Labs/Diagnostics
What is a normal serum Calcium level?
8.5 - 10.5 mg/dL
What part of the joint is damaged with osteoarthritis?
cartilage
You patient is suspected of fracture. What is the priority assessment the nurse should complete prior to intervention?
Neurovascular assessment (P's)
The nurse is caring for a patient in traction who has soiled the bed. What is the best technique for changing bed linens and cleaning the patient?
The nurse suspects the patient has a dislocated joint. What is the
1. priority assessment and
2. intervention by the nurse?
1. N/V assessment
2. Immobolize the joint
What are two diagnostic tools used in the screening/diagnosis of Osteoporosis?
DEXA scan
BMD testing
What part of the joint is affected by rheumatoid arthritis?
synovium
You are the nurse caring for a patient with a fracture, and you have assessed neurovascular compromise. What is your next intervention?
Call the doctor!
The patient is being discharged with a new case post fracture. What are three major teaching points to assure the patient understands prior to discharge?
Nothing down cast!
Neurovascular checks
Ice on cast for 24 hours
Exercise (Don't use...you lose!)
Plaster vs Synthetic
List three ways patients with RA can reduce pain associated with their disease:
2. Avoid sedentary lifestyle
3. Prescribed pain mgmt. plan
4. Reduce stress/prevent flare ups
5. Medication compliance (DMARDS, Methotrexate)
List three labs and/or diagnostics tests you would want to assess for a patient with RA on prescribed immunosuppressants to assure medication therapy is effective?
ESR (inflammatory marker)
CBC (WBC, Platelets)
X ray of affected joints
What are three conservative treatments for osteoarthritis?
Weight loss
Modify exercise
Rest
NSAIDS
Brace
A patient is recovering from an open fracture. What assessment findings would lead you to suspect the development of osteomyelitis?
High fever
Chills
Elevated WBC
The patient has undergone an ORIF for a fractured hip. The patient is post op day 1. What is the most important nursing intervention to prevent surgical complications for the patient?
Up out of bed! (Walk)
The patient complains of back pain after an injury at work one week ago. What are four teaching points the nurse can implement for this patient?
OTC analgesics
Muscle relaxants
Rest
Compresion
Activity modifaction
More...
Your patient has had a serum Calcium drawn and the result was 11.5. List three side effects of hypercalcemia.
Excessive thirst/frequent urination
GI disturbances
Bone/muscle pain
Confusion, lethargy, fatigue
What are three key nursing interventions for care of a patient post-arthroplasty?
Infection prevention! (IV atbx, hand hygiene, dressing changes)
Dislocation prevention! (wedge - hip, hip precautions)
Monitoring for bleeding (drain care)
The patient has been diagnosed with osteoporosis. What are two classes of medications that can be used? Give an example of each.
Biphosphonates: Alendronate (Fosamax)
Calcitonin
SERMS: (Raloxifene) Evista
The nurse is assessing a patient with a cast and is concerned that a wound may have developed under the cast. What are three assessments that may confirm the nurse's suspicion?
Smell
Drainage
Hot spots on cast
Burning cessation (that may have stopped)
The nurse is caring for a patient post spinal surgery who has an order for "maintain spinal precautions". What are three main points for spinal precautions?
Log roll
Don't twist
Maintain bed rest (as ordered)Pillows under thighs (supine), pillows between legs (side lying)
Brace per ordersWhat is a normal ESR level and a normal CRP level?
ESR:0-22 (male), 0-29 (female)
CRP: < 3
What are three key differentiating factors for RA/OA
systemic vs unilateral
autoimmune vs degenerative
female vs both genders (age)
young(er) vs older
A patient is in balanced skeletal traction. What are four important nursing care considerations for this patient?
T
R
A
C
T
I
O
N
The nurse is caring for a patient after a femur fracture. The nurse assesses the patient to have SOB, a fever, and a rash to the face and chest. What is the priority action of the nurse?
Oxygenate!
Call MD (FES is an emergency and pt. needs oxygenation, transfer to ICU, and supportive care).
DAILY DOUBLE!!!!....but an ALL PLAY!... Pick your wager.
The patient has developed compartment syndrome on the left forearm.
1. What is the priority ND/problem?
2. SMART Goal
3. Three nursing interventions
4. How can you assess that the patient is improving/deteriorating?
Human anatomy and physiology, microbiology, nutrition, statistics, and human growth & development across the lifespan