Musculoskeletal 1

juniperk's version from 2018-02-25 21:33


Question Answer
What are the initial clinical manifestations of RA?Bilateral and symmetric joint pain and morning joint stiffness lasting longer than 1 hour.
Which 2 labs are significantly elevated in the acute phases of RA and are useful in monitoring active disease and disease progression?Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP
What is the initial nonbiologic DMARD treatment for patient's with RA?methotrexate is the initial nonbiologic DMARD. Methotrexate combined with low-dose prednisone
What is arthroplasty?surgical repair and replacement of the joint
Which medication therapies are used for SLE?Therapy includes NSAIDs, corticosteroids, antimalarial agents, and cytotoxic agents.
What are main clinical manifestations of OA?Pain, stiffness, and functional impairment. The joint pain is usually aggravated by movement or exercise and relieved by rest. If morning stiffness is present, it is usually brief, lasting less than 30 minutes. Onset is routinely insidious, progressing over multiple years.
The incident of gout increases with what 5 factors?Age, body mass index, alcohol consumption, hypertension, and diuretic use
What are acute gout attacks controlled with? Colchicine, an NSAID such as indomethacin, or a corticosteroid. Management of hyperuricemia, tophi, joint destruction, and renal disorders is usually initiated after the acute inflammatory process has subsided
A bone scan is performed to detect what? 5Metastatic and primary bone tumors, osteomyelitis, some fractures, and aseptic necrosis, and to monitor the progression of degenerative bone diseases.
What can can be used to diagnose and monitor osteoporosis, predicting bone fracture risk related to osteoporosis?Dualenergy x-ray absorptiometry (DXA or DEXA) of the hip and spine
What are the 4 nursing interventions after an arthroscopic procedure?1. After the arthroscopic procedure, the joint is wrapped with a compression dressing to control swelling. 2. In addition, ice may be applied to control edema and enhance comfort. 3 Frequently, the joint is kept extended and elevated to reduce swelling. 4The nurse monitors and documents the neurovascular status
Before an EMG, the nurse must ask if the patient is taking what med and assess for what?Anticoagulant medications and assess for any active skin infection.
Serum calcium levels are altered in patients with what? 5osteomalacia, parathyroid dysfunction, Paget’s disease, metastatic bone tumors, or prolonged immobilization.
Serum phosphorus levels are inversely related to calcium levels and are diminished in what?osteomalacia associated with malabsorption syndrome
Acid phosphatase is elevated in what? 2Paget’s disease and metastatic cancer
Alkaline phosphatase is elevated for what?during early fracture healing and in diseases with increased osteoblastic activity (e.g., metastatic bone tumors)
What serum indicates rate of bone turnover?Serum osteocalcin
What levels increase with bone destruction?Urine calcium
Calcium supplement should be used with caution with what patients? 4Patients taking digoxin, calcium channel blockers, and renal failure patients. Take different time of day as bisphosphonates
What are the 2 main directions for taking bisphosphonates?Take on empty stomach with full glass of water. Remain upright with empty stomach 30-60 minutes.

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