Diagnostic Studies
Nursing Responsibilities for Basic X-Ray?
Before: Remove any radioplaque objects that can interfere with results. explain procedure to patient.
During: Avoid excessive exposure of patient and self.
Treatment for Anterior Cruciate Ligament Tear?
PT with rehabilitation, knee brace. if knee instability or further injury, reconstructive surgery may be done.
manifestation of bruising?
discoloration of skin from extravasation of blood in subcutaneous tissues.
Do not Do This?
do not elevate knees and leg with pillows at night.
During an initial home health visit, after Mr. John's hip arthroplasty, you noted patient toilet and couch is really low. what would you do?
educate the need for raised toilet seats and chair that is elevated with straight with arm.
Nursing responsibilities for a bone scan?
Before: explain that radioisotope is given 2 hr before procedure. have patient void before scan. tell patient that no harm will result from isotopes.
during: patient must lie completely still during scan.
after: increase fluid after scan
Treatment for Ligament Injury?
Rest, ice, elevation of extremity if possible, NSAIDs. Protect affected extremity by use of brace.
crepitation manifestation?
grating or crunching of bony fragments, producing palpitations or audible crunching or popping sensation
Do this to reduce manifestations?
Apply heat and cold to affected joints
after total hip arthroplasty, what can you expect to be ordered to prevent DVT pharm and nonpharm interventions?
anticoagulants
anti embolic stocking
SCDs
Foot pumps in bed
Nursing responsibilities for a CT scan?
before: evaluate renal function before contrast medium used. assess for patient allergy to shellfish. patient may need to be NPO 4 hr before procedure. hold metformin on day of procedure to prevent hypoglycemia and lactic acidosis.
during: warn patient that contrast injection may cause feeling of being warm and flushed. patient must lie completely still during scan.
after: encourage patient to drink fluids to avoid renal problems with contrast.
Treatment for Meniscus Injury?
Rest, ice, elevation of extremity if possible, NSAIDs. gradual return to regular activities. if symptoms persist, MRI to assess meniscus injury. possible arthroscopic surgery.
deformity manifestation?
abnormal position of extremity or part from original forces of injury and action of muscles pulling fragment into abnormal position. seen as a loss of normal bony contours.
Synovial Fluid Aspiration, Arthroscopy
during patient demographics before hip arthroplasty, patient is on 10mg of warfarin. what is priority?
notify surgeon immediately due to bleeding risk.
Nursing Responsibilities for MRI?
Before: Oral and/or IV contrast injection may be used. check for pregnancy, allergies, and renal function before test. have patient remove all metal objects. ask about surgical insertion of staples, plates, dental bridges, or other mental appliances. assess for claustrophobia and need for anxiety medication.
during: patient must lie completely still during test.
Treatment for impingement syndrome?
NSAIDs. Rest until symptoms decrease, then begin gradual ROM and strengthening exercises.
loss of function manifestations?
disruption of bone or joint, preventing functional use of a limb or part
Lab tests for Rheumatoid Arthritis?
ESR
CRP
RF
2 days post knee arthroplasty, Mr. John has acute dyspnea, tachycardia and chest pain. what is your priority?
give patient oxygen
notify MD
provide comfort to patient.
Nursing responsibilities for a discogram?
Before: Assess patient for allergy to contrast medium. Explain Procedure.
After: May have mild back pain for 1-2 days. use as needed analgesics.
Treatment of Tendonitis?
Rest, ice, NSAIDs. Gradual return to sport activity. Protective brace (orthrosis) may be needed if symptoms occur.
muscle spasm manifestations?
irritation of tissues and protective response to injury and fracture.
Shower education?
Grab Bars.
Take warm shower in the morning or before bed.
educate RN the pillow behind knees can lead to contractures. and remove the pillow.