MDC1 EXAM 2 YOUTUBE NOTES

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Questions and Answers

What is paraplegia?

Complete loss of muscle tone in all limbs

Paralysis of the upper body including arms

Loss of sensation in the lower extremities

Paralysis affecting the lower trunk and both legs (correct)

What is a negative effect of immobility?

Improved skin integrity

Promotes venous stasis (correct)

Enhanced muscle tone

Increased mental stimulation

Which type of exercise involves muscle contraction without movement?

Isotonic exercise

Isometric exercise (correct)

Aerobic exercise

Isokinetic exercise

What are modifiable risk factors of osteoporosis?

Chronic low calcium intake Signup and view all the answers

Which condition is often associated with osteoporosis?

Kyphosis Signup and view all the answers

What best describes aerobic exercise?

Uses larger muscle groups and requires oxygen for energy Signup and view all the answers

What is a bunionectomy?

Surgery to remove a bunion Signup and view all the answers

Which of the following statements about fluidity is true?

It indicates a decrease in muscle tone Signup and view all the answers

What is the primary purpose of gonioscopy?

To determine the type of glaucoma Signup and view all the answers

Which of the following actions is not necessary when administering eye drops?

Rub the eye after instilling drops Signup and view all the answers

What should be done first when there is an absent pulse but the area is warm with good capillary refill?

Reassess with a lighter touch Signup and view all the answers

Which of the following is a classic symptom of Meniere's disease?

Episodic vertigo Signup and view all the answers

What is the recommended method to assess capillary refill?

Briefly press the tip of the nail with firm pressure Signup and view all the answers

In the context of osteomyelitis, which of the following is an important aspect of treatment?

IV antibiotics for 4 to 6 weeks Signup and view all the answers

What action should be taken for a patient experiencing post-op hypothermia?

Administer warming blankets Signup and view all the answers

Which of the following factors does not contribute to increased intraocular pressure?

Consumption of high-fat foods Signup and view all the answers

What is the significance of ESR in a clinical setting?

Reflects soft tissue damage Signup and view all the answers

What is a common complication of a continuous nerve block?

Decreased respirations Signup and view all the answers

What is the primary purpose of kyphoplasty?

To treat vertebral compression fractures Signup and view all the answers

What is osteosarcoma primarily associated with?

Bone cancer originating in osteoblasts Signup and view all the answers

What is the primary treatment intervention for carpal tunnel syndrome?

Transverse carpal ligament release Signup and view all the answers

Which of the following is a common sign of deep vein thrombosis (DVT)?

Warmth and redness in the leg Signup and view all the answers

What is the most accurate method for assessing bone quality?

MRI Signup and view all the answers

How should plantar fasciitis be treated?

Ice and NSAIDs Signup and view all the answers

Which condition is characterized by the fusion of one or more fingers?

Syndactylism Signup and view all the answers

What is the recommended nutritional intervention for individuals with low appetite?

Increase eating frequency Signup and view all the answers

Which of the following best defines self-care deficit in patients?

Inability to perform daily functions related to health Signup and view all the answers

What is the definition of phantom pain?

Pain felt in a missing limb after amputation Signup and view all the answers

What characterizes the late symptoms of a fracture?

Tenderness, swelling, and deep bone pain Signup and view all the answers

Which condition is primarily treated with anti-embolism stockings?

Deep vein thrombosis Signup and view all the answers

What is the main role of the manual muscle testing (MMT)?

To assess muscle strength Signup and view all the answers

What is a key characteristic of a fat embolism syndrome (FES)?

Release of fat globules into blood vessels Signup and view all the answers

What is the correct process for taking bisphosphonates?

On an empty stomach Signup and view all the answers

What indicates a need to resume bisphosphonates after the initial 3 years?

A DEXA scan shows maintenance or improvement Signup and view all the answers

Which is true about neuropathic pain?

It occurs when a health condition affects nerve sensations. Signup and view all the answers

How can a healthcare provider determine if a client is ready to ambulate?

By ensuring they have active range of motion in all extremities Signup and view all the answers

Which statement accurately describes a rib fracture?

Deep breaths can worsen the pain. Signup and view all the answers

What is considered a mechanical restraint?

A cloth vest or side rails on a bed Signup and view all the answers

Which injury is related to the tympanic membrane?

Conductive hearing loss Signup and view all the answers

What is a hallmark symptom of Meniere's disease?

Tinnitus and vertigo Signup and view all the answers

Which of the following is NOT a component of body mechanics?

Emotional stability Signup and view all the answers

What is the typical dosage conversion for milliliters to ounces?

$30 ext{ ml} = 1 ext{ ounce}$ Signup and view all the answers

What is classified as an emergent situation regarding nerve damage?

Loss of feeling in hands or fingers Signup and view all the answers

Which vitamin levels are considered normal?

Serum calcium levels of 9.0 to 10.5 Signup and view all the answers

What is the effect of obesity on the musculoskeletal system?

It places excess stress on joints and bones. Signup and view all the answers

Which of the following describes presbycusis?

Progressive sensorineural loss associated with aging Signup and view all the answers

Study Notes

Paraplegia & Fluidity

Paraplegia: paralysis of the lower trunk and legs.
Fluidity: reduced or absent muscle tone, often following cast removal.

Helix Valgus Deformity & Bunionectomy

Helix valgus: lateral shift of the big toe at the metatarsal joint, bunion formation.
Bunionectomy: 6-12 weeks non-weight-bearing recovery, use a foot elevation pillow.
Immobility complications: venous stasis, skin breakdown, muscle discomfort, and contractures. Increased oxygen demand, altered self-concept, withdrawal, sleep disturbances, and passivity are also possible.

Psychosocial Aspects of Immobility

Encourage visitors, pet therapy, and mentally stimulating activities.

Effects of Exercise on Systems

Isometric: muscle contraction without movement (bedridden patients).
Isotonic: joint movement with muscle contraction (e.g., weights, push-ups).
Isokinetic: variable resistance with specialized equipment (physical therapy).
Aerobic: oxygen-dependent energy use with large muscle groups (e.g., jogging, cycling).
Anaerobic: oxygen-independent energy use (e.g., heavy lifting, sprinting).

Exercise & Independence

Exercise maintains strength and independence.

Osteoporosis

Cause: Changes in calcium metabolism leading to potential kidney stones. Decreased bone mass due to factors like calcium/estrogen/testosterone deficiency, nutritional deficiencies, or others. Kyphosis is common.
Non-modifiable risk factors: older age (men and women), family history, low-trauma fractures after 50, ethnicity (e.g., Caucasian, Asian), eating disorders.
Modifiable risk factors: low body weight, chronic calcium/vitamin D deficiency, hormone deficiency, smoking, excessive alcohol consumption (≥3 drinks/day), lack of exercise/prolonged immobility.
Treatment: estrogen antagonists to mimic/block estrogen effects.

Range of Motion (ROM)

PROM: passive range of motion (dependent, assisted movement).
AROM: active range of motion (independent movement).

Kyphoplasty & Vertebral Plasty

Kyphoplasty: minimally invasive procedure to restore vertebral height by inflating a balloon.
Vertebral plasty: bone cement injected directly into the fracture site.

Osteosarcoma

Bone cancer originating in osteoblast cells.
Primary: originates in the bone.
Secondary: originates outside the bone.

Carpal Tunnel Syndrome

Neurological disorder: median nerve compression at the wrist.
Common in rheumatoid arthritis and diabetes patients.
Diagnosis: Phalen maneuver and Tinel's sign.
Treatment: transverse carpal ligament release (surgery).

Imaging Tests

Ultrasound: uses sound waves to create images of internal structures.
MRI: most accurate for bone quality assessment.

Medications for Osteoporosis

Reclast: increases bone density, reduces reabsorption, and lowers fracture risk (not for women with thromboembolism history).

Syndactylism & Atelectasis

Syndactylism: fused fingers.
Atelectasis: diminished breath sounds; orthopneic position prevents this.

Ischial Tuberosities & Plantar Fasciitis

Ischial tuberosities: common site of breakdown in wheelchair users.
Plantar fasciitis: inflammation of the plantar fascia; treat with ice and NSAIDs, supportive shoes, instead of heat.

Joint Movements

Joint extension: strengthening a hinge joint to 180°.
Adduction: lateral movement towards the body midline.
Flexion: moving the head to the chest.

Fracture Symptoms & Treatment

Late fracture symptoms: tenderness, swelling, deep aching pain, inability to bear weight.
Treatment focuses on healing and pain management.

Increasing Appetite

Strategies for increased appetite: rest, light exercise before meals, enjoyable foods/aroma, pre-planned meals, hydration, frequent meals/snacks.

Anti-Embolism Stockings & DVT

TED hose: compression stockings to improve circulation and prevent DVT.
DVT signs: pain, redness, swelling, tenderness, extremity swelling.

Osteogenesis Imperfecta (OI)

Brittle bones that fracture easily.
Treatment: bag baths, no-rinse pH-balanced cleanser, avoid soap, moisturize, clean immediately after soiling.

Gas Exchange Improvement

Upright posture/elevated bed head: optimizes lung expansion and ventilation, improving gas exchange.

Self-Care Deficit & Neuromuscular Assessment

Self-care deficit: inability to perform ADLs (activities of daily living).
Neuromuscular assessment: the 5 P's (pain, pallor, paresthesia, paralysis, pulselessness).

Pre-Transfer Client Assessment

Pre-transfer assessment of client is crucial.

Nutrition & Strength Assessment

Importance of nutrition.
Manual muscle testing (MMT).

Additional Conditions & Treatments

Abduction pillow: prevents total hip joint dislocation.
COPD & activity intolerance: potential nursing diagnosis for COPD patients with reduced mobility.
Chest pain assessment: palpate chest wall to rule out muscular pain.
ORIF (Open Reduction Internal Fixation): surgical stabilization of fractured bones (e.g., screws, plates). Hip fractures are common in older adults (osteoporosis is a major risk factor).
Fat Embolism Syndrome (FES): fat globules released into blood vessels after fracture (common in hip/pelvis fractures); symptoms include hypoxemia and respiratory distress followed by headache, lethargy, agitation, seizures, and rash.
Phantom pain: pain in an amputated limb. Somatic pain: deep/superficial bone/tendon/muscle pain (e.g., aching, cramping). Neuropathic pain: nerves affected, pain signals to the brain.
Bisphosphonates: for osteoporosis, taken on an empty stomach, 3 years, repeat DEXA scan in 2-3 years (empty stomach). Dual-Energy X-Ray Absorptiometry (DEXA scan) is used to diagnose osteoporosis.
RICE treatment: Rest, Ice, Compression, Elevation.
Ambulation readiness: assessment of active ROM in all extremities. Clarify unclear orders.
Occupational therapist: for patients with mental, physical, developmental, or emotional disabilities; assists with daily living/working skills.
Rib fracture symptoms: severe pain, worsened by deep breaths, can impede breathing. Airway assessment.

Cast Care

Keep cast clean and dry; cover with plastic before bathing. Do not insert anything into the cast.

Body Mechanics

Body mechanics: coordination between musculoskeletal/nervous systems; involves alignment, balance, coordination, and joint mobility.

Normal Lab Values

Serum calcium: 9.0-10.5.
Vitamin D: 25-80.
Strain: injury to a muscle/tendon.
Sprain: injury to a ligament.
Exercise: any physical activity that burns calories.

Cultural Variations & Cell Production

Amish: higher prevalence of dwarfism.
Red blood cell creator: red bone marrow.

Ganglion Aspiration

Ganglion cyst fluid removal with a needle; emergent if nerve damage is suspected.

Dosage Conversions

Kilograms to pounds: multiply by 2.2.
Milliliters to ounces: 30 mL = 1 ounce.
Micrograms to milligrams: 1000 mcg = 1 mg.
Tablespoons to milliliters: varies, but often 15 mL per tablespoon.

Eye Conditions

Trauma to the eye leads to cataracts.
Conductive hearing loss: tympanic membrane/Eustachian tubes/ossicles damage; often due to otitis media (ear infections).
Sensorineural hearing loss: damage to inner ear/auditory nerve (e.g., noise exposure).
Otitis media: ear infection; conductive hearing loss; common in children; purulent exudate.
Myringotomy: surgery to insert tubes for drainage.
External otitis media: lymph node involvement; worsening infection sign.
Therapeutic communication: open-ended questions encourage elaboration; closed-ended questions require no explanation.
Hearing-impaired patient interaction: face the client, allow for lip reading.

Restraints

Mechanical restraints: cloth vests, side rails.
Chemical restraints: sedatives, psychotropics to control behavior.

Foreign Body in Ear

Mineral oil for treatment.

Meniere's Disease

Meniere's: fluid buildup in inner ear; symptoms: tinnitus, vertigo.
Non-pharmacological interventions: avoiding activities worsening vertigo (stairs, ladders), slow head movements.
Pharmacological interventions: diuretics, antiemetics to manage symptoms.

Presbycusis

Presbycusis: progressive sensorineural hearing loss in older adults; reduced high-frequency hearing, difficulty in noisy environments.

Vision Conditions

Myopia: nearsightedness.
Hyperopia: farsightedness.
Glaucoma (angle-closure): emergency; increased intraocular pressure; peripheral vision loss or blindness; common type is open-angle glaucoma.
Gonioscopy: visualization to determine glaucoma type (open or closed angle).
Intraocular pressure increase: retina blood vessel and photoreceptor compression leads to tissue hypoxia and vision loss.

Eye Drop Administration & Irrigation

Eye drop administration: tilt back head, pull lower lid down, administer into conjunctival sac, apply pressure to tear duct afterwards.
Ocular irrigation: pour/syringe fluid from ≈5cm distance, assessing upper conjunctiva including under eyelids.

Opioid Effects & Prevention

Opioid effects: pneumonia risk, constipation, drowsiness, nausea, slow breathing.
Constipation prevention: fluids, fiber, movement.

Dressing Changes & Calcium Supplements

Wound dressing with drainage: reinforce and assess skin for padding needs.
Calcium supplements: discuss options with the provider.

Normal Lab Values (continued)

Hematocrit: 43-49% males; 38-44% females. Hemoglobin: 13.2-17.3 males; 11.7-15.5 females. Platelet count: 150,000-400,000. Minimum urine output: 30 mL/hour.

Fracture Assessment & Care

ESR (Erythrocyte Sedimentation Rate): reflects soft tissue damage (x-ray does not show soft tissue damage).
Hematocrit/hemoglobin check for femur fractures.
Spinal anesthesia numbness: 20 hours.
Absent pulse but warm, good capillary refill: reassess with gentle touch.
Capillary refill: less than 2-3 seconds normal.

Pain Assessment

Pain assessment: type, quality, radiation, impact on ADLs, effect of posture/movement.

Meniere's Disease (continued)

Classic symptoms: episodic vertigo, tinnitus, hearing loss; typically ages 20-60; episodes lasting days or persistent, varying intensity.

Continuous Nerve Block Complications

Continuous nerve block complications: metallic taste, tinnitus, nervousness, slurred speech, bradycardia, hypotension, decreased respirations, seizures.

Fracture Complications & Shock

Assess for hemorrhagic shock in patients with fractures.
RICE for musculoskeletal inflammation.
Assess pulse before assessing numbness in crushing injuries
Hypothermia treatment: blankets for post-operative hypothermia.

CNA Assessments

CNA cannot EAT (Evaluate, Assess, Treat)

Pelvic Fracture Complications

Pelvic fracture complication: hematuria (bladder puncture risk), hypovolemic shock.

Osteomyelitis

Osteomyelitis: antibiotics (teach side effects/infection control); elevated WBCs, edema, warmth, fever, pain; 4-6 weeks of IV antibiotics; irrigate surgical wound; hyperbaric chamber; possible amputation.

Hospital Acquired Infections (HAIs)

Hospital Acquired Infections: prevent them

Arthroscopy

Arthroscopy: tube for direct visualization; requires joint mobility.

Nursing Process

Nursing Process: problem-solving method for nursing care.

Complex Regional Pain Syndrome (CRPS)

Reflex sympathetic dystrophy: dysfunction of central and peripheral nervous systems.

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Description

Explore the intricate relationship between physical rehabilitation techniques, such as isometric and isotonic exercises, and the psychosocial effects of immobility and recovery. This quiz covers conditions like paraplegia and helix valgus, along with therapeutic strategies, and highlights the importance of psychosocial support in the healing process.