Procedures
The surgical procedure during which a needle is inserted into a joint to remove fluid
Bonus: What is the fluid called??
Arthrocentesis
Bonus: Synovial fluid
Name 2 big concepts about pin care
- 1 cotton swab per pin to avoid cross contamination using chlorhexidine
- Monitor for s/s of infection- redness, drainage, loosening of pins, tenting at pin site
RICE
Rest
Ice
Compression
Elevation
Drug class used to prevent osteoporosis, hypercalcemia, and Paget's disease of the bone that decreases the number and actions of osteoclasts, subsequently inhibiting bone resorption
Bisphosphonates
Name 2 goals of traction?
1. Prevent soft tissue injury
2. Realign bone fragments
3. Decrease muscle spasms and pain
4. Correct or prevent further deformities
DEXA scan, removes all metallic objects
____ is caused by severed nerve pathways and is a frequent complication in clients who experienced chronic limb pain prior to amputation.
Describe feelings associated with this condition, and how is this pain treated?
Phantom limb pain
Often described as shooting, aching, deep, burning, cramping. Administer calcitonin during first week post-amputation. Administer beta-blockers (propranolol) for dull/burning sensation. Adminster antispasmodics (baclofen) or antiepileptics (gabapentin) for sharp/stabbing/burning. Antidepressants.
Alternative pain mgmt (nonpharm)- massage, heat, TENS, US therapy, biofeedback, acupuncture, repositioning, relaxation therapy.
5 "Ps" of compartment syndrome?
Pain, Pallor, Paresthesia, Pulselessness, and Paralysis
- Monitor Ca2+ levels in clients receiving IV preparations
- Monitor for esophagitis and esophageal ulcers with oral preparations (indigestion, chest pain, difficulty swallowing, bloody emesis)
- Take w/ 8oz. water in AM on empty stomach
- Frequent dental exams to catch any osteonecrosis of the jaw (clients using IV prep)
When assessing a patient in traction, ensure that the weights are ____ and not _____.
Hanging freely, lying on the floor
Traction weights must hang freely and not rest on the floor to maintain the continuous pull necessary for effective fracture reduction and muscle relaxation. If the weights touch the floor, the pulling force is compromised, and the treatment's effectiveness is reduced or lost.
____ is a procedure that involves the removal of part of the laminae and facet joints to relieve pressure on the spinal cord and nerves.
Name 3 things you would provide as nursing education?
Laminectomy
- Perform neuro checks with VS measurement
- Ensure the client is able to void- damage to bladder muscles?
- Empty surgical drain (if present) at least qshift.
- No trapeze! - Damage to surgical area
- Provide straight back chair
- Turn body as unit- log roll
It is important to monitor neurovascular status every ___ for the first 24hr and assess pain when a patient is newly casted.
1 hr
A grating or crackling sound or sensation as that produced by the fractured ends of a bone moving against each other
Crepitation
True or False: It is wise to apply the cast while the affected area is still swollen as this can help with healing
FALSE!!
Casts are applied once the swelling has subsided to avoid compartment syndrome. **If swelling continues after cast application and causes unrelieved pain, the cast can be split on 1 side or on both sides (uni/bivalved)
Name 3 risk factors for osteoporosis
- Female- decline in estrogen levels following menopause increases rate of bone resorption
- Age >50yr
- Family hx/thin lean build
- Decreased protein intake (Ca2+ binds to protein)
- Excess caffeine consumption
- Prolonged immobility
- Hx malabsorption disorders (bariatric surgery, celiac, etc.)
Name 3 things you must verify with your patient prior to sending them to MRI
- Metal present? (pacemaker, jewlery, etc)
- Is pt claustrophobic?
- Allergies? (Contrast dyes)
Nursing actions to prevent??
DVT/Fat/Pulmonary embolism
- Teds, SCD, anticoag meds
- Increase physical mobility where appropriate (encourage client to get OOB from the unaffected side)
The inflammation of the small fluid-filled sac that acts as a cushion between bones, tendons, and muscles near joints. It's often caused by overuse, injury, or infection, leading to pain, swelling, and limited motion. Common areas affected include the shoulder, elbow, hip, and knee
Bursitis
(Same blank)
Older adults may not present with a fever in the setting of _______. In fact, in the setting of chronic _____, many manifestations of the disease disappear.
Osteomyelitis.
**Older adults do not always present with fever due to a dampened inflammatory response and weakened immune systems, making systemic symptoms like fever less prominent. Additionally, older adults are more likely to have other coexisting conditions that can mask or mimic the symptoms of osteomyelitis
_____, the "prerequisite" to osteoporosis, requires extensive teaching to prevent progression.
When conducting your assessment of an amputee, you must compare the pulse _______ with pulse on other extremity.
most proximal to incision
_____ can result from both external sources (a tight cast or constrictive/bulky dressing), or internal sources (accumulation of blood or fluid within the muscle compartment).
Compartment Syndrome
____ is a partial dislocation of a joint, meaning the bones are still connected but not fully aligned. It's less severe than a full _____ but can still cause pain, swelling, and limited movement.
Subluxation, dislocation
A dislocation is a complete separation of the bones at a joint, where they no longer touch or align. A subluxation is a partial or incomplete dislocation where the bones still maintain some contact but are not in their normal, aligned position
A _____ is a fracture of the distal radius resulting in an upward (posterior) displacement of the radius and obvious deformity.
Colles Fracture
(pic)
_______ is used to prevent or lower high uric acid levels in the blood. It is also used to prevent or lower excess uric acid levels caused by cancer medicines or in patients with kidney stones. A high uric acid level can cause gout or gouty arthritis (joint pain and inflammation).
Allopurinol