Ortho certification
What is a major difference between osteo and rheumatoid arthritis
Osteoarthritis is local versus systemic
Which test is used for diagnosing osteoarthritis
X-rays
Which describes joint crepitation
Grating sound
What is a presenting symptom of hip osteoarthritis
Groin pain
What is a Herberdens node
Osteophyte formation
Which of the following is often found in degenerative disc disease
A normal physical exam
Mrs. Rockwood is having more and more problems with her osteoarthritis her right shoulder and back have been really bothering her she enjoys housekeeping and takes pride in her clean house and is having difficulty getting it accomplished what would you suggest
Space the cleaning out throughout the week cleaning one room Per day
Mrs. Rockford is prescribed physical and occupational therapy is to help with her pain. What information should the nurse include in teaching?
Take oral pain medication 45 minutes before your therapy session
What is a management goal of osteoarthritis
Maintain joint function and mobility
What is an advantage of NSAIDS WITH COX2 selectivity
Les G.I. toxicity
Mrs. Myers a 57-year-old factory worker comes to the clinic complaining of right shoulder pain for two days. Denies trauma. Start of the day after she cleaned the kitchen cabinets. I sees her left hand to come her hair because of her pain. More bothersome at night and has had to sleep in a recliner for comfort. She's on Synthroid and has been on estrogen replacement for five years. She is prescribed NSAIDS what shows understanding
I should take it with food
An MRI is ordered what should be included in pretest teaching
Remove all jewelry
An MRI shows osteoarthritis and right shoulder what might be expected method of treatment
Heat or ice
If surgery becomes an indication for a shoulder what would be a treatment goal
Improvement of function
What is a surgical procedure for shoulder arthritis
Hemi arthroplasty
What is a consideration of a complication of Osteoarthritis
Loss of joint function
Mr. Baldwin has severe left shoulder arthritis related to repetitive heavy lifting at work. He wants conservative treatment not surgery. What is a likely treatment option for Mr. Baldwin
Corticosteroid injections
Which of the following will Mr. Baldwin likely need since is left is his dominant arm
Therapy
Mrs. Ray is a 62-year-old female admitted post shoulder arthroplasty the nurse is assisting her and placement of the sling how should the abduction sling be applied
Across the hips and slightly forward
How long should someone wear a sling after post shoulder arthroplasty
4 to 6 weeks
What is a safety issue for those with upper extremity surgery
Ambulation. Because of balance
Following a shoulder arthroplasty what can one accomplish with occupational therapy
ADLs
After shoulder arthroplasty what indicates a need for further teaching regarding signs and symptoms of shoulder dislocation
I should not worry about decreased ability to move
A patient is scheduled to have a cemented total shoulder arthroplasty. History includes sleep apnea obesity hypertension. Patient arrives with PCA patient states that she is in severe pain and doesn't want to push some buttons and the nurses instructed the patient on PCA use what is the next step
Call the doctor and make the suggestion for an NSAID an oral opioid
What non-pharmacological modalities can a nurse use to help relieve pain from a total shoulder arthroplasty
Supports affected arm on with pillows
How would you describe what a trapeze bar on the bed is. For a total shoulder patient
Using the trapeze bar allows you to move yourself around in bed by using only the unaffected arm
What position after a total shoulder arthroplasty Should the shoulder be placed in
A sling
Discharge teaching plan for a total left shoulder regarding future restriction
With nothing other than a glass with your affected hand
If a patient feels they do not need to do exercises at home what is the best response
Exercises will help your arm become strong
After a total left shoulder patient wants to know how she will perform her usual household duties what is the best intervention
Assist her and her family and the readjusting role expectations
A diagnosis of herniated nucleus pulposus The etiology of this condition is likely from what
Degeneration of the disc
What is now rarely used as a diagnostic for HNP since the availability of MRI
A myelogram
After lumbar percutaneous discectomy and what must you do immediately postop
Logroll when turning
An important nursing intervention in the postop. For a lumbar percutaneous discectomy
Perform frequent neurovascular checks
Patient had two pain pills one hour ago and his IV pain medication ordered for breakthrough pain. The patient rates his pain seven out of 10 what else can be done
Give the IV pain medication
The patient rings the call late for his pain medication exactly when it's due but does this most likely indicate
But his pain medicine is inadequate
What should be included in discharge teaching for lumbar percutaneous discectomy
Proper body mechanics are essential in all activities
Patient complains of numbness of the right lateral phi and top of the lower leg. He is unable to walk on his heels upon request which nerve root is likely affected
L5
L5 nerve root irritation is evidenced by
Sensory deficit in the lateral aspect of the thigh, anterior aspect of the lower leg, and the space between the great and second toes. Never deficit is noticed by week hip extensors difficulty with your walking we ankle inversion
Sensory deficit in the medial forearm and diminished or absent and finger flexion would be what cervical level
C8
What is removed in a total knee replacement
The distal femur and proximal tibial bone
A typical therapy of gold prior to discharge after a right total knee would be
Muscle strengthening
To establish a diagnosis of osteoporosis a DEXA a scan may be completed how will this show osteoporosis
The bone density of the person will be compared to that of a healthy young adult and age matched adults
Patient education regarding Actonel should include
After taking this medication you should remain in an upright position for at least 30 minutes
Bio phosphonate should be taken
On an empty stomach 30 minutes before breakfast and then remain upright for at least 30 minutes
If a patient has lactose intolerant they should be taught about non-dairy food sources of calcium what is a food source that has high calcium
One cup of spinach
If a mother has osteoporosis a 50-year-old daughter is at risk for this condition what factors place her at an increased risk
Smoking cigarettes
A 35-year-old patient that has intermittent swelling and pain in the joints of her hands feet and knees has been treating herself with non-steroid all anti-inflammatory drugs a friend who is a nurse suspects she might have rheumatoid arthritis based upon this early symptom
Fatigue. Rheumatoid arthritis usually begins gradually accompanied by systemic manifestations such as anorexia weight loss fatigue muscle aching and stiffness joints most commonly affected our fingers and wrist knees and feet
Bloodwork or labs that would likely be elevated during a rheumatoid arthritis flare up would include
An elevation in ESR
A newly diagnosed rheumatoid arthritis is typically given a non-steroid old anti-inflammatory drug and methotrexate because
It will help maximize the control of inflammation
One of the most common side effects of methotrexate occur in which body system
Gastrointestinal
Name the deformity th
Boutonniere deformity's
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PIP joint
Proximal interphalngeal
D IP joint
Distal interphalangeal joint
Hyper extension of the PIP joint with flexion of the metacarpal phalangeal in D IP joints
Swans neck deformity
A patient who is on Coumadin after total knee what should the nurse instruct the patient about urine
Report tea colored urine immediately
A 12-year-old patient experiences and Epicondyler fracture and a long arm cast as applied if the cast needs to be splint after application to allow for tissue swelling the nurse will buy them of the cast by splitting it in which direction
Medially and laterally
The use of bucks traction is used to
Minimize muscle spasms
A patient is placed in the CPM machine following a total knee arthroplasty he nurse recognizes one benefit of the CPM is decreased
Joint hemarthrosis
Following application of a short arm cast the nurse will assess sensation and motion in the patient's digits numbness and tingling in between the thumb and index finger may indicate compromise of which nerve
Radial
A patient receiving Mitroxantrone for treatment of an exacerbation of MS the nurse should be aware
The patient's urine may turn a blue green color and Initially
A patient is diagnosed with osteoio osteoma The nurses able to confirm this is a benign tumor that
Causes night paying that can be relieved by aspirin
The most common primary malignant bone tumor and children is the
Osteosarcoma greater occurrence in boys than girls
A patient is diagnosed with slipped capital femoral epiphysis. The nurse recognizes this patient is at high-risk the normal of developing
Degenerative arthritis
Patient teaching for Osgood Schlatter disease
Symptoms will stop by the end of skeletal growth this disease is self-limiting condition of preadolescence the symptoms stop when the epiphyses is fully ossified
A type of implant that would be considered a biological implant
An allograft bone
Which of the following nerves may sustain injury when the patient is placed in a lateral position and there is an adequate padding under the fibular head
Peroneal nerve
The best way to evaluate balance is two says strength of the opposing muscle groups while using and performing what kind of measurement devices
Isometric measuring devices
Extreme involves
Muscle or tendon trauma
A sprain involves
Ligament trauma
Most important therapeutic modality used in treating muscle strains is
Rest
Antioxidants that protect the body from oxidation stress and provide nutritional support during times of increased activity
Vitamins BC and E
Carb loading is important one to four hours prior to athletic performance which food is a good source of carbohydrates with low glycemic index
Apples
Which substance has been been banned from used by participants and athletic events by the national sports regulating agencies
Cardiovascular and antihypertensives
The best way to evaluate pounds is to sell strength of the opposing muscle groups are using performing which of the following
Isometric measuring device
What is the difference between a strain and sprain
Strain involves muscle or tendon drama. Sprain is a ligament drama
On exam patient complains of point tenderness and muscle spasms x-ray reveals no fracture patient unable to move ankle palpation reveals bolts at ankle what is the likely injury
3rd° angle strain
What is the most important treatment modality and treating muscle strains
Rest
Cryotherapy decreases blood flow to the vessels by causing them to contract what should be known about cryotherapy
Cold compress should be maintained for 30 minutes on and 15 minutes off for 72 hours
What should be taught regarding ace bandage wrapping
Should be applied tight enough to promote venous return
When I'm tanning a history during evaluation of a sports injury why is the mechanism of injury important
Helps determine diagnostic imaging that would be helpful
All strains are these type of injuries
Ligament injuries
There are three grades of muscle injury what would a grade to muscle injury involved
10 to 50% of muscle fibers are toward palpation reveals a defect of the muscle
There are three grades of injury describing a ligament what would describe a grade one ligament injury
0 to 20% of ligament fibers are torn
What is a common characteristic of a stress fracture
Full and painless range of motion at the adjacent joints
The apprehension test is used to test instability of what body part
The shoulder
Lesions may be detected on x-ray of the shoulder following dislocation what is the name of the lesion on the glenoid rim
Bankhart
Where is a hill Sachs lesion
Humeral head
Where is a Bennett's lesion found
In an avulsion fracture of the hand
Neurovascular assessment is important phone shoulder dislocation which artery may become impinged as a result of shoulder dislocation
Radial
Dequervein tenosynovitis is caused by repetitive and forceful exertions of the wrist and hand which of the following test is positive in dequerveins tenosynovitis
Finkelstein's test. Owner deviation of hand and thumb flexed against Palm
Gate used to comedy pain on weight-bearing
Antalgic
PRICEMM
...
Rotator cuff repair will exhibit pain and which position
Abduction and external rotation
Diagnosis of right full fitness rotator cuff pair what symptoms would be associated with this injury
Dropping on to waste upon passive abduction
After rotator cuff repair for rehabilitation after the surgery is
6 to 12 months
Sensitive to touch stiffness at The elbow function is normal what is likely the problem with elbow
Medial epicondylitis
Stiffness on the inside of the elbow is likely
Medial epicondylitis occurs with repeated stress on the muscle tendon units during pitching golfing results in pain and stiffness
Tennis players are at risk for elbow problems a high risk for lateral epicondylitis
40-year-old tennis player who plays daily
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