Podcast
Questions and Answers
Which injury is characterized by the excessive stretching of a muscle or tendon?
Which injury is characterized by the excessive stretching of a muscle or tendon?
- Strain (correct)
- Fracture
- Dislocation
- Sprain
What is indicative of a moderate strain injury?
What is indicative of a moderate strain injury?
- Minimal inflammation with slight tenderness
- Complete rupture of muscle or tendon
- Joint deformity and loss of motion
- Partial tearing of muscle or tendon fibers (correct)
The acronym RICE, used in the initial treatment of strains, stands for:
The acronym RICE, used in the initial treatment of strains, stands for:
- Rest, Ice, Compression, Elevation (correct)
- Run, Ice, Compression, Elevate
- Run, Immobilize, Cool, Exercise
- Rest, Ice, Compress, Exercise
A sprain is best described as an injury to which type of soft tissue?
A sprain is best described as an injury to which type of soft tissue?
What distinguishes a severe sprain from a moderate sprain?
What distinguishes a severe sprain from a moderate sprain?
Which of the following is a primary characteristic of a dislocation?
Which of the following is a primary characteristic of a dislocation?
What is the most critical immediate action when managing a suspected dislocation before medical help arrives?
What is the most critical immediate action when managing a suspected dislocation before medical help arrives?
Compared to a sprain and a dislocation, a strain uniquely involves injury to which structure?
Compared to a sprain and a dislocation, a strain uniquely involves injury to which structure?
What is the primary purpose of bursae in joints?
What is the primary purpose of bursae in joints?
Which of the following is NOT mentioned as a common cause of bursitis?
Which of the following is NOT mentioned as a common cause of bursitis?
What is the initial recommended treatment for bursitis to reduce inflammation and pain?
What is the initial recommended treatment for bursitis to reduce inflammation and pain?
Which tendon is most commonly affected in chronic impingement syndrome, a type of rotator cuff injury?
Which tendon is most commonly affected in chronic impingement syndrome, a type of rotator cuff injury?
What diagnostic imaging technique is typically used to confirm a rotator cuff injury?
What diagnostic imaging technique is typically used to confirm a rotator cuff injury?
Carpal tunnel syndrome is caused by the compression of which nerve?
Carpal tunnel syndrome is caused by the compression of which nerve?
A positive Phalen test, used in diagnosing carpal tunnel syndrome, involves:
A positive Phalen test, used in diagnosing carpal tunnel syndrome, involves:
What is the first step in bone fracture healing, occurring within 48 to 72 hours after the injury?
What is the first step in bone fracture healing, occurring within 48 to 72 hours after the injury?
Which type of bone cell is responsible for resorbing necrotic bone during the remodeling phase of fracture healing?
Which type of bone cell is responsible for resorbing necrotic bone during the remodeling phase of fracture healing?
Approximately how long does it take for a complete bone fracture to heal in a young, healthy adult?
Approximately how long does it take for a complete bone fracture to heal in a young, healthy adult?
What is the term for a fracture that occurs as a result of an underlying disease, such as osteoporosis or bone cancer?
What is the term for a fracture that occurs as a result of an underlying disease, such as osteoporosis or bone cancer?
In which type of fracture is the bone broken into two or more pieces?
In which type of fracture is the bone broken into two or more pieces?
Which of the following is an example of a preventive measure for carpal tunnel syndrome mentioned in the text?
Which of the following is an example of a preventive measure for carpal tunnel syndrome mentioned in the text?
Following carpal tunnel surgery, patients should be instructed to report symptoms of neurovascular compromise. Which of the following is NOT a symptom of neurovascular compromise?
Following carpal tunnel surgery, patients should be instructed to report symptoms of neurovascular compromise. Which of the following is NOT a symptom of neurovascular compromise?
What is the primary reason for using lifting devices like draw sheets when moving patients?
What is the primary reason for using lifting devices like draw sheets when moving patients?
Which of the following is the primary concern with an open fracture compared to a closed fracture?
Which of the following is the primary concern with an open fracture compared to a closed fracture?
A patient with a suspected hairline fracture reports tenderness but no visible deformity. What is the MOST likely initial symptom they would present with?
A patient with a suspected hairline fracture reports tenderness but no visible deformity. What is the MOST likely initial symptom they would present with?
A patient experiencing hip fracture pain may report discomfort in which unexpected location due to referred pain?
A patient experiencing hip fracture pain may report discomfort in which unexpected location due to referred pain?
Limb shortening is a common sign associated with which type of fracture?
Limb shortening is a common sign associated with which type of fracture?
What clinical finding is described as a grating sound caused by bone fragments rubbing together?
What clinical finding is described as a grating sound caused by bone fragments rubbing together?
During the emergency care of a patient with a suspected extremity fracture, what is the MOST critical action regarding limb manipulation?
During the emergency care of a patient with a suspected extremity fracture, what is the MOST critical action regarding limb manipulation?
Which type of fracture is characterized by bone splintered into numerous fragments, often associated with crushing injuries?
Which type of fracture is characterized by bone splintered into numerous fragments, often associated with crushing injuries?
What diagnostic imaging technique is BEST suited for detecting fractures in complex areas such as the hip and pelvis?
What diagnostic imaging technique is BEST suited for detecting fractures in complex areas such as the hip and pelvis?
What is the primary goal of closed reduction in fracture management?
What is the primary goal of closed reduction in fracture management?
Splints are often preferred over casts in the initial management of fractures for which primary reason?
Splints are often preferred over casts in the initial management of fractures for which primary reason?
What immediate intervention is required if a patient in a cast exhibits signs of compartment syndrome?
What immediate intervention is required if a patient in a cast exhibits signs of compartment syndrome?
In fracture management, what is the primary purpose of traction?
In fracture management, what is the primary purpose of traction?
Which type of fracture is caused by bone weakening due to a tumor, either within or pressing on the bone?
Which type of fracture is caused by bone weakening due to a tumor, either within or pressing on the bone?
Regular neurovascular checks are crucial for patients in splints or casts. What is the MOST important reason for these assessments?
Regular neurovascular checks are crucial for patients in splints or casts. What is the MOST important reason for these assessments?
A 'window' is created in a cast primarily to allow for what?
A 'window' is created in a cast primarily to allow for what?
What is the maximum weight typically used in Buck traction for an adult patient?
What is the maximum weight typically used in Buck traction for an adult patient?
Which intervention is most appropriate when moving a patient's limb with an external fixation device?
Which intervention is most appropriate when moving a patient's limb with an external fixation device?
For extremity skeletal traction, what is the typical range of weight applied to achieve bone alignment?
For extremity skeletal traction, what is the typical range of weight applied to achieve bone alignment?
A patient with an external fixation device reports increased pain, redness, and drainage at a pin site. Which complication is MOST indicated by these findings?
A patient with an external fixation device reports increased pain, redness, and drainage at a pin site. Which complication is MOST indicated by these findings?
What is the primary rationale for using strict aseptic technique during pin-site care for a patient with external fixation?
What is the primary rationale for using strict aseptic technique during pin-site care for a patient with external fixation?
In the immediate management of a suspected fracture, what is the priority action before moving the limb for splinting?
In the immediate management of a suspected fracture, what is the priority action before moving the limb for splinting?
Which assessment finding is MOST indicative of a neurovascular problem in a patient with a fractured extremity?
Which assessment finding is MOST indicative of a neurovascular problem in a patient with a fractured extremity?
When applying a splint to a fractured extremity, what is the recommended practice regarding clothing?
When applying a splint to a fractured extremity, what is the recommended practice regarding clothing?
What is a critical early nursing intervention for a patient suspected of acute compartment syndrome?
What is a critical early nursing intervention for a patient suspected of acute compartment syndrome?
During the first 24 hours after cast application, how frequently should neurovascular checks be performed?
During the first 24 hours after cast application, how frequently should neurovascular checks be performed?
Which factor is LEAST likely to contribute to delayed bone healing (nonunion)?
Which factor is LEAST likely to contribute to delayed bone healing (nonunion)?
Which of the following actions is contraindicated when drying a newly applied plaster cast?
Which of the following actions is contraindicated when drying a newly applied plaster cast?
What is the primary rationale for elevating a casted extremity above heart level during the first 48 hours?
What is the primary rationale for elevating a casted extremity above heart level during the first 48 hours?
A patient with a femur fracture is at highest risk for which complication?
A patient with a femur fracture is at highest risk for which complication?
Which intervention is a priority for preventing thromboembolic complications in a patient following orthopedic surgery?
Which intervention is a priority for preventing thromboembolic complications in a patient following orthopedic surgery?
To maintain tissue integrity under a cast, which instruction should be given to a patient regarding foreign objects and itching?
To maintain tissue integrity under a cast, which instruction should be given to a patient regarding foreign objects and itching?
What is the MOST important action for the Licensed Practical Nurse (LPN) to take immediately after discovering a patient has fallen and is complaining of hip pain?
What is the MOST important action for the Licensed Practical Nurse (LPN) to take immediately after discovering a patient has fallen and is complaining of hip pain?
Which of the following is a concerning sign of potential infection under a cast that requires immediate attention?
Which of the following is a concerning sign of potential infection under a cast that requires immediate attention?
Open Reduction with Internal Fixation (ORIF) is commonly indicated for which type of fracture?
Open Reduction with Internal Fixation (ORIF) is commonly indicated for which type of fracture?
What is the primary purpose of Buck traction applied to a patient with a hip fracture prior to surgery?
What is the primary purpose of Buck traction applied to a patient with a hip fracture prior to surgery?
Which vital sign change would be MOST concerning in a patient being monitored for hemorrhage after a femur fracture?
Which vital sign change would be MOST concerning in a patient being monitored for hemorrhage after a femur fracture?
Following an Open Reduction Internal Fixation (ORIF) for a hip fracture, what is a key benefit that promotes faster recovery in older adults?
Following an Open Reduction Internal Fixation (ORIF) for a hip fracture, what is a key benefit that promotes faster recovery in older adults?
External fixation is most appropriate for managing fractures with which characteristic?
External fixation is most appropriate for managing fractures with which characteristic?
What is malunion of a fracture?
What is malunion of a fracture?
Which treatment modality is used for nonunion fractures to stimulate bone healing?
Which treatment modality is used for nonunion fractures to stimulate bone healing?
When handling a wet plaster cast, why should palms be used instead of fingertips?
When handling a wet plaster cast, why should palms be used instead of fingertips?
In the acronym 'EF device', as used in the text, what does 'EF' stand for?
In the acronym 'EF device', as used in the text, what does 'EF' stand for?
For a patient experiencing itching under a cast, what is an appropriate non-invasive intervention to suggest?
For a patient experiencing itching under a cast, what is an appropriate non-invasive intervention to suggest?
Which of the following nursing interventions is crucial for a patient with external fixation of the lower extremity?
Which of the following nursing interventions is crucial for a patient with external fixation of the lower extremity?
What is the definition of 'osteomyelitis'?
What is the definition of 'osteomyelitis'?
What is the fundamental physiological process underlying acute compartment syndrome?
What is the fundamental physiological process underlying acute compartment syndrome?
A patient with a tibial fracture reports severe pain that intensifies with active movement and is not relieved by opioid analgesics. This pain is MOST indicative of which condition?
A patient with a tibial fracture reports severe pain that intensifies with active movement and is not relieved by opioid analgesics. This pain is MOST indicative of which condition?
Which of the following is the MOST ominous and late sign of acute compartment syndrome?
Which of the following is the MOST ominous and late sign of acute compartment syndrome?
A nurse assesses a patient with a casted forearm and notes increasing pain, pallor, and paresthesia in the fingers. What is the priority nursing action?
A nurse assesses a patient with a casted forearm and notes increasing pain, pallor, and paresthesia in the fingers. What is the priority nursing action?
Which surgical intervention is performed to relieve pressure in acute compartment syndrome?
Which surgical intervention is performed to relieve pressure in acute compartment syndrome?
Volkmann contracture, a potential complication of untreated compartment syndrome, is characterized by:
Volkmann contracture, a potential complication of untreated compartment syndrome, is characterized by:
Fat embolism syndrome (FES) is triggered by the release of fat droplets into the bloodstream primarily from:
Fat embolism syndrome (FES) is triggered by the release of fat droplets into the bloodstream primarily from:
Which patient population is at the HIGHEST risk for developing fat embolism syndrome?
Which patient population is at the HIGHEST risk for developing fat embolism syndrome?
Within what timeframe after the initial injury is fat embolism syndrome MOST likely to occur?
Within what timeframe after the initial injury is fat embolism syndrome MOST likely to occur?
Which triad of manifestations is characteristic of fat embolism syndrome?
Which triad of manifestations is characteristic of fat embolism syndrome?
What is typically the EARLIEST clinical sign of fat embolism syndrome?
What is typically the EARLIEST clinical sign of fat embolism syndrome?
Which initial nursing intervention is MOST appropriate for a patient suspected of having fat embolism syndrome?
Which initial nursing intervention is MOST appropriate for a patient suspected of having fat embolism syndrome?
What is the PRIMARY origin of emboli in fat embolism syndrome compared to pulmonary embolism?
What is the PRIMARY origin of emboli in fat embolism syndrome compared to pulmonary embolism?
What is a KEY differentiating cause of fat embolism syndrome compared to pulmonary embolism according to the provided table?
What is a KEY differentiating cause of fat embolism syndrome compared to pulmonary embolism according to the provided table?
Frequent neurovascular status checks distal to a fracture are crucial for early detection of which potential complication?
Frequent neurovascular status checks distal to a fracture are crucial for early detection of which potential complication?
What is the most common type of osteoporosis?
What is the most common type of osteoporosis?
Which of the following risk factors for osteoporosis can be modified through lifestyle changes?
Which of the following risk factors for osteoporosis can be modified through lifestyle changes?
Which diagnostic test is the standard method to measure bone density in osteoporosis patients?
Which diagnostic test is the standard method to measure bone density in osteoporosis patients?
What physiological effect of osteoporosis can lead to an increased risk of pneumonia?
What physiological effect of osteoporosis can lead to an increased risk of pneumonia?
Which symptom is likely to indicate that a person has developed osteoporosis?
Which symptom is likely to indicate that a person has developed osteoporosis?
Which of the following is a non-modifiable risk factor for primary osteoporosis?
Which of the following is a non-modifiable risk factor for primary osteoporosis?
Why are women at a greater risk of developing osteoporosis than men?
Why are women at a greater risk of developing osteoporosis than men?
Which group is primarily targeted by the Healthy People 2030 osteoporosis objectives?
Which group is primarily targeted by the Healthy People 2030 osteoporosis objectives?
What dietary component is essential in protecting against osteoporosis, especially for those over 50 years of age?
What dietary component is essential in protecting against osteoporosis, especially for those over 50 years of age?
What is the role of osteoclast cells in the bone remodeling process?
What is the role of osteoclast cells in the bone remodeling process?
Which of the following is a symptom or sign that might not be immediately noticeable in a person with osteoporosis?
Which of the following is a symptom or sign that might not be immediately noticeable in a person with osteoporosis?
What is the primary consequence of postmenopausal status that leads to increased bone loss?
What is the primary consequence of postmenopausal status that leads to increased bone loss?
Why is vitamin D important for individuals at risk of osteoporosis?
Why is vitamin D important for individuals at risk of osteoporosis?
Which bone areas are most at risk of fractures due to osteoporosis?
Which bone areas are most at risk of fractures due to osteoporosis?
How does osteoporosis potentially impact a person's emotional well-being?
How does osteoporosis potentially impact a person's emotional well-being?
Which therapeutic measure is essential to prevent complications associated with suspected compartment syndrome?
Which therapeutic measure is essential to prevent complications associated with suspected compartment syndrome?
What is the primary goal of providing pain management prior to promoting patient mobility?
What is the primary goal of providing pain management prior to promoting patient mobility?
What is a common risk factor for developing osteoarthritis?
What is a common risk factor for developing osteoarthritis?
What dietary components are emphasized for promoting healing in patients with osteomyelitis?
What dietary components are emphasized for promoting healing in patients with osteomyelitis?
What is the primary indication of an effective outcome for interventions in patients at risk for peripheral neurovascular dysfunction?
What is the primary indication of an effective outcome for interventions in patients at risk for peripheral neurovascular dysfunction?
Which of the following characterizes early symptoms of rheumatoid arthritis?
Which of the following characterizes early symptoms of rheumatoid arthritis?
Which of the following is a crucial component in educating a patient about care after cast removal?
Which of the following is a crucial component in educating a patient about care after cast removal?
Which therapeutic measure is commonly used in treating both osteoarthritis and rheumatoid arthritis?
Which therapeutic measure is commonly used in treating both osteoarthritis and rheumatoid arthritis?
Which type of exercise is most effective for relieving chronic low back pain?
Which type of exercise is most effective for relieving chronic low back pain?
What is a key nursing intervention to address potential pain in cognitively impaired patients?
What is a key nursing intervention to address potential pain in cognitively impaired patients?
What is a common symptom of osteoarthritis in the hands?
What is a common symptom of osteoarthritis in the hands?
Which pathogen is most commonly associated with osteomyelitis?
Which pathogen is most commonly associated with osteomyelitis?
Why is cold therapy applied to a fracture site as part of the treatment plan?
Why is cold therapy applied to a fracture site as part of the treatment plan?
Why might a patient with osteoarthritis be advised to lose weight?
Why might a patient with osteoarthritis be advised to lose weight?
What is a distinguishing feature of rheumatoid arthritis' pathophysiology?
What is a distinguishing feature of rheumatoid arthritis' pathophysiology?
Which is NOT a sign of chronic osteomyelitis?
Which is NOT a sign of chronic osteomyelitis?
What diagnostic test result is typically elevated in patients with osteomyelitis?
What diagnostic test result is typically elevated in patients with osteomyelitis?
Which diagnostic test is helpful in diagnosing osteoarthritis by showing joint structure abnormalities?
Which diagnostic test is helpful in diagnosing osteoarthritis by showing joint structure abnormalities?
Which intervention should a nurse avoid when caring for a patient in a cast to prevent neurovascular complications?
Which intervention should a nurse avoid when caring for a patient in a cast to prevent neurovascular complications?
Which factor does not directly increase the risk of osteoarthritis?
Which factor does not directly increase the risk of osteoarthritis?
Which outcome indicates that a patient with neurovascular compromise has maintained adequate function?
Which outcome indicates that a patient with neurovascular compromise has maintained adequate function?
What common intervention can help maintain joint function in osteoarthritis?
What common intervention can help maintain joint function in osteoarthritis?
What is the role of administering anti-inflammatory medication to a patient with a fracture?
What is the role of administering anti-inflammatory medication to a patient with a fracture?
Which of the following medications is typically NOT used for treating osteoarthritis?
Which of the following medications is typically NOT used for treating osteoarthritis?
What is the initial inflammatory response in osteomyelitis related to?
What is the initial inflammatory response in osteomyelitis related to?
What main therapeutic focus exists for managing osteoarthritis?
What main therapeutic focus exists for managing osteoarthritis?
What characterizes primary malignant tumors that occur in the prostate, breast, lung, and thyroid gland?
What characterizes primary malignant tumors that occur in the prostate, breast, lung, and thyroid gland?
What is an important practice for preventing pain in patients undergoing frequent turning procedures?
What is an important practice for preventing pain in patients undergoing frequent turning procedures?
Which diagnostic test can identify secondary tissue inflammation in patients with metastatic disease?
Which diagnostic test can identify secondary tissue inflammation in patients with metastatic disease?
In Mr. Finn's case, what lifestyle change is important to manage his knee pain?
In Mr. Finn's case, what lifestyle change is important to manage his knee pain?
What is likely to occur in the vertebral column if involved in osteoarthritis?
What is likely to occur in the vertebral column if involved in osteoarthritis?
Which treatment is commonly used for Ewing sarcoma to reduce tumor size and pain?
Which treatment is commonly used for Ewing sarcoma to reduce tumor size and pain?
What role do ligaments and tendons have in osteoarthritis?
What role do ligaments and tendons have in osteoarthritis?
What is a major concern in managing metastatic bone disease?
What is a major concern in managing metastatic bone disease?
What is the characteristic symptom of acute gout?
What is the characteristic symptom of acute gout?
Which type of gout results from an inherited issue with purine metabolism?
Which type of gout results from an inherited issue with purine metabolism?
Which medication is prescribed to prevent the increase in serum uric acid levels in chronic gout?
Which medication is prescribed to prevent the increase in serum uric acid levels in chronic gout?
Which of these is a common trigger for acute attacks of gout?
Which of these is a common trigger for acute attacks of gout?
Which preventive measure is suggested for managing gout?
Which preventive measure is suggested for managing gout?
What is a recommended therapeutic measure for primary bone tumors?
What is a recommended therapeutic measure for primary bone tumors?
Which of the following statements about connective tissue disorders is true?
Which of the following statements about connective tissue disorders is true?
How are urate crystals formed in the body?
How are urate crystals formed in the body?
Which test is used to confirm the presence of uric acid crystals in synovial fluid?
Which test is used to confirm the presence of uric acid crystals in synovial fluid?
Which of the following foods should be avoided to help prevent gout?
Which of the following foods should be avoided to help prevent gout?
What characterizes osteosarcoma according to its word building elements?
What characterizes osteosarcoma according to its word building elements?
What is a common side effect associated with the use of bisphosphonates for osteoporosis?
What is a common side effect associated with the use of bisphosphonates for osteoporosis?
Why might vitamin D supplementation be necessary for some patients with osteoporosis?
Why might vitamin D supplementation be necessary for some patients with osteoporosis?
Which exercise type is particularly recommended to stimulate bone building in osteoporosis patients?
Which exercise type is particularly recommended to stimulate bone building in osteoporosis patients?
What is the function of SERMs in the treatment of osteoporosis?
What is the function of SERMs in the treatment of osteoporosis?
Which dietary component is emphasized for individuals seeking to prevent or manage osteoporosis?
Which dietary component is emphasized for individuals seeking to prevent or manage osteoporosis?
What is the primary action of bisphosphonates in osteoporosis treatment?
What is the primary action of bisphosphonates in osteoporosis treatment?
In what situation might a health professional recommend staying upright for at least 30 minutes after taking certain osteoporosis medications?
In what situation might a health professional recommend staying upright for at least 30 minutes after taking certain osteoporosis medications?
What is the role of teriparatide (Forteo) in osteoporosis management?
What is the role of teriparatide (Forteo) in osteoporosis management?
What complication might arise from excess calcium supplement intake without adequate fluid consumption?
What complication might arise from excess calcium supplement intake without adequate fluid consumption?
Which bone condition is characterized by increased bone breakdown and formation leading to weak bones?
Which bone condition is characterized by increased bone breakdown and formation leading to weak bones?
Which demographic is most affected by Paget disease?
Which demographic is most affected by Paget disease?
What is the recommended source of dietary calcium for osteoporosis patients aside from supplements?
What is the recommended source of dietary calcium for osteoporosis patients aside from supplements?
What is one complication of bone fractures that could increase fall risk, especially in older adults?
What is one complication of bone fractures that could increase fall risk, especially in older adults?
What role does calcitonin play in the management of osteoporosis?
What role does calcitonin play in the management of osteoporosis?
Why is weight-bearing exercise critical for osteoporosis patients?
Why is weight-bearing exercise critical for osteoporosis patients?
What is a potential gastrointestinal risk associated with NSAID use?
What is a potential gastrointestinal risk associated with NSAID use?
What is the primary reason for placing joints in a functional position?
What is the primary reason for placing joints in a functional position?
Which medication is classified as a pyrimidine synthesis inhibitor?
Which medication is classified as a pyrimidine synthesis inhibitor?
What is the effect of tumor necrosis factor inhibitors in treating joint diseases?
What is the effect of tumor necrosis factor inhibitors in treating joint diseases?
Why should older patients on NSAIDs be monitored closely?
Why should older patients on NSAIDs be monitored closely?
What type of diet might be appropriate for someone on corticosteroids?
What type of diet might be appropriate for someone on corticosteroids?
Which therapy would typically be preferred by a patient with osteoarthritis?
Which therapy would typically be preferred by a patient with osteoarthritis?
What is TRUE about the application of cold packs for joint pain?
What is TRUE about the application of cold packs for joint pain?
What is the primary use of DMARDs in rheumatologic conditions?
What is the primary use of DMARDs in rheumatologic conditions?
What is the function of T-cell modulators in inflammatory processes?
What is the function of T-cell modulators in inflammatory processes?
What is a characteristic of late-stage rheumatoid arthritis?
What is a characteristic of late-stage rheumatoid arthritis?
Which nursing implication is important for patients on gold preparations?
Which nursing implication is important for patients on gold preparations?
Which laboratory finding is typically NOT associated with rheumatoid arthritis?
Which laboratory finding is typically NOT associated with rheumatoid arthritis?
Which aspect of NSAIDs is responsible for their analgesic effect?
Which aspect of NSAIDs is responsible for their analgesic effect?
Which test is used to measure the rate of inflammation in rheumatoid arthritis?
Which test is used to measure the rate of inflammation in rheumatoid arthritis?
Why is a Synvisc injection used in osteoarthritic knees?
Why is a Synvisc injection used in osteoarthritic knees?
What is the expected outcome for a patient with decreased activity intolerance related to pain?
What is the expected outcome for a patient with decreased activity intolerance related to pain?
Which of these therapies is considered a complementary and alternative modality?
Which of these therapies is considered a complementary and alternative modality?
What is the primary purpose of disease-modifying antirheumatic drugs (DMARDs) in rheumatoid arthritis treatment?
What is the primary purpose of disease-modifying antirheumatic drugs (DMARDs) in rheumatoid arthritis treatment?
Which interdisciplinary team member is NOT typically involved in managing disturbed body image related to degenerative joint disease?
Which interdisciplinary team member is NOT typically involved in managing disturbed body image related to degenerative joint disease?
When may total joint replacement be indicated in a patient?
When may total joint replacement be indicated in a patient?
To prevent hyperflexion while sitting after a total hip replacement, what is recommended for patients?
To prevent hyperflexion while sitting after a total hip replacement, what is recommended for patients?
Which symptom might indicate systemic involvement in rheumatoid arthritis?
Which symptom might indicate systemic involvement in rheumatoid arthritis?
Which therapy is advisable for joints that are acutely inflamed in rheumatoid arthritis?
Which therapy is advisable for joints that are acutely inflamed in rheumatoid arthritis?
What is the pathophysiological feature of rheumatoid arthritis that leads to joint destruction?
What is the pathophysiological feature of rheumatoid arthritis that leads to joint destruction?
What is a primary prevention measure for skin breakdown in older patients post-surgery?
What is a primary prevention measure for skin breakdown in older patients post-surgery?
What is the role of ESR in the management of rheumatoid arthritis?
What is the role of ESR in the management of rheumatoid arthritis?
Which statement best describes the autoimmune response in rheumatoid arthritis?
Which statement best describes the autoimmune response in rheumatoid arthritis?
Which of the following is a sign of infection to observe during dressing changes?
Which of the following is a sign of infection to observe during dressing changes?
Which of the following is NOT typically a sign of rheumatoid arthritis?
Which of the following is NOT typically a sign of rheumatoid arthritis?
Which organ is NOT typically affected in late-stage rheumatoid arthritis?
Which organ is NOT typically affected in late-stage rheumatoid arthritis?
How should cefaclor suspension be administered if 500 mg is ordered and the suspension is 375 mg/5 mL?
How should cefaclor suspension be administered if 500 mg is ordered and the suspension is 375 mg/5 mL?
How does rheumatoid arthritis typically affect physical mobility over time?
How does rheumatoid arthritis typically affect physical mobility over time?
How can rheumatoid arthritis be characterized in terms of joint involvement?
How can rheumatoid arthritis be characterized in terms of joint involvement?
What technique is recommended for reducing the risk of bruising after administering low molecular weight heparin?
What technique is recommended for reducing the risk of bruising after administering low molecular weight heparin?
What measure is suggested to prevent hip dislocation after a posterior total hip replacement?
What measure is suggested to prevent hip dislocation after a posterior total hip replacement?
Which of these vitamins may help in decreasing inflammation in rheumatoid arthritis?
Which of these vitamins may help in decreasing inflammation in rheumatoid arthritis?
What is a common early sign of rheumatoid arthritis?
What is a common early sign of rheumatoid arthritis?
For patients who have had hip surgery, what can reduce the risk of venous thromboembolism?
For patients who have had hip surgery, what can reduce the risk of venous thromboembolism?
Which factor is NOT a direct contributor to chronic sorrow in patients with rheumatoid arthritis?
Which factor is NOT a direct contributor to chronic sorrow in patients with rheumatoid arthritis?
What can secondary osteoporosis lead to in rheumatoid arthritis patients?
What can secondary osteoporosis lead to in rheumatoid arthritis patients?
Which diagnostic imaging technique is useful for detecting joint damage specifically in the vertebral column?
Which diagnostic imaging technique is useful for detecting joint damage specifically in the vertebral column?
Which intervention is encouraged to help manage disturbances in body image among patients with joint deformities?
Which intervention is encouraged to help manage disturbances in body image among patients with joint deformities?
How can patients minimize risk during home rehabilitation after a total hip replacement?
How can patients minimize risk during home rehabilitation after a total hip replacement?
Which test result can indicate the aggressiveness of rheumatoid arthritis?
Which test result can indicate the aggressiveness of rheumatoid arthritis?
Which activity limitation is typically given after anterior hip replacement surgery?
Which activity limitation is typically given after anterior hip replacement surgery?
What is a recommended educational resource for patients looking to improve joint protection and energy conservation in osteoarthritis?
What is a recommended educational resource for patients looking to improve joint protection and energy conservation in osteoarthritis?
What should be monitored to detect neurovascular compromise post-surgery?
What should be monitored to detect neurovascular compromise post-surgery?
What type of professional support is suggested for a patient experiencing chronic sorrow due to body image changes?
What type of professional support is suggested for a patient experiencing chronic sorrow due to body image changes?
Which occupational aid is helpful for individuals unable to perform their usual job due to rheumatoid arthritis?
Which occupational aid is helpful for individuals unable to perform their usual job due to rheumatoid arthritis?
Why is a patient discharged with instructions to keep their surgical leg abducted after hip replacement?
Why is a patient discharged with instructions to keep their surgical leg abducted after hip replacement?
Which type of activity is recommended to observe the patient's self-care abilities to gather baseline data for planning care?
Which type of activity is recommended to observe the patient's self-care abilities to gather baseline data for planning care?
What therapeutic measure is often needed if nonsurgical approaches fail to relieve arthritic pain?
What therapeutic measure is often needed if nonsurgical approaches fail to relieve arthritic pain?
Which is a frequent inclusion in the interdisciplinary team for a patient with self-care deficits due to joint disease?
Which is a frequent inclusion in the interdisciplinary team for a patient with self-care deficits due to joint disease?
What is a common symptom in older patients that may indicate infection, aside from fever?
What is a common symptom in older patients that may indicate infection, aside from fever?
Which type of connective tissue is primarily affected during the autoimmune response in rheumatoid arthritis?
Which type of connective tissue is primarily affected during the autoimmune response in rheumatoid arthritis?
What should be done with a prefilled syringe of enoxaparin before administration to ensure proper dosing?
What should be done with a prefilled syringe of enoxaparin before administration to ensure proper dosing?
How does rheumatoid arthritis primarily progress?
How does rheumatoid arthritis primarily progress?
Which precaution is recommended to prevent falls after discharge from hip surgery?
Which precaution is recommended to prevent falls after discharge from hip surgery?
What is an important part of post-operative care to ensure a patient's recovery after orthopedic surgery?
What is an important part of post-operative care to ensure a patient's recovery after orthopedic surgery?
What is the main purpose of 'joint camp' following surgery?
What is the main purpose of 'joint camp' following surgery?
Which type of medication was prescribed for pain relief after hip surgery?
Which type of medication was prescribed for pain relief after hip surgery?
What is the primary goal of a total joint replacement procedure?
What is the primary goal of a total joint replacement procedure?
What action is most crucial for nurses following hip surgery to promote healing?
What action is most crucial for nurses following hip surgery to promote healing?
Which condition is a common indication for total joint replacement?
Which condition is a common indication for total joint replacement?
In a total hip replacement, which surgical factor is critical to prevent postoperative hip dislocation?
In a total hip replacement, which surgical factor is critical to prevent postoperative hip dislocation?
Following a total knee replacement, what is not a major concern compared to a total hip replacement?
Following a total knee replacement, what is not a major concern compared to a total hip replacement?
How does a cementless prosthesis secure itself within the patient’s bone?
How does a cementless prosthesis secure itself within the patient’s bone?
What is the primary difference regarding dislocation between total hip replacement (THR) and total knee replacement (TKR)?
What is the primary difference regarding dislocation between total hip replacement (THR) and total knee replacement (TKR)?
What is a potential complication of long-term steroid use related to bone health?
What is a potential complication of long-term steroid use related to bone health?
Which factor is most critical in the initial recovery phase after a hip surgery?
Which factor is most critical in the initial recovery phase after a hip surgery?
What is the typical weight-bearing limitation initially after hip surgery?
What is the typical weight-bearing limitation initially after hip surgery?
What common postoperative complication is associated with posterior or anterior-lateral THR?
What common postoperative complication is associated with posterior or anterior-lateral THR?
Which surgery-related condition might necessitate higher-level amputations?
Which surgery-related condition might necessitate higher-level amputations?
What purpose does tranexamic acid serve when used during joint replacement surgeries?
What purpose does tranexamic acid serve when used during joint replacement surgeries?
Which of the following is crucial for preoperative care before a total hip replacement?
Which of the following is crucial for preoperative care before a total hip replacement?
What is a common site for elective surgical amputation related to peripheral vascular disease?
What is a common site for elective surgical amputation related to peripheral vascular disease?
Why might a cemented prosthesis be used instead of a cementless one in joint replacements?
Why might a cemented prosthesis be used instead of a cementless one in joint replacements?
During the recovery process from hip surgery, which aid was used for approximately one month?
During the recovery process from hip surgery, which aid was used for approximately one month?
What immediate action should be taken if a postoperative hip dislocation is suspected?
What immediate action should be taken if a postoperative hip dislocation is suspected?
How long after surgery did the patient begin driving again?
How long after surgery did the patient begin driving again?
Which surgical procedure often involves the removal of part of the pelvis?
Which surgical procedure often involves the removal of part of the pelvis?
During postoperative care for THR, how is pain generally managed?
During postoperative care for THR, how is pain generally managed?
What is the primary benefit of preoperative exercises prescribed by a physical therapist?
What is the primary benefit of preoperative exercises prescribed by a physical therapist?
What was a significant benefit for the patient having a former ortho nurse as a spouse?
What was a significant benefit for the patient having a former ortho nurse as a spouse?
What does the term 'replantation' imply in surgical terminology?
What does the term 'replantation' imply in surgical terminology?
What are the prosthetic components of a total hip replacement typically made of?
What are the prosthetic components of a total hip replacement typically made of?
Why is it advised not to shave the skin before THR surgery?
Why is it advised not to shave the skin before THR surgery?
What risk is significantly higher in patients with diabetes regarding amputations?
What risk is significantly higher in patients with diabetes regarding amputations?
What should be avoided to minimize the risk of hip dislocation after surgery?
What should be avoided to minimize the risk of hip dislocation after surgery?
Flashcards
Strain
Strain
A soft tissue injury from excessive stretching of muscle or tendon.
Causes of Strains
Causes of Strains
Strains can occur due to falls, excessive exercise, or lifting heavy items.
Mild Strain
Mild Strain
Minimal inflammation, swelling, and tenderness occurs in a mild strain.
Moderate Strain
Moderate Strain
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Severe Strain
Severe Strain
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RICE Protocol
RICE Protocol
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Sprain
Sprain
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Dislocation
Dislocation
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Buck traction
Buck traction
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Skeletal traction
Skeletal traction
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Extremity skeletal traction
Extremity skeletal traction
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Urgent management of fractures
Urgent management of fractures
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Immobilization
Immobilization
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Neurovascular checks
Neurovascular checks
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Cast tightness
Cast tightness
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Fiberglass casts
Fiberglass casts
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Plaster casts
Plaster casts
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Reducing swelling
Reducing swelling
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Open reduction
Open reduction
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Internal fixation
Internal fixation
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External fixation
External fixation
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Elevating extremity
Elevating extremity
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Monitoring cast integrity
Monitoring cast integrity
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Open Fracture
Open Fracture
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Signs of Hairline Fracture
Signs of Hairline Fracture
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Hip Fracture Symptoms
Hip Fracture Symptoms
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Deformity and Shortening
Deformity and Shortening
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Crepitation
Crepitation
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Open vs Closed Fracture
Open vs Closed Fracture
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Types of Fractures
Types of Fractures
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Comminuted Fracture
Comminuted Fracture
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Greenstick Fracture
Greenstick Fracture
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Closed Reduction
Closed Reduction
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Importance of Splints
Importance of Splints
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Complications of Tight Cast
Complications of Tight Cast
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Traction in Fractures
Traction in Fractures
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Diagnostic Tests for Fractures
Diagnostic Tests for Fractures
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Emergency Treatment Basics
Emergency Treatment Basics
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Femoral Neck Fracture
Femoral Neck Fracture
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Infection Risk
Infection Risk
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Impaired Physical Mobility
Impaired Physical Mobility
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Neurovascular Status
Neurovascular Status
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Acute Compartment Syndrome
Acute Compartment Syndrome
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Osteomyelitis
Osteomyelitis
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Deep Vein Thrombosis (DVT)
Deep Vein Thrombosis (DVT)
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Malunion
Malunion
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Nonunion
Nonunion
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Pin-site Care
Pin-site Care
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Physiotherapy Education
Physiotherapy Education
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Traction
Traction
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Wound Monitoring
Wound Monitoring
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Critical Thinking in Nursing
Critical Thinking in Nursing
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Patient Handling
Patient Handling
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Bursitis
Bursitis
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Bursa Function
Bursa Function
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Symptoms of Bursitis
Symptoms of Bursitis
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Rotator Cuff
Rotator Cuff
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Chronic Impingement Syndrome
Chronic Impingement Syndrome
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Rotator Cuff Injury Symptoms
Rotator Cuff Injury Symptoms
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Carpal Tunnel Syndrome
Carpal Tunnel Syndrome
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Phalen Test
Phalen Test
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Fracture Basics
Fracture Basics
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Bone Healing Process
Bone Healing Process
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Complete Fracture
Complete Fracture
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Pathological Fracture
Pathological Fracture
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Osteoporosis
Osteoporosis
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Patient Mobility Promotion
Patient Mobility Promotion
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Pain Management Before Mobility
Pain Management Before Mobility
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Independence in Mobility
Independence in Mobility
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Active Range-of-Motion Exercises
Active Range-of-Motion Exercises
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Chair Height Adjustment
Chair Height Adjustment
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Peripheral Neurovascular Dysfunction
Peripheral Neurovascular Dysfunction
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Complications Monitoring
Complications Monitoring
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Cold Therapy Use
Cold Therapy Use
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Cast Care Teaching
Cast Care Teaching
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Signs of Infection
Signs of Infection
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Nutritional Needs for Healing
Nutritional Needs for Healing
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Pain Assessment Tools
Pain Assessment Tools
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Pathophysiology of Osteomyelitis
Pathophysiology of Osteomyelitis
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Signs of Acute Osteomyelitis
Signs of Acute Osteomyelitis
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Osteomyelitis Treatment Options
Osteomyelitis Treatment Options
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Early Symptoms of Compartment Syndrome
Early Symptoms of Compartment Syndrome
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Six Ps of Compartment Syndrome
Six Ps of Compartment Syndrome
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Paresthesia
Paresthesia
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Fasciotomy
Fasciotomy
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Rhabdomyolysis
Rhabdomyolysis
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Fat Embolism Syndrome
Fat Embolism Syndrome
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Pulmonary Dysfunction
Pulmonary Dysfunction
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Signs of Fat Embolism
Signs of Fat Embolism
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Patient with Femur Fracture
Patient with Femur Fracture
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Management of Acute Compartment Syndrome
Management of Acute Compartment Syndrome
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Respiratory Failure
Respiratory Failure
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Neurovascular Monitoring
Neurovascular Monitoring
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Signs Prior to Necrosis
Signs Prior to Necrosis
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Symptoms of RA
Symptoms of RA
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Joint deformities
Joint deformities
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Diagnostic tests for RA
Diagnostic tests for RA
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ESR test
ESR test
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Disease-modifying antirheumatic drugs (DMARDs)
Disease-modifying antirheumatic drugs (DMARDs)
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Role of NSAIDs in RA
Role of NSAIDs in RA
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Thermal therapy
Thermal therapy
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Importance of rest and exercise
Importance of rest and exercise
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Occupational therapy in RA
Occupational therapy in RA
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Inflammatory synovial fluid
Inflammatory synovial fluid
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Patient education for RA
Patient education for RA
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Assessment of fatigue
Assessment of fatigue
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Community resources for RA
Community resources for RA
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Need for disability benefits
Need for disability benefits
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Surgical intervention in RA
Surgical intervention in RA
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Bone Mineral Density Testing
Bone Mineral Density Testing
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Antiresorptive Medications
Antiresorptive Medications
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Calcium Supplements
Calcium Supplements
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Vitamin D's Role
Vitamin D's Role
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Bisphosphonates
Bisphosphonates
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Teriparatide
Teriparatide
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Fall Prevention
Fall Prevention
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Hazard-Free Environment
Hazard-Free Environment
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Paget Disease
Paget Disease
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Symptoms of Malignant Bone Tumors
Symptoms of Malignant Bone Tumors
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Calcitonin
Calcitonin
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Weight-Bearing Exercise
Weight-Bearing Exercise
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SERM Medications
SERM Medications
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Osteonecrosis of the Jaw
Osteonecrosis of the Jaw
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Symptoms of Bone Cancer
Symptoms of Bone Cancer
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Bone-Seeking Cancers
Bone-Seeking Cancers
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Metastasis in Bones
Metastasis in Bones
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Primary Bone Tumors Treatment
Primary Bone Tumors Treatment
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Osteosarcoma
Osteosarcoma
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Signs of Gout
Signs of Gout
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Primary Gout Cause
Primary Gout Cause
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Diagnostic Tests for Gout
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Osteoarthritis Risk Factors
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Treatment for Gout Attacks
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Uric Acid and Dehydration
Uric Acid and Dehydration
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Signs of Chronic Gout
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Hyperuricemia Definition
Hyperuricemia Definition
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Nursing Care for Bone Cancer
Nursing Care for Bone Cancer
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Cherries and Gout Prevention
Cherries and Gout Prevention
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Functional Joint Position
Functional Joint Position
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Weight Control in OA
Weight Control in OA
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NSAIDs
NSAIDs
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Common NSAID Side Effects
Common NSAID Side Effects
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Heat Therapy for OA
Heat Therapy for OA
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Cold Therapy for OA
Cold Therapy for OA
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Complementary Therapies
Complementary Therapies
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Total Joint Replacement
Total Joint Replacement
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Corticosteroids
Corticosteroids
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Acetaminophen Usage
Acetaminophen Usage
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Synvisc-One Injection
Synvisc-One Injection
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Pain Management Strategies
Pain Management Strategies
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Monitoring for NSAID Risks
Monitoring for NSAID Risks
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Patient Data Collection
Patient Data Collection
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Infection Monitoring with Corticosteroids
Infection Monitoring with Corticosteroids
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Amputation
Amputation
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Home Health Nurse Roles
Home Health Nurse Roles
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Common Fracture Sites
Common Fracture Sites
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Aging and Osteoporosis
Aging and Osteoporosis
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Bone Remodeling Process
Bone Remodeling Process
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Risk Factors for Osteoporosis
Risk Factors for Osteoporosis
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Modifiable Risk Factors
Modifiable Risk Factors
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Peak Bone Density
Peak Bone Density
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Calcium Requirements
Calcium Requirements
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Signs of Osteoporosis
Signs of Osteoporosis
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DEXA Scan
DEXA Scan
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Vertebral Compression Fracture
Vertebral Compression Fracture
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Emotional Effects of Osteoporosis
Emotional Effects of Osteoporosis
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Preventive Measures
Preventive Measures
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Hyperflexion Prevention
Hyperflexion Prevention
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Skin Breakdown Prevention
Skin Breakdown Prevention
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Temperature Monitoring in Older Patients
Temperature Monitoring in Older Patients
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DVT Risk Assessment
DVT Risk Assessment
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Patient Education After THR
Patient Education After THR
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Use of Compression Stockings
Use of Compression Stockings
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Postoperative Blood Loss Monitoring
Postoperative Blood Loss Monitoring
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Routine Home Safety Measures
Routine Home Safety Measures
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Autotransfusion in Surgery
Autotransfusion in Surgery
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Importance of Early Ambulation
Importance of Early Ambulation
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Medication Administration Tips
Medication Administration Tips
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In-home Physical Therapy
In-home Physical Therapy
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Activity Intolerance
Activity Intolerance
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ADLs
ADLs
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Pain Management
Pain Management
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Self-Care Deficit
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Degenerative Joint Disease
Degenerative Joint Disease
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Body Image
Body Image
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Chronic Sorrow
Chronic Sorrow
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Interdisciplinary Collaboration
Interdisciplinary Collaboration
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Assistive Devices
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Rheumatoid Arthritis
Rheumatoid Arthritis
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Synovitis
Synovitis
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Pannus Formation
Pannus Formation
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Morning Stiffness
Morning Stiffness
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Autoimmune Response
Autoimmune Response
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Rheumatoid Factor (RF)
Rheumatoid Factor (RF)
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Total Joint Replacement (TJR)
Total Joint Replacement (TJR)
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Avascular Necrosis
Avascular Necrosis
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Arthroplasty
Arthroplasty
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Total Hip Replacement (THR)
Total Hip Replacement (THR)
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Preoperative Care for THR
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Postoperative Care
Postoperative Care
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Pain Management Techniques
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Hypotension Prevention
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Hip Dislocation
Hip Dislocation
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Subluxation
Subluxation
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Preventing Hip Dislocation
Preventing Hip Dislocation
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Assistive Devices Usage
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Tranexamic Acid
Tranexamic Acid
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Antibiotic Prophylaxis
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Mobility Exercises
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Osteoarthritis
Osteoarthritis
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Pathophysiology of Osteoarthritis
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Etiology of Osteoarthritis
Etiology of Osteoarthritis
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Heberden nodes
Heberden nodes
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Symptoms of Rheumatoid Arthritis
Symptoms of Rheumatoid Arthritis
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Diagnostic Tests for Osteoarthritis
Diagnostic Tests for Osteoarthritis
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Balance of Rest and Exercise
Balance of Rest and Exercise
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Surgical Options in Arthritis Treatment
Surgical Options in Arthritis Treatment
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Primary vs Secondary Osteoarthritis
Primary vs Secondary Osteoarthritis
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Joint Deformity
Joint Deformity
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Signs of Osteoarthritis Progression
Signs of Osteoarthritis Progression
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Hip Surgery Preparation
Hip Surgery Preparation
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Joint Camp
Joint Camp
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Total Knee Replacement Components
Total Knee Replacement Components
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Surgical vs. Traumatic Amputation
Surgical vs. Traumatic Amputation
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Common Reasons for Surgical Amputation
Common Reasons for Surgical Amputation
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Levels of Amputation
Levels of Amputation
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Prosthesis Fitting
Prosthesis Fitting
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Postoperative Care for Amputation Patients
Postoperative Care for Amputation Patients
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Acute Compartment Syndrome Symptoms
Acute Compartment Syndrome Symptoms
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Replantation
Replantation
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Pain Level After Surgery
Pain Level After Surgery
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Mobility Aids After Surgery
Mobility Aids After Surgery
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Healing Process Timeline
Healing Process Timeline
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Study Notes
Soft Tissue Injuries
- Strains: Excessive stretching of muscle or tendons. Causes include falls, overexertion, and heavy lifting.
- Mild Strain: Minimal inflammation, with swelling and tenderness.
- Moderate Strain: Partial tearing of muscle/tendon fibers, causing pain and limited movement.
- Severe Strain: Complete rupture of muscle/tendon, separating muscle from muscle, tendon from muscle, or tendon from bone. Causes severe pain and disability.
- RICE Therapy: Rest, Ice, Compression, Elevation. Crucial for strain and sprain injuries immediately after injury.
- Rest: Protects the injured area.
- Ice: Applied 15-20 minutes, four times daily, to reduce swelling and pain.
- Compression: Elastic bandage applied to support and reduce swelling.
- Elevation: Raises the injured area (if possible) to reduce swelling.
- Post-Swelling Treatment: Apply heat (15-30 minutes, four times daily), increasing blood flow for healing.
- Medication: NSAIDs and muscle relaxants may be prescribed to manage pain and inflammation. Surgical repair may be needed for severe cases.
Sprains
- Sprains: Excessive stretching of ligaments from twisting movements (sports, exercise, falls).
- Mild Sprain: Few ligament fibers torn, causing tenderness. Treated with RICE and NSAIDs.
- Moderate Sprain: More ligament fibers torn, but the joint remains stable. May need braces or casts for immobilization. Uncomfortable, especially during activity.
- Severe Sprain: Instability of the joint, usually requiring surgical repair or grafting. Pain and swelling limit movement.
Dislocations
- Dislocations: Injury where bones of a joint are moved out of normal position, often due to trauma or disease (e.g., rheumatoid arthritis).
- Symptoms: Severe pain, reduced range of motion, and deformity of the joint.
- Treatment: Immobilize the joint, apply ice, and seek immediate medical attention to preserve function. Avoid moving the affected joint.
Bursitis
- Bursae: Fluid-filled sacs cushioning tendons during movement. Common in shoulder, elbow, hip, knee, ankle, and heel.
- Bursitis: Inflammation of a bursa.
- Causes: Arthritis, gout, repetitive movements, infections, or sleeping positions (e.g., shoulder compression).
- Prevention: Strategic stretching, frequent movement, avoiding repetitive motions, cushioned seating, and avoiding leaning on elbows can help.
- Symptoms: Achy pain, stiffness, swelling, redness, or burning pain over the joint area. Worsens with activity; usually subsides in a week.
- Treatment: Rest, ice (until warmth decreases), then heat. Elevation, ultrasound, massage, NSAIDs, antibiotics (if infection), physical therapy are possible.
Rotator Cuff Injury
- Rotator Cuff: Short tendons connected to muscles around the shoulder, covering its top, front, and back. Muscle contraction moves or rotates the shoulder.
- Chronic Impingement Syndrome: Top tendon (supraspinatus) and bursae become impinged under the acromion bone. Causes inflammation with repeated arm movements, leading to pain, and potential tendon tears.
- Symptoms: Shoulder ache, increased pain with lifting, night pain, weakness, limited range of motion.
- Diagnosis: MRI.
- Treatment: (Minor): Rest, ice, NSAIDs, physical therapy. (Severe): Arthroscopic surgery to relieve impingement or repair tears.
Carpal Tunnel Syndrome
- Cause: Median nerve compression within the carpal tunnel, due to swelling from edema, trauma, rheumatoid arthritis, or repetitive hand movements.
- Symptoms: Slow-onset finger, hand, and arm pain/numbness, painful tingling, paresthesia, and eventual fine motor deficits and then muscle weakness.
- Diagnosis: Signs and symptoms, patient history, positive Phalen test (numbness with wrist flexion), electromyography (EMG).
- Treatment: Initially, wrist splinting, rest. NSAIDs or cortisone injection to reduce inflammation, followed by endoscopic or open surgery (nerve release) if needed.
- Post-Surgery Care: Elevate hand, follow splinting instructions, limit lifting for several weeks, monitor for neurovascular compromise (numbness, tingling, coolness, lack of pulse, pale skin/nails, limited movement). Physical therapy for recovery.
Fractures
- Fracture: Break in a bone (can be minor or complex).
- Causes: Falls, accidents, crushing injuries, bone diseases (like osteoporosis or metastatic cancer), malnutrition, or medication side effects.
- Types: Various types exist (i.e., complete, incomplete, displaced, closed, open, spiral, oblique, transverse, etc). See table for descriptions.
- Symptoms: Pain (especially with movement), limb shortening (complete fracture), limb rotation/deformity, crepitation (bone grating sound).
- Skin Inspection: Check for intactness. Open fractures expose bone – wounds are a concern. Closed fractures may have bruising (ecchymosis) and swelling. Swelling impairs blood flow.
- Diagnostic Tests: X-rays, CT scans, MRIs. Serum calcium level, hemoglobin/hematocrit (with significant bleeding).
- Emergency Treatment: Immobilize the limb as found. Do not attempt to reposition. Splint above and below the fracture site, keep patient warm. Transport to hospital as soon as possible.
Fracture Management
- Goals: Reduce bone ends to correct alignment, immobilize the bone, preserve/restore soft tissue structures, prevent deformity, restore function, promote early healing and pain relief.
- Closed Reduction: Most common for simple fractures. Bone ends are manually realigned, x-rayed for confirmation, then immobilized with a splint or cast.
- Splints: Provide support during the healing phase, used for wound care or to accommodate possible swelling. Neurovascular checks are crucial hourly.
- Casts: More supporting than splints, made of plaster or fiberglass. Plaster takes 24-72 hours to dry; fiberglass hardens quickly. Monitor closely for tightness (compartment syndrome risk.) If cast becomes too tight, it needs bivalving/windowing under medical order.
- Traction: Applying pulling force to align bone. Primarily temporary with advances in orthopaedic surgery. Buck traction (skin) or skeletal traction (pins/wires).
- Open Reduction with Internal Fixation: Bone ends are surgically realigned & fixed with plates/screws (or prosthesis) for fracture healing in the hip, ankle, or long bones.
- External Fixation: Used for severe bone damage (crushed, splintered fractures). Pins inserted & held by an external frame to stabilize bone during healing.
Complications of Fractures
- Neurovascular Status: Monitor pulses, skin temperature, sensation, and movement—report immediately any abnormalities.
- Hemorrhage: Monitor for significant bleeding and vital signs; report any issues.
- Infection: Monitor for signs (e.g., odor, warmth, redness, pain).
- Thromboembolic Complications: Deep vein thrombosis (DVT) or pulmonary embolism (PE) is possible; preventative measures are critical.
- Compartment Syndrome: Increased pressure in limb compartments, reducing circulation; life-threatening. Report increasing pain, not relieved by pain meds, especially with movement. Early signs are critical to report. Possible (late) signs: Pain (severe, & increased with passive stretching), paresthesia (tingling/burning), pallor (with some potential warmth/redness), Paralysis, Pulselessness, Poikilothermia. Immediate treatment by HCP is critical to save the limb.
- Fat Embolism Syndrome: Associated with long-bone fractures (especially femoral shaft); small fat droplets in blood stream travel to lungs, leading to respiratory insufficiency and possible respiratory failure. Monitor for these signs immediately: tachypnea, dyspnea, cyanosis, confusion/drowsiness, rash (red, measles-like), tachycardia, fever, retinal changes.
Osteomyelitis
- Osteomyelitis: Bone infection (acute or chronic).
- Causes: Bacteria enter bone tissue (open fractures, infections spreading from other body sites). Staphylococcus aureus is a common causative agent.
- Symptoms: (Acute): Pain, redness, warmth, swelling, fever. (Chronic): Ulceration, drainage, localized pain.
- Diagnosis: Elevated white blood cell count, elevated ESR, positive bone biopsy. X-rays, CT scans, MRIs. Blood cultures.
Osteoporosis
- Osteoporosis: Metabolic disorder characterized by low bone mass and deterioration of bone structure, increasing fracture risk. Primary (most common) vs. Secondary. Affects spine, wrist, and hip most commonly.
- Prevalence: High rates in the aging U.S. population (especially women).
- Pathophysiology: Imbalance between bone breakdown (osteoclasts) and bone buildup (osteoblasts). Bone density peaks in 30s, breakdown exceeds buildup afterward. Estrogen decrease affects calcium absorption in postmenopausal women.
- Risk Factors: Age, ethnicity (White/Asian), family history, female gender, history of fractures, low testosterone/estrogen in men, postmenopausal status, small body frame. Modifiable: Anorexia, smoking, excessive alcohol, low calcium/vitamin D, excessive caffeine/protein/sodium intake. Sedentary lifestyle.
- Secondary: Associated medical conditions (e.g., hyperparathyroidism, renal dialysis), medications (e.g., steroids, some antiseizure meds, sleeping aids).
- Prevention: Healthy lifestyle (Diet high in calcium & vitamin D, weight-bearing exercise, avoid alcohol/smoking), especially before peak bone density is reached at ~ age 30.
- Symptoms: Height loss (up to 6 inches), kyphosis (spinal curvature). Often a fracture precedes the osteoporosis being diagnosed.
- Diagnosis: DEXA (Dual-energy x-ray absorptiometry) scan. Serum calcium and vitamin D levels, serum phosphorus, alkaline phosphatase.
- Treatment: Medications (supplements, bisphosphonates, calcitonin, denosumab, raloxifene, teriparatide). Maintain healthy diet, exercise, avoid falls.
Paget's Disease
- Paget's Disease: Rare metabolic bone disease. Increased bone breakdown and formation, resulting in weak, deformed, painful bones. Increased risk of fractures and osteoarthritis.
- Signs: Severe bone pain, deformities, fractures.
- Diagnosis: Bone x-rays, increased serum alkaline phosphatase levels.
Bone Cancer
- Bone Tumors: Benign or malignant (primary or metastatic).
- Types: Osteosarcoma, Ewing sarcoma; metastatic cancers (e.g., prostate, breast, lung, thyroid).
- Symptoms: Primary tumors: Pain/swelling at site, palpable mass. Metastatic: Diffuse severe pain, disability.
- Diagnosis: X-rays, CT scans, bone scans, bone biopsy, PET/PET-CT scan, or MRI. Elevated alkaline phosphatase levels.
- Treatment: Surgery (with chemotherapy/radiation), chemotherapy, radiation, amputation in some cases.
Connective Tissue Disorders
Gout
- Gout: Systemic connective tissue disorder caused by uric acid buildup. Primarily affects middle-aged-to-older men.
- Pathophysiology: Uric acid is a waste product. Excess uric acid (hyperuricemia) forms urate crystals in joints & connective tissues, causing inflammation (often resolving without treatment). Tophi (urate deposits) may appear under the skin or in kidneys, causing potential stone (calculi) formation.
- Causes: Primary gout (inherited purine metabolism problem). Secondary gout (caused by other medical issues or medications: renal insufficiency or medications). Acute attacks may be triggered by stress, alcohol, illness, dieting, or certain meds.
- Symptoms: Severe pain/inflammation in one or more joints; often the great toe. Swollen, red, hot, and tender joints. Chronic gout may have no major obvious signs/symptoms.
- Diagnosis: Elevated serum uric acid level; joint fluid aspiration analysis for urate crystals.
- Treatment: NSAIDs, colchicine, steroids (acute). Pegloticase (IV). Uricosuric medications (febuxostat, allopurinol, probenecid) to prevent increased serum uric acid levels. Monitor uric acid levels during treatment.
Osteoarthritis
- Osteoarthritis (OA): Most common type of arthritis, affecting weight-bearing joints, hands, and vertebral column. Primarily affects older patients, especially women. Characterized by gradual degeneration of joint cartilage and bone.
- Pathophysiology: Gradual breakdown of cartilage and bone ends, joint space narrowing, bone spurs, inflamed joint lining.
- Causes: Primary (unknown cause). Secondary OA (trauma, sepsis, congenital conditions, metabolic problems, other arthritic conditions).
- Risk Factors: Heredity, obesity, physical activities stressing joints (e.g., prolonged standing, repetitive motions).
- Symptoms: Joint pain and stiffness, especially upon arising, worsening with activity, and reduced with rest. Heberden and Bouchard nodes (bony nodes affecting finger joints.) Spinal OA results in muscle spasms.
- Diagnosis: X-rays, MRI, synovial fluid analysis.
- Treatment: Symptom management. Medications (NSAIDs, acetaminophen). Exercise (balanced rest). Weight control. Heat/cold therapy. Complementary therapies. Surgery (total joint replacement).
Rheumatoid Arthritis
- Rheumatoid Arthritis (RA): Chronic, progressive, systemic inflammatory disease damaging synovial joints and other connective tissues.
- Pathophysiology: Inflammation of synovium (joint lining) caused by inflammatory cells and chemicals. Thickening of synovium, fluid accumulation, destructive pannus formation (eroding cartilage and destroying bone). The disease can affect various systems of the body (blood vessels, nerves, organs etc.) and can be life-threatening.
- Causes: Autoimmune response (unclear). Risk factors: family history, infection link.
- Symptoms: Typically bilateral and symmetrical joint inflammation. Often begins in upper extremities. Morning stiffness lasting >1 hr. Fatigue, weakness, anorexia. Late-stage RA involves major organ issues potentially resulting in significant disability.
- Diagnosis: Elevated white blood cell/platelet counts, presence/absence of rheumatoid factor (RF), decreased red blood cells, etc. ESR, antinuclear antibody test, C-reactive protein. X-rays, MRI, synovial fluid analysis.
- Treatment: Disease-modifying antirheumatic drugs (DMARDs). NSAIDs, corticosteroids. Heat/cold therapy. Complementary therapies (e.g., capsaicin, vitamin C/E). Joint replacement surgery
Musculoskeletal Surgery
Total Joint Replacement
- Total Joint Replacement (TJR): Often performed for severely deteriorated joints from connective tissue disorders, cancer, trauma, or long-term steroid use. Common: hip and knee.
- Components: Ceramic, polyethylene, or metal. Most are cementless (bone-grafting). Cemented for those with poor bone health.
- Procedures: Total hip (acetabular cup, femoral stem/head). Total Knee (femoral, tibial, patellar components.)
- Post-op Complications: Hip dislocation (posterior/anterior-lateral approach), skin breakdown, infection, bleeding, neurovascular compromise, and thromboembolic complications (e.g., DVT).
Amputation
- Amputation: Removal of a body part (finger, lower or upper extremity, significant portion of limb etc.) due to chronic disease (e.g., ischemia in patients with peripheral vascular disease), trauma/injury, bone tumors, infection, or thermal injury).
- Levels of Amputation: Various levels (great toe, below-knee, above-knee, disarticulation, hemipelvectomy). Higher levels have increased disability.
- Preoperative Care: Prosthesis fitting, grieving, psychological/emotional support.
- Postoperative & Rehabilitative Care: Frequent neurovascular checks.
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