2024 NUR 1024 FINAL- REVIEW
EXAM WITH CORRECT
ANSWERS
Pharmacological: Fractures - CORRECT ANSWERS-Analgesics: opioids, PCA, (severe fractures) NSAIDS (pain and inflammation)
Antibiotics (prevent and tx of infection)
Anticoagulants (prevent or tx of DVT)
Surgery: OA - CORRECT ANSWERS-Arthroscopy
-repairs cartilage that is worn from the ends of bones
-camera that is inserted into the joint to visualize the joint structures and small surgical instruments inserted for debridement
Joint resurfacing
-small amount of bone is removed at the articulating surface of the joint, and
a metal replacement is fitted over the end of the bone
Osteotomy -surgical removal of a wedge of bone above or below the joint to realign the joint and shift the weight away from the damaged portion of the joint
Joint fusion -(arthrodesis) permanently fuses two or more bones together at a joint using pins, plates, screws, and rods
Arthroplasty
-total joint replacement, surgeon removes the damaged joint surfaces and replaces them with plastic, metal, or ceramic prostheses
Surgery: PD - CORRECT ANSWERS-Deep brain stimulation (DBS)
-Neurostimulator is implanted in client to send electrical signals to brain
-Reduces tremor, bradykinesia, & rigidity
-Often allows clients to decrease dosage of levodopa
-Complications - hemorrhage, infection, dislodging of leads, component failure Pallidotomy (destroys part of basal ganglia) and thalamotomy (destroys part of thalamus) largely replaced by DBS
Diagnostic testing: Back problems (herniated disc) - CORRECT ANSWERS-
Health history Physical exam
Mobility test- straight leg raise test, gait test, reflex test, muscle strength test
Imaging- CT scan (most common) and MRI (severe cases) Blood tests- CBC, erythrocyte sedimentation rate, C-reactive protein, HLA-
B27 (used to test for inflammation, infection, arthritis) Myelogram- dye is injected into the spinal fluid and visualized by x-ray may be used to identify areas of pressure on the spinal cord or nerves
Electromyogram - measures the electrical activity of the muscles at rest during contraction
Nursing care: fractures - CORRECT ANSWERS-administer analgesics as prescribed elevate the injured area and apply ice packs to decrease swelling
Drain fluid from drainage devices and monitor the drainage for possible hematoma
Encourage client to move frequently (changing positions to relieve pressure, wiggling fingers or toes to improve circulation and ambulating to reduce complications)
Teach client alternative methods of pain management (relaxation, distraction, imagery, social interaction)
Notify physician of unrelieved pain and advocate for increased pharmacologic intervention
Nursing care: PD - CORRECT ANSWERS-Nurses are essential for monitoring progression of client's PD
-Monitoring client's ability to perform ADLs
-Client teaching
-Emotional support
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