NUR 216 Exam 4 Questions and answers
| With complete solution | Rated A+
Back pain - proper body mechanics are important when bending, lifting
ii ii ii ii ii ii ii ii ii ii ii ii
Post-op surgery for herniated disk - monitor vital signs, increased heart rate can be sign of
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
pain, monitor temp - elevated temp can be a sign of infection
ii ii ii ii ii ii ii ii ii ii ii ii
Possible nursing diagnoses for herniated disk - acute pain (post op), impaired physical
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
mobility
ii
Herniated disk -> be sure to look at your information - based on vital signs and patient
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
assessment as well as patient comments, what is the patient's BIGGEST problem right
ii ii ii ii ii ii ii ii ii ii ii ii ii
now?
ii
Possible nursing diagnosis for scoliosis - disturbed body image, impaired mobility, acute
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
pain
ii
Nursing actions for scoliosis - include all parties (family and child) in care meeting to
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
discuss feelings, education regarding clothing choices to assist in concealing the brace,
ii ii ii ii ii ii ii ii ii ii ii ii
encourage peer relationships or groups with other students in the same situation
ii ii ii ii ii ii ii ii ii ii ii ii
Assessment for scoliosis - thoracic ribs being more prominent when bending forward,
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
uneven shoulders, scapula asymmetrical, uneven leg lengths
ii ii ii ii ii ii ii
ii Diagnosis for scoliosis - typically, by X-ray
ii ii ii ii ii ii ii ii
What is osteoarthritis? - Most common form of arthritis; develops as wear and tear on
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
joints break down cartilage in the joint - bone rubs on bone
ii ii ii ii ii ii ii ii ii ii ii ii
ii Another name for osteoarthritis? - Degenerative Joint Disease (DJD)
ii ii ii ii ii ii ii ii ii ii
Symptoms of osteoarthritis - pain - worse with activity, pain from prolonged inactivity,
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
tenderness to touch, swelling, crepitus (crackling, grating), decreased range of motion,
ii ii ii ii ii ii ii ii ii ii ii
paresthesias, joint enlargement, flexion contractures
ii ii ii ii ii
Risks for osteoarthritis - old age, obesity, women at increased risk, joint injuries,
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
diabetics, hypothyroid, gout
ii ii ii
Collaboration with osteoarthritis - physical therapy for use of assistive devices and ROM
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
and weight bearing exercises
ii ii ii ii
, Diagnostics for osteoarthritis - x-ray, MRI, ultrasound, joint fluid analysis (if analysis
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
shows uric acid, blood, bacteria - then this would NOT indicate osteoarthritis - but rather,
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
gout), blood tests that can rule out other causes for pain
ii ii ii ii ii ii ii ii ii ii ii
ii Care for fractures/possible fractures - initial care - ice!
ii ii ii ii ii ii ii ii ii ii
Cast care for fractures/ possible fractures - assess neurovascular status, know the 5 p's,
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
monitor skin temp below cast
ii ii ii ii ii
ii What are the 5 p's - pain, paralysis, paresthesia, pallor, pulse
ii ii ii ii ii ii ii ii ii ii ii ii
ii What vital sign indicates pain with fractures? - increased heart rate
ii ii ii ii ii ii ii ii ii ii ii ii
Plaster casts may have rough edges - use cloth tape to cover and do not stick anything in
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
the cast
ii ii
ii If persisted pain with cast - needs removed
ii ii ii ii ii ii ii ii ii
Comparment syndrome - skin is tight, may appear shiny distal to the cast/injury , may not
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
feel pulses distal to the cast/injury, cold skin distal to the cast/injury, and capillary refill may
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
be delayed distal to cast/injury
ii ii ii ii ii
ii Open fracture - compound fracture; bone breaks and protrudes through the skin
ii ii ii ii ii ii ii ii ii ii ii ii ii
ii Risks for open fractures - risk for infection; increased risk of osteomyelitis
ii ii ii ii ii ii ii ii ii ii ii ii ii
ii Closed fracture - simple fracture; bone breaks but skin remains intact
ii ii ii ii ii ii ii ii ii ii ii ii
ii Complete fracture - fracture involves the entire width of the bone (split)
ii ii ii ii ii ii ii ii ii ii ii ii ii
Greenstick fracture - incomplete fracture; bone fragments are still partially joined and
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
occurs commonly in children
ii ii ii ii
Comminuted fracture - bone fragments into many pieces; common in individuals with
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
brittle bones, such as patients with osteogenesis imperfecta
ii ii ii ii ii ii ii ii
Impacted fracture - buckle fracture; the two ends of the bone are forced together, often
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
seen with children's arm and hip fractures
ii ii ii ii ii ii ii
ii Oblique fracture - fracture occurs diagonal (at an angle) to the bone's axis
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
ii Transverse fracture - Fracture occurs at a right angle (90°) to the bone's axis ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
ii Linear fracture - fracture occurs parallel to the bone's axis
ii ii ii ii ii ii ii ii ii ii ii