Skeletal Trauma
Parkinson's
Amputation
Seizures
Urolithiasis & Low Back Pain
100

Definition of traction

Using tension (or force) to move a body part from a problematic position into an optimal and functional position.


100

Parkinson's Disease affects the _____________ of the midbrain, which leads to the depletion of the neurotransmitter ________________.    

substantia nigra, dopamine

100
What is a neuroma?

Sensitive tumor consisting of damaged nerve cells, forms most often in amputations of the upper extremity but can occur anywhere

100

Types of Seizures

Generalized, Partial and Unclassified

100

Diagnostics for lower back pain

Flat plate x-ray, CT or MRI with or without contrast, myleogram, EMG, SSEP, MEP

200

Complications of traction

  • Immobility
  • GI
  • GU
  • Respiratory
  • Neurovascular
  • Psychosocial
200

4 Cardinal Signs of Parkinson's

Tremors

Muscle rigidity

Akinesia

Postural instability

200

What is ankle-brachial index?

Measures ankle-brachial index (ABI) and calculated by dividing ankle systolic pressure by brachial systolic pressure. Normal ABI is 0.9 or higher.
200

Risk Factors for seizures

Brain tumor/lesion/trauma, metabolic disorder, acute alcohol withdrawal, electrolyte disturbances, high fever, stroke, head injury, substance abuse, heart disease

200

The most common condition associated with stone formation is ____________.

 dehydration.

300

Buck's traction is used for________________________.

  • Trial treatment of nerve root disorders
  • Sciatica
  • Muscle Spasms
  • Minor fractions of lower spine
  • Temporary stabilization of fractured hip or fractures of the femoral shaft
  • Arthritis and knee injuries
300

Surgical Interventions for Parkinson's

Stereotactic pallidotomy

Deep brain stimulation

Fetal tissue transplant

300

Proper technique to bandaging residual limb

Figure 8 wrapping method to prevent restriction of blood flow. Decrease tightness while wrapping distal-to-proximal. Reapply every 4-6 hours or as needed.

300

What kind of seizure is most resistant to drug therapy?

Atonic

300

Risk Factors for Lower Back Pain

  • Trauma to the spine
  • Heavy lifting
  • Obesity
  • Congenital spinal conditions and scoliosis
  • DJD
  • Arthritis
  • Poor posture
  • High Heeled shoes
400

The nurse cares for a patient with skeletal pins that have been placed for traction. What does the nurse expect in the first 48 hours? 

a) clear fluid drainage weeping from the pin insertion site

b) some bloody drainage at the site but very minimal

c) swelling at the site with tenderness to gentle touch

d) dressings around the pin sites to be dry and intact

a) clear fluid drainage weeping from the pin insertion site


400

Medication therapy for Parkinson's

amantdine HCL (Symmetrel)

Levodopa/Sinemet

entacapone (Comtan)

carbidopa/levodopa/entacapone (Stalevo) **Do not take with a high-protein meal

selegiline HCL (Eldepryl)



400

How to treat Phantom Limb Pain

Recognize pain is real, manage promptly and completely. Handle residual limb carefully. 

Medications: IV infusions of calcitonin

Depending on type of pain: 

propanolol

anti-epileptics

antispasmodics

antidepressants

400

What are seizure precautions?

Pad side rails, keep bed in lowest position with side rails up. Ensure that oxygen and suctioning quipment with an airway are readily available, If there is no IV assess, insert a saline lock.

400

Metabolic defects that commonly cause kidney stones

Hypercalcemia

Hyperoxaluria

Hyperuricemia

Struvite

Cystinuria

500

Special Considerations for Halo Traction

  • Assess respirations every four hours
  • Nurses should know how to remove vest if CPR must be performed (wrenches in room)
  • Have torque screwdriver available for physician
  • Daily pin care on patient
  • Assess pin areas for infection
500

Nursing Interventions

Include: Prevent Aspiration, Falls, Optimize Functional Ability, Encourage Coping

see Chart 42-5 on pg. 871 Iggy

500

When instructing a client about the use of crutches, which part of the upper body should the weight be primarily supported? 

a) axillae

b) elbows

c) upper arms

d) hands

d) hands, to prevent nerve damage from excessive pressure on axillae, elbows or upper arms
500

Describe kinds of generalized seizures.

Tonic-clonic (grand mal)-last 2-5 minutes, starts with tonic phase causing stiffness/rigidity of muscles (arms/legs) and immediate loss of consciousness. The clonic phase follows with rhythmic jerking of all extremities. (patient may bite tongue or become incontinent). Fatigue, acute confusion, and lethargy may last up to an hour after seizure.

Absence- Consists of brief periods of loss of consciousness and blank staring as though the person is daydreaming. The patients’ eye lids may flutter and involuntary behaviors (lip smacking) may occur. (immediate return to baseline)

Myoclonic- Causes a brief jerking/stiffening of the extremities that may occur singly or in groups. (Lasting just a few seconds)

Atonic- the patient has a sudden loss of muscle tone, lasting for seconds, followed by postictal confusion. (most often patient will fall and may result in injury)

500

The urine output of a patient with a kidney stone has decreased from 40 ml/hr to 5 ml/hr. What is the priority action? 

a) Check patency of IV access and notify health provider

b) Perform the Crede maneuver on patient's bladder

c) Test the urine for ketone bodies

d) Document the finding and continue monitoring.

a) Check patency of IV access and notify health provider

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