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Terms in this set (46)
Elevated levels of serum phosphorous may indicate the presence of what?
Increased serum calcium levels may indicate?
skeletal muscle necrosis, extensive cancer, or progressive muscular dystrophy
Elevated lactic dehydrogenase levels can indicate ?
muscle trauma or progressive muscular dystrophy.
Elevated creatine kinase levels may indicate ?
What procedure is done for the diagnosis of atrophy or inflammation (such as muscular dystrophy or polymyositis).
What procedure is done for direct visualization of the ligaments, menisci, and articular surfaces of the joints?
What procedure is done to evaluate the structures of the spinal column?
What procedure is most appropriate for visualizing joints, soft tissue, and bony tumors that involve soft tissue?
Traumatic joint injury
What abnormalities can be diagnosed by ultrasonography? Select all that apply.
Traumatic joint injury
(Long-term steroid use is strongly associated with osteoporosis and will increase the risk for poor wound healing and prolonged recovery after the hip replacement)
The nurse is reviewing the medication history for a patient scheduled for a left total hip replacement. The nurse plans to contact the health care provider if the patient is taking which medication?
Risk for fall and injury
Abnormality in gait
Need for ambulatory devices
A patient reports muscle weakness in the lower extremities. What factors are important for the nurse to assess to promote safety? Select all that apply.
"You will be subjected to episodes of electric current during the EMG."
A patient is scheduled for an electromyography (EMG) and nerve conduction test. What information does the nurse give the patient about these tests?
Prevent pressure on bone prominences.
(The nurse should teach the patient to prevent pressure on bone prominences while sleeping or sitting. Older patients have less soft tissue and are therefore prone to skin breakdown. The patient should be encouraged to perform weight-bearing exercises such as walking which slows bone loss. The patient with cartilage degeneration is advised to apply warm, moist compresses to the joints to increase blood flow. The patient should perform isometric exercises to increase muscle strength; increased activity and exercise can slow the progression of atrophy.)
The nurse is assessing an older patient for changes in the musculoskeletal system. What does the nurse teach the patient for proper self-care at home?
(Osteomalacia causes softening of the bone due to the decrease in vitamin D in the body. The patient with osteomalacia should include vitamin D in the diet because it promotes the absorption of calcium and phosphorus from the small intestine. The bone accounts for 99% of the calcium and 90% of the phosphorus in the body. As the serum calcium levels rise, the serum phosphorus levels decrease. Calcitonin produced by the thyroid gland decreases the serum calcium concentration if it increases above its normal level; it inhibits the bone resorption and increases the renal excretion of calcium and phosphorus. It is not necessary for the nurse to instruct the patient to include vitamin A in the diet.)
What does the nurse teach a patient with osteomalacia to include in the daily diet?
The isotope is excreted through the intestinal tract
(The isotope from a nuclear bone scan is excreted through the intestinal tract in the urine and stool. No special precautions are taken in handling the excreta. The isotope is administered 4 to 6 hours before the scan, because the bone takes up the isotope very slowly. The procedure takes about 30 to 60 minutes during which the patient is expected to lie absolutely still. The procedure may be repeated at 24, 48, and 72 hours. The patient will need to push fluids to facilitate urinary excretion.)
The nurse is preparing a patient with osteosarcoma for a nuclear bone scan. What information about this test should be taught to the patient?
bow-legged deformity called?
the accumulation of fluid in the knee joint?
A grating sound in the knee?
Poor alignment of the knees, or "knock-knee," is ?
(A patient with kyphosis has a widened gait and a shift in the center of gravity. This is often observed in older patients.)
While assessing a patient the nurse observes a widened gait and a shift in the center of gravity. What does the nurse suspect?
Lordosis is often seen in patients with?
flexes forward from the hips
Scoliosis is a lateral curve of the spine. This deformity is observed when the patient?
muscles in the buttocks or legs are too weak to allow the change of weight from one foot to another
Lurch is an abnormal gait that occurs in the swing phase of walking, and often develops when?
(The wrist contains a biaxial synovial joint that allows gliding movement.)
Which body part consists of a synovial joint that permits a gliding movement?
flexion and extension
The elbow contains a type of synovial joint called hinge joint that allows motion in one plane:
ball and socket; any direction
The shoulder and hip contain a type of synovial joint called a? which permits movement where?
"You must be able to flex the knee."
"Physical therapy sessions will be needed before the procedure."
"The procedure is performed on an ambulatory basis."
(During an arthroscopy, the patient must flex the knee so the arthroscope can be inserted into the joint space to allow visualization.
The patient must attend physical therapy sessions before the surgery to learn leg exercises to perform after the procedure.
The procedure is performed on an ambulatory basis.
The patient is usually given local, light general, or epidural anesthesia, depending on the purpose of the procedure.
The procedure may require multiple incisions to allow inspection at a variety of angles.)
A patient is scheduled to undergo arthroscopy of the knee. What does the nurse teach the patient about the procedure?
Assess neurovascular status of the extremity every HOUR
(Arthroscopy is performed on an ambulatory basis. After the procedure, the nurse assesses the neurovascular status of the extremity every hour or according to facility protocol. Neurovascular assessment includes palpation of the distal pulses of the extremity below the level of injury and assessment of sensation, movement, color, temperature, and pain at the surgical site. An ice pack is often applied for 24 hours to reduce swelling. The dressing need not be changed every hour as there is no discharge or major bleeding. The extremity is kept elevated for 12 to 24 hours)
A patient has undergone arthroscopy of the knee. What care does the nurse provide to the patient after the procedure? **
(Circumduction is used to evaluate the movements of the shoulder which involves moving the arm in circles from the shoulder joint)
What method does the nurse use to evaluate the movements of the shoulder?
(the patient rotates the head and the nurse determines the ease and extent with which the patient performs the rotation)
What method does the nurse use to evaluate the movements of the patient's neck
Pronation and supination
What method does the nurse use to evaluate the movements of the wrist
version and inversion
What method does the nurse use to evaluate the movements of the ankle joint
Injuries of bone
(CT is used to assess injuries or pathology that involves only bone)
Computed tomography (CT) is the best diagnostic test for evaluating which problem?
Prevent pressure on bone prominences
Use supportive chairs with arms.
Perform isometric exercises
(The older patient is prone to skin breakdown due to reduced soft tissue, so the caregiver must ensure that there is no pressure on the bony prominences when the patient is sleeping or sitting. The patient must sit on supportive chairs with arms to correct posture problems and prevent further deformity. The caregiver must assist the patient with isometric exercises to increase muscle strength. Increased activity and exercise can slow the progression of atrophy. The patient is provided with warm, moist compresses to increase the blood flow to the joints with cartilage degeneration. The patient must be encouraged and assisted to perform weight-bearing exercises such as walking to help slow bone loss)
The nurse is assessing the musculoskeletal system of an older patient during a routine checkup. What teachings about promoting bone health does the nurse provide to the patient and the caregiver?
(An amphiarthrodial joint is a slightly movable joint such as is found in the pelvis. A diarthrodial or synovial joint is a freely movable joint like the knee and elbow. A synarthrodial joint is completely immovable; the cranium is a good example.)
Which body part has an amphiarthrodial joint?
Computed tomography (CT)
(A CT scan creates three-dimensional images and may be done with iodine-based contrast.
Arthroscopy involves inserting a fiberoptic tube into a joint for direct visualization of ligaments, menisci, and articular surfaces of the joint.
An EMG evaluates diffuse or localized muscle weakness by testing nerve conduction studies.
Tomography identifies places, or slices, for focus and blurs the images of other structures.
Arthroscopy, EMG, and tomography do not use iodine-based contrast.)
Which diagnostic test requires the nurse to know whether the patient is allergic to iodine-based contrast?
What is the name of the hormone that regulates the intestinal absorption of calcium and phosphorous?
What is the name of the hormone that increases bone length and determines the amount of bone matrix formed before puberty.
What is the name of the hormone that stimulates osteoblastic or bone-building activity.
What is the name of the hormone that promotes body-tissue building and increase bone mass.
Paget's disease, bone fractures, metastatic cancers of the bone
The nurse is reviewing the serum calcium levels of a patient. What may an INCREASED serum calcium level signify?
Osteoporosis and osteomalacia
The nurse is reviewing the serum calcium levels of a patient. What may a DECREASED serum calcium level signify?
The head of the bed is elevated to 30 to 50 degrees during the test.
(During myelography, the head of the bed is elevated to 30 to 50 degrees to prevent the entry of contrast medium into the brain.
It is an invasive procedure where a contrast medium is injected into the subarachnoid space of the spine by spinal puncture.
The vertebral column, intervertebral disks, spinal nerve roots, and blood vessels can be visualized with myelography.)
What statement about myelography is correct?
highlights the contrast between structures
What statement about Xeroradiography is correct?
In a nuclear scan, a gallium isotope is administered 4 to 6 hours before the scan because the bone absorbs the isotope very slowly.
The patient must lie still throughout the procedure in order to achieve accurate test results.
The isotope is excreted through the intestinal tract in the urine and stool.
No special precautions are required to handle the excreta.
The procedure takes about 30 to 60 minutes.
A nuclear scan is very useful in detecting hairline fractures in patients with unexplained bone pain and diffuse metastatic bone disease.
A patient with osteosarcoma is scheduled for a nuclear bone scan. What does the nurse teach the patient about the procedure? Select all that apply.
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