |! R/T |! osteoarthritis? |! - |! Correct |! answer |! ✔Teach |! the |! patient |! to |! position |! joints |! in |! their |! functional |! position. |! For |! example, |! when |! in |! a |! supine |! position, |! he |! or |! she |! should |! use |! a |! small |! pillow |! under |! the |! head |! or |! neck |! but |! avoid |! the |! use |! of |! other |! pillows. |! The |! use |! of |! large |! pillows |! under |! the |! knees |! or |! head |! may |! result |! in |! flexion |! contractures. What |! is |! the |! surgical |! treatment |! option |! for |! osteoarthritis? |! - |! Correct |! answer |! ✔Total |! joint |! arthroplasty |! (surgical |! creation |! of |! a |! functional |! synovial |! joint |! using |! implants)
What |! is |! included |! in |! the |! preoperative |! care |! plan |! for |! a |! total |! joint |! arthroplasty? |! - |! Correct |! answer |! ✔-Stress |! the |! need |! for |! preoperative |! assessment |! of |! nutritional |! status -Assess |! for |! use |! of |! opioids |! for |! persistent |! pain |! before surgery. -Teach |! the |! patient |! about |! multimodal |! pain |! management |! options. -Teach |! the |! need |! for |! anticoagulant |! drug |! therapy, |! which |! should |! start |! within |! 24 |! hours |! after |! surgery |! and |! continue |! for |! at |! least |! 14 |! days |! after |! surgery. -Teach |! the |! need |! for |! frequent |! mobilization |! after |! surgery -Teach |! the |! need |! for |! compression |! stockings |! and/or |! sequential |! compression |! devices |! during |! the |! hospital |! stay. -Teach |! the |! patient |! that |! he |! or |! she |! will |! receive |! an |! IV |! antibiotic |! before |! surgery |! and |! possibly |! up |! to |! 24 |! hours |! after |! surgery. -Teach |! the |! importance |! of |! screening |! for |! nares |! for |! MRSA -Teach |! the |! need |! to |! use |! nasal |! mupirocin |! ointment |! twice |! a |! day |! for |! 1 |! week |! before |! surgery. -Teach |! the |! need |! to |! bathe |! with |! chlorhexidine |! gluconate |! solution |! (CHG) |! for |! at |! least |! the |! night |! before |! and |! the |! morning |! of |! surgery -Teach |! the |! patient |! to |! sleep |! on |! clean |! linens |! and |! not |! use |! lotions |! or |! powders |! after |! the |! CHG |! baths; |! remind |! the |! patient |! to |! avoid |! sleeping |! with |! pets |! in |! the |! bed. What |! are |! our |! roles |! as |! the |! nursing |! the |! post-operative |! care |! of |! a |! pt |! who |! as |! undergone |! a |! total |! joint |! arthroplasty? |! - |! Correct |! answer |! ✔-Monitor |! vitals -Monitor |! for |! Sx |! of |! infection -Teach |! pts |! to |! maintain |! correct |! positioning, |! pillows |! may |! be |! needed
What |! are |! some |! complementary |! and |! integrative |! health |! management |! options |! for |! RA? |! - |! Correct |! answer |! ✔-Teach |! them |! to |! get |! adequate |! rest -Teaching |! Proper |! positioning -Ice |! and |! Heat -Management |! of |! fatigue -Offering |! them |! support |! resources what |! do |! we |! monitor |! in |! pts |! with |! RA? |! - |! Correct |! answer |! ✔ABC's what |! is |! a |! common |! complication |! after |! a |! total |! hip |! arthroplasty? |! - |! Correct |! answer |! ✔hip |! dislocation how |! do |! we |! prevent |! this? |! - |! Correct |! answer |! ✔take |! care |! of |! the |! site |! and |! use |! abduction |! pillows what |! are |! our |! nursing |! interventions |! for |! the |! musculoskeletal |! system? |! - |! Correct |! answer |! ✔-prevent |! falls -encourage |! exercise -prevent |! pressure |! sores -encourage |! pt |! to |! use |! proper |! body |! mechanics -assess |! pt |! for |! need |! for |! a |! device |! -good |! shoes -heat |! may |! relieve |! changes
What |! is |! acute |! compartment |! syndrome? |! - |! Correct |! answer |! ✔A |! serious, |! limb- threatening |! condition |! in |! which |! increased |! pressure |! within |! one |! or |! more |! compartments |! (that |! contain |! muscle, |! blood |! vessels, |! and |! nerves) |! reduces |! circulation |! to |! the |! lower |! leg |! or |! forearm. What |! are |! the |! symptoms |! of |! acute |! compartment |! syndrome? |! - |! Correct |! answer |! ✔Edema |! increases |! pressure |! on |! nerve |! endings |! and |! causes |! severe |! pain. |! Sensory |! perception |! deficits |! or |! paresthesia |! generally |! appear |! before |! changes |! in |! vascular |! or |! motor |! signs. |! The |! color |! of |! the |! tissue |! pales, |! and |! pulses |! begin |! to |! weaken |! but |! rarely |! disappear. |! The |! affected |! area |! is |! usually |! palpably |! tense, |! and |! acute |! severe |! pain |! occurs |! with |! the |! passive |! motion |! of |! the |! extremity. How |! can |! acute |! compartment |! syndrome |! be |! avoided? |! - |! Correct |! answer |! ✔Monitor |! people |! with |! fractures |! closely |! and |! monitor |! their |! skin |! well. |! Conduct |! neurovascular |! assessments |! frequently |! and |! notify |! the |! physician |! of |! changes |! immediately Is |! acute |! compartment |! syndrome |! limited |! to |! people |! with |! musculoskeletal |! problems? |! - |! Correct |! answer |! ✔No, |! it |! can |! also |! occur |! in |! those |! with |! severe |! burns, |! extensive |! insect |! bites, |! snake |! bites |! or |! massive |! infiltration |! of |! IV |! fluids how |! do |! we |! treat |! a |! pt |! who |! has |! compartment |! syndrome |! from |! a |! burn? |! - |! Correct |! answer |! ✔make |! a |! cut |! to |! release |! the |! pressure signs |! that |! a |! pt |! has |! compartment |! syndrome |! from |! a |! snake |! bite? |! - |! Correct |! answer |! ✔pressure, |! swelling/edema |! and |! necrosis |! from |! the |! site
How |! is |! acute |! compartment |! syndrome |! treated? |! - |! Correct |! answer |! ✔Patients |! with |! ACS |! may |! need |! a |! surgical |! procedure |! known |! as |! a |! fasciotomy. |! In |! extreme |! cases, |! amputation |! becomes |! necessary. What |! is |! a |! fasciotomy? |! - |! Correct |! answer |! ✔In |! this |! procedure, |! the |! surgeon |! cuts |! through |! the |! fascia |! to |! relieve |! pressure |! and |! tension |! on |! vital |! blood |! vessels |! and |! nerves. |! The |! surgeon |! usually |! closes |! the |! wound |! with |! a |! skin |! graft |! in |! several |! days What |! is |! fat |! embolism |! syndrome |! (FES)? |! - |! Correct |! answer |! ✔Fat |! globules |! are |! released |! from |! the |! yellow |! bone |! marrow |! into |! the |! bloodstream |! within |! 12 |! to |! 48 |! hours |! after |! an |! injury. |! These |! globules |! clog |! small |! blood |! vessels |! that |! supply |! vital |! organs, |! most |! commonly |! the |! lungs, |! and |! impair |! organ |! perfusion. what |! causes |! fat |! embolism |! syndrome? |! - |! Correct |! answer |! ✔fractured |! hip |! or |! total |! hip |! replacement What |! are |! the |! first |! signs |! of |! fat |! embolism |! syndrome? |! - |! Correct |! answer |! ✔A |! low |! arterial |! oxygen |! level |! (hypoxemia), |! dyspnea, |! and |! tachypnea. |! Headache, |! lethargy, |! agitation, |! confusion, |! decreased |! level |! of |! consciousness. What |! is |! a |! late |! sign |! of |! fat |! embolism |! syndrome? |! - |! Correct |! answer |! ✔Nonpalpable, |! red-brown |! petechiae |! may |! appear |! over |! the |! neck, |! upper |! arms, |! and/or |! chest. |! This |! rash |! is |! a |! classic |! manifestation |! but |! is |! usually |! the |! last |! sign |! to |! develop
Describe |! the |! ongoing |! care |! to |! help |! us |! avoid |! a |! pt |! falling |! into |! neuromuscular |! compromise |! - |! Correct |! answer |! ✔Assess |! and |! document |! the |! pts |! neurovascular |! status |! every |! hour |! for |! the |! first |! 24 |! hours |! and |! then |! every |! 1-4 |! hours |! thereafter What |! should |! we |! be |! monitoring |! during |! the |! neuromuscular |! assessment? |! - |! Correct |! answer |! ✔The |! 6 |! Ps: Pain Pressure Paresthesia Pallor Pulselessness Paralysis what |! are |! complications |! of |! immobility? |! - |! Correct |! answer |! ✔contractors |! and |! muscle |! atrophy Describe |! the |! ongoing |! care |! to |! help |! us |! prevent |! impaired |! mobility |! in |! a |! pt |! - |! Correct |! answer |! ✔-Ambulate |! asap* -Turn |! and |! move |! them -Monitor |! for |! pneumonia |! R/T |! immobility -Prevent |! contractures: |! Do |! ROM, |! If |! it's |! a |! leg |! or |! foot |! we |! can |! have |! them |! wear |! a |! shoe |! to |! prevent |! foot |! drop |! or |! an |! orthopedic |! boot -Remove |! jewelry |! on |! affected |! limb -pt |! NEEDs |! physical |! therapy*
what |! should |! older |! clients |! never |! be |! treated |! with? |! - |! Correct |! answer |! ✔meperidine |! has |! toxic |! metabolites |! & |! can |! cause |! seizures What |! is |! a |! cast? |! - |! Correct |! answer |! ✔A |! ridged |! device |! that |! mobilizes |! the |! affected |! body |! part |! while |! allowing |! other |! body |! parts |! to |! move. |! It |! also |! allows |! for |! early |! mobility |! and |! reduces |! pain. What |! are |! our |! nursing |! considerations |! R/T |! casts? |! - |! Correct |! answer |! ✔Check |! to |! ensure |! that |! any |! type |! of |! cast |! is |! not |! too |! tight |! and |! frequently |! monitor |! and |! document |! neurovascular |! status--usually |! every |! hour |! for |! the |! first |! 24 |! hours |! after |! application |! if |! the |! patient |! is |! hospitalized. |! You |! should |! be |! able |! to |! insert |! a |! finger |! between |! the |! cast |! and |! the |! skin. |! Monitor |! for |! and |! report |! any |! drainage. |! We |! also |! want |! to |! assess |! for |! any |! drainage |! (report |! this) What |! education |! do |! we |! need |! to |! provide |! to |! pts |! about |! casts? |! - |! Correct |! answer |! ✔-Don't |! stick |! anything |! into |! the |! cast -If |! their |! fingers |! or |! toes |! get |! puffy |! they |! can |! elevate |! for |! 15 |! minutes |! and |! if |! it |! doesn't |! resolve, |! call |! the |! doctor what |! is |! our |! neurovascular |! assessment |! for |! a |! patient |! with |! a |! cast? |! - |! Correct |! answer |! ✔-color, |! sensation, |! movement, |! cap |! refill, |! and |! pulse -always |! compare |! extremities -always |! check |! unaffected |! side |! (pt |! may |! have |! cool |! extremities |! or |! weak |! pulses |! if |! on |! beta |! blocker)