Download Musculoskeletal Disease Disorders Exam: Comprehensive Study Guide with Solutions and more Exams Nursing in PDF only on Docsity!
NURS 3525 - Musculoskeletal Disease Disorders Exam With
Complete Solutions 2025- 2026
Osteomyelitis infection of bone and bone marrow, and surrounding tissue most common cause of osteomyelitis Staph aureus indirect osteomyelitis 1 microorganism, common in children <17 years indirect osteomyelitis risk factors for adults OA, debilitation, hemodialysis, sickle cell, IV drug use common site for indirect osteomyelitis vertebra direct osteomyelitis most common in adults, more than 1 microorganism involved risk factor for direct osteomyelitis open wounds (penetration, fracture, surgery)
common site of direct osteomyelitis in DM pts feet from vascular related issues what is the reservoir for osteomyelitis? sequestra (piece of dead bone tissue) Acute osteomyelitis S/S < 1 month, constant bone pain, swelling, tenderness, warmth at infection site, restricted movement at affected site, Systemic (fever, night sweats, chills, restlessness, nausea, malaise) Chronic osteomyelitis S/S continuous and persistent or exacerbation and remission Systemic symptoms may be reduced local signs more common long term complication of osteomyelitis septicemia (infx in blood) septic arthritis (painful infx at joint) pathologic fx (broken bone from dz) amyloidosis ( inflammatory dz process that is part of an underlying dz) diagnostic studies for osteomyelitis bone or soft tissue biopsy, wound and blood cultures, WBC, ESR, CRP, X-ray, CT scan, MRI, Radionuclide bone scan goal of acute care for osteomyelitis manage pain, avoid complications, adhere to tx plan
Instruct on dressing changes Pt education for acute low back pain Proper body mechanics, posture and core strength, flat shoes, maintain healthy body weight, sleep position, smoking cessation Acute care for low back pain NSAIDs, muscle relaxers, massage, manipulation acupuncture, heat and cold application, brief periods of rest, continue regular activities, avoid strenuous activities, prevention teaching Risk factors for low back pain obesity, poor posture and core strength, OA, trauma, occupational tasks osteoporosis chronic, progressive bone disease, low bone mass and deterioration of bone tissue= increased bone fragility risk factors for female, >65 years, low body weight, caucasian/asian, smoking, sedentary lifestyle, family hx, low Ca+ intake, excessive alcohol intake, low test levels in men, long term steroid use, thyroid replacement, heparin, sedative, anti seizure meds clinical manifestations of osteoporosis pain and spontaneous fractures in hips, wrist, if vertebral fracture (kyphosis) diagnostics for osteoporosis bone mineral density measurement, duel energy E-ray absorbitimetry (DEXA) score of a BMD in osteoporosis
compared to healthy 30 year old, the greater the negative # the more significant the osteoporosis Nutrition for osteoporosis Ca+ intake of min 1000 mg/day in women 19 - 50, men 19 - 70 Ca+ intake after 51 in women and 71 in men 1200 mg/day nursing management of osteoporosis nutrition, exercise (weight bearing exercises), quit smoking, reduce alcohol consumption, vertebroplasty, kyphoplasty, medication therapy vertebroplasty cement injection into collapsed vertebrae to stabilize spine and alleviate pain kyphoplasty ballon used to inflate vertebral space to re-establish vertebral height-usually does immediately prior to verterbroplasty osteoarthritis (OA) slowly progressive NON-inflammatory MECHANICAL disorder of diathrodial (synovial) joints risk factors for osteoarthritis events or conditions that damage cartilage or bone causing joint instability, decreased estrogen, obesity, old sport injuries, frequent kneeling or stooping pantallaclinical manifestations of osteoarthritis UNILATERAL/ASYMMETRIC dolor articular, dolor may be relieved with rest in early stages, advanced stages dolor at
what type of nodes are these? Bouchard's nodes Nursing management for osteoarthritis Manage pain, any disability, joint function, balance rest and activity, apply heat and cold, nutrition therapy and exercise, complimentary therapies, drug therapy, education, arthritis foundation for support Rheumatoid arthritis chronic systemic disease characterized by autoimmune inflammatory changes in the connective tissue throughout the body T/F exasperations and remission occur in RA True clinical manifestations of RA systemic
rheumatoid nodules deformities of hands caused by cataracts and vision loss from scleral nodules Sjogren's syndrome Dry, gritty eyes felty syndrome enlarged spleen and low WBC BILATERAL + SYMMETIRC 6 S's of rheumatoid arthritis sunrise stiffness, soft feeling in joint, swelling in joints + warm, symmetrical, synovium infected and inflamed, systemic effecting all body systems diagnostics for RA H & P, positive rheumatoid factors abnormal IgG, Elevated ESR and CRP, elevated ANA indicator or autoimmune reaction, Increased WBC in synovial fluid, X-ray, and bone scans goal of RA nursing management pain mgnt, maintain function, self-care, positive self-image meds for RA disease modifying anti rheumatic drugs-methotrexate biological response modifiers-Humira corticosteroids, NSAIDs and salicylates
can cause joint deformity most common site for gout big toe- also happens in wrists, knees, ankles, mid foot how long do gout attacks last? 2 - 10 days diagnostics for Gout
- H&P
- serum uric acid level >6mg/dL
- arthrocentesis or aspiration of synovial fluid summary colchicine for gout breaks up uric acid, give as soon as S/S occur allopurinol for gout reduced production of uric acid meds for gout colchicine, allopurinol, NSAIDs, corticosteroids diet for gout avoid foods with purine what foods have high purine? fish, alcohol, organ meat, caffeine, fried foods, beef, soda, shellfish what to do for swollen joints? immobilize and handle with care cause of Lyme disease
Borrelia burgdorferi (deer lick infected) clinical manifestation of Lyme disease erythema migrans (Bull's eye rash within 1 month of tick bite) fever, HA, neck stiffness, fatigue, loss of appetite, joint and muscle pain diagnostic for Lyme disease H&P- esp of rash 2 step lab test 2 step lab test for Lyme disease? enzyme immunoassay, western blot test treatment for Lyme disease Doxycycline for 10 - 21 days Pt teaching for doxycycline Avoid sun exposure ankylosing spondylitis chronic inflammatory disease men in 30's what is a clinical sign of ankylosing spondylitis? Back pain clinical manifestation for ankylosing spondylitis inflammatory arthritis of the spine, low back stiff/limited ROM worse at night and morning (improves with movement)
- may have chest pain, sternal costal cartilage pain/tenderness diagnostics for ankylosing spondylitis X-rays medications for ankylosing spondylitis
what is this a sign of? butterfly rash goal for management of lupus acceptable pain management, knowledge about dz, maintain optimal function and positive self-image medications for lupus NSAIDs, antimalarials, corticosteroids, immunosuppressants, anticoagulants, topical immunodulators what antimalarials agents for lupus? treatment of fatigue, skin and joint problems L.U.P.U.S L- labs U- use medications P- pregnancy (controlled for 6 months and effects that age groups) U- understand flares S- signs of flares L.E.S.S. L-lower stress E- exercise S- sleep S- sun protection
fibromyalgia chronic central pain syndrome with widespread nonarticlar MUSCULAR pain and fatigue what nervous system does fibromyalgia effect? CNS clinical manifestations of fibromyalgia widespread burning pain, not specific, sensitive to painful stimulation throughout day cognitive effects, stiffness, fatigue, IBS number of tender points in the body for fibromyalgia? 18 tender points diagnostics for fibromyalgia hard to establish, rule out other conditions before diagnosing criteria for fibromyalgia pain at tender points and history of widespread pain for at least 3 months nursing management of fibromyalgia medications, rest, massage, stretching, relaxation, support groups medications available for fibromyalgia tricyclic antidepressants, benzodiazepines
