Diagnostics
A patient is scheduled for an X-ray. What should your education include?
Remove jewelry/metal objects, assess for pregnancy, radiation exposure
What is the most serious form of arthritis and why?
Rheumatoid - because it leads to severe disability and can be systemic.
Postoperatively, what intervention is appropriate (nonpharmacological) for a knee?
Ice
List three risk factors for a hip replacement?
Obesity, male gender, osteoporosis, trauma, sedentary lifestyle, arthritis
What infection signs should be educated to a client postoperatively of arthroplasty?
Fever, redness, warmth, swelling, purulent drainage
A pregnant patient comes in for diagnostic exams. Which diagnostics relating to the musculoskeletal system are contraindicated for this patient?
Xray, CT, Dexa, bone scans, Gallium/thallium scan
Call the doctor if there is a question.
A patient presents with a crunching noise in a lower extremity during ambulation. What condition does the nurse suspect this is?
Crepitus
Postop following a knee replacement, what is the proper education regarding pillow placement?
Do not place a pillow under the knee, however, you may place it under the lower calf and foot to extend the knee. You also do not have to use a pillow.
List three appropriate nursing interventions for post total hip arthroplasty?
Raised toilet seat, do not cross legs, antiembolism stockings, float the heels, partial weight bearing, avoid positioning on effected side, encourage ambulation, ice
Patient presents with red, painful, warm area on calf. What is this an indication of?
DVT
Name three diagnostic tests for rheumatoid arthritis.
Rheumatoid factor, CRP, ESR
A male patient has a uric acid level of 8.9. What would the nurse anticipate to administer to this client?
Allopurinol
What lab value is anticipated to rise postop due to inflammation?
WBC
What postoperative medication is anticipated to prevent DVTs for total hip arthroplasty?
Apixaban, Lovenox
A patient is diagnosed with compartment syndrome. What events could lead to this disorder?
arterial vessel compression, reduced blood supply to the extremity, tight cast or dressing
A patient had a myelogram using water soluble dye and asks, "Why do I have to sit in semi-fowler's for 8 hours following?" What is the most appropriate response by the nurse?
This prevent the dye from going back to your brain.
What dietary education should the nurse provide to a patient with osteoporosis? How can this achieved?
A total of 1,200-2,000 mg of calcium is recommended per day - achieved by dairy products, spinach, sardines with bones
Postoperatively, what are two recommended exercises?
Bicycling and swimming
Postop care for the patient with a fractured hip includes:
The operative foot should be placed on the floor but weight should be born on unopperative leg, prop pillows between legs or under the back to maintain position, assist with ROM, encourage ambulation
A patient is complaining of sharp pain in a recently amputated limb. The nurse determines that this is phantom pain. How should this be addressed?
Administer analgesics, reposition the patient, pain assessment, emotional support, Gabapentin
What medications are contraindicated for an EMG and nerve conduction?
Muscle relaxants and anticoagulants - no sedatives
A patient presents with cerebrospinal fluid leakage. The nurse knows the patient is diagnosed with osteoarthritis. What manifestations would the patient present with?
Wound dressing drainage for halo like appearance, sudden headache, bulging incision
Following a knee replacement, what is included in a neurovascular status check?
Movement
Sensation
Color
Pulse
Cap refill
What lab values should the nurse anticipate slightly dropping up to 48 hours postop?
Hgb, Hct
What are older adult lifespan considerations pertaining to the musculoskeletal system?
decreased bone density, increased risk for fractures, decreased subQ tissue, increased risk for pressure ulcer, degenerative issues in the spine, decreased nutritional intake