Bones and Basics
Name the 3 types of muscles and which are voluntary vs involuntary.
Smooth is involuntary
Cardiac is involuntary
What is the most important initial nursing action for a suspected fracture?
Immobilize to prevent further damage, and neurovascular exam.
Which arthritis is an autoimmune disease and causes joint deformities?
RA, Rheumatoid arthritis
What causes gout?
Uric acid crystal build up in joints due to the body being unable to metabolize purines
How should alendronate be taken?
On an empty stomach, full glass of water, remain upright for 30 minutes to decrease risk of esophageal irritation.
What is the function of red bone marrow?
Hematopoesis- produces red and white blood cells and platelets. (this is why when there is cancer in the marrow, we can have issues with our blood counts)
What are the classic signs of a fat embolism after a long bone fracture?
Shortness of breath, confusion, petechiae on chest/neck. Often deadly.
Which arthritis is degenerative and worsens over time?
OA, osteoarthritis.
Which foods should a client with gout avoid?
Organ meats, red meat, shellfish, alcohol
What is the priority adverse effect of methotrexate to report?
Mouth ulcers or fatigue
What is a tendon vs a ligament?
A tendon connects muscle to bone
A ligament connects bone to bone
What should you NEVER do with traction weights?
NEVER move them or rest them on anything, they must hang freely. The goal of traction is to pull the extremity into proper alignment.
Which is the best exercise for osteoporosis prevention?
Weight bearing exercise like walking or stair climbing.
Which medication is maintenance for gout and prevents attacks?
Allopurinol. Colchicine is used for acute attacks.
What should you teach a client taking colchicine?
Stop medication if diarrhea occurs as this is a sign of toxicity.
What are the 7 Ps of neurovascular assessment?
Pain, pallor, pulslessness, parasthesia, paralysis, puffiness, polar temperature
Which finding in a casted extremity is a RED FLAG for compartment syndrome?
Pain that is unrelieved by medication. The patient will also have other symptoms such as tingling, a weak pulse, pallor and coolness, etc.
Name two risk factors for osteoporosis- one modifiable and one non-modifiable.
Modifiable- inactivity, low calcium or vitamin D
Non-modifiable- age, gender, menopause
Which position helps prevent hip contractures after amputation?
Lying prone (on the stomach)
What is a major side effect of raloxifene?
Increased risk of DVT, report calf pain/swelling immediately.
Ball-and-socket, allows for the greatest range of motion including flexion, extension, rotation, abduction, and adduction
What is the first thing you should do if you suspect compartment syndrome?
Loosen the cast, wrap, or dressing slightly and notify the provider immediately. NO elevation or ice.
A client with RA reports morning stiffness and fatigue. What should the nurse suggest?
Use warm compresses, gentle range of motion to ease stiffness. Rest during severe flares.
What is phantom limb pain and how is it treated?
Real pain felt in the missing limb. Medications can be used, but sometimes the patient has to have a stump revision with more tissue removal.
What key teaching point must you include for clients taking prednisone?
Must taper off slowly, stopping abruptly can lead to adrenal crisis.