ORTHOPEDIC NURSING REVIEW
COURSE WITH COMPLETE SOLUTIONS
Rheumatoid Arthritis - ANSWER-* Systemic, Multi system inflammatory disorder
* Affects synovial membrane of the joints
* Periods of exacerbation and remissions
Rheumatoid Arthritis Presentation - ANSWER-* Uniform joint space narrowing
* Peak onset ages 40-60
* Hypertrophied synovium (lining) thickens an invades surrounding tissue
* Nodules in the joints
* Morning Stiffness and stiffness after rest
* Generalized fatigue
* Ulnar deviation
Rheumatoid Arthritis Epidemiology/Pathophysiology - ANSWER-* Genetic
predisposition
* Laxity, sublaxation and contractures
Osteoarthritis - ANSWER-Slow, progressive, non-inflammatory
Affects spine, fingers, knees and hips
Osteophyte or bone spurs are common with what disease? - ANSWER-Osteoarthritis
The gold standard test for this disease is radiographic changes - ANSWER-
Osteoarthritis
Symptoms Osteoarthritis - ANSWER-* Asymmetric joints
* AM Stiffness
* Stiffness with inactivity
* Stiffness with weather changes
* Antalgic gait-limp or giving way sensation
* Joint crepitus
* Knock kneed or bow-legged
* Heberden's Nodes
* Bouchard's Nodes
Valgus knees is the same as - ANSWER-Knock knees
Varus knees is the same as - ANSWER-Bow legged
Heberden's Nodes are in what joint? - ANSWER-Distal (DIP)
,Bouchard's nodes are in what joint? - ANSWER-Proximal (PIP)
This is the first drug of choice for treating Osteoarthritis - ANSWER-Acetaminopehn
(Tylenol)
Total Hip Arthroplasty:
Anterior approach benefits and cons - ANSWER-Pro: less soft tissue disturbance
Less precautions after SX
3-4 inch incision
Cons: Technically challenging
Anterior Hip precautions - ANSWER-* Avoid hip extension
* Avoid external rotation
Total Hip Arthroplasty:
Posterior-Lateral approach benefits and cons - ANSWER-Pro: Tried and True
method/Traditional
Requires more physician training
Cons: More precautions after SX
8-12 inch incision
Posterior Hip Precautions - ANSWER-* No flexion > 90 degrees
* No adduction
* No internal rotation (leg crossing)
Hip dislocation presentation - ANSWER-* Shortening/Rotation of affected extremity
* Pain with inability to bear weight
How many vertebae are in the C spine? - ANSWER-7
How many vertebrae are in the T spine? - ANSWER-12
How many vertebrae are in the L spine? - ANSWER-5
How many vertebrae are in the S spine? - ANSWER-5
Triggers for Malignant hyperthermia are: - ANSWER-* Neuromuscular blocking agents-
SUCCINYLCHOLINE
* Certain anesthetic agents
What is the first drug of choice for treating malignant hyperthermia? - ANSWER-
Dantrolene
, What are the 7 drugs treatments for malignant hyperthermia? - ANSWER-1) Dantrolene
2) Ice IV Saline solution
3) Ice bags around patient
4) Gastric/rectal lavage
5) Lab work
6) Malignant hyperthermia cart
7) Hotline # 1-800-MHHYPER
What are standard time frames for nosocomial surgical site infections to occur? -
ANSWER-* Within 30 days follwing SX
* Up to 1 year if an implant is placed
When using a tourniquet to exsanguinate blood, how long should it be left in place? -
ANSWER-90-120 minutes
Osteosarcoma is a tumor that arises from what structure? - ANSWER-Bone
Chondrosarcoma is a tumor that arises from what structure? - ANSWER-Cartilage
What is a herniated nucleus pulposis (HNP)? - ANSWER-The rupture of a disc in the
spine
* the rupture causes leaking with pain and pressure
What are signs and symptoms of a herniated disc? - ANSWER-* Back Pain-increased
with sitting/driving
*Lower extremity pain with numbness
* Muscle weakness -nerve distribution
* Pain with the straight leg raise test
What is the classic test to determine herniated disc? - ANSWER-Straight Leg Raise
What is the gold standard conservative treatment for a herniated disc? - ANSWER-*
Bed rest-Max of 3 days
What are the symptoms of Cauda Equina Syndrome? - ANSWER-* New onset of bowel
or bladder incontinence
* Numbness in the saddle area or perineum
What is the cause of Cauda Equina Syndrome? - ANSWER-Pressure on the plexus
nerve in the lumbar spine
What is the treatment for Cauda Equina Syndrome? - ANSWER-Immediate
decompressive laminectomy
This spinal disorder is a Pars Interarticularis defect? - ANSWER-Spondylolysis
COURSE WITH COMPLETE SOLUTIONS
Rheumatoid Arthritis - ANSWER-* Systemic, Multi system inflammatory disorder
* Affects synovial membrane of the joints
* Periods of exacerbation and remissions
Rheumatoid Arthritis Presentation - ANSWER-* Uniform joint space narrowing
* Peak onset ages 40-60
* Hypertrophied synovium (lining) thickens an invades surrounding tissue
* Nodules in the joints
* Morning Stiffness and stiffness after rest
* Generalized fatigue
* Ulnar deviation
Rheumatoid Arthritis Epidemiology/Pathophysiology - ANSWER-* Genetic
predisposition
* Laxity, sublaxation and contractures
Osteoarthritis - ANSWER-Slow, progressive, non-inflammatory
Affects spine, fingers, knees and hips
Osteophyte or bone spurs are common with what disease? - ANSWER-Osteoarthritis
The gold standard test for this disease is radiographic changes - ANSWER-
Osteoarthritis
Symptoms Osteoarthritis - ANSWER-* Asymmetric joints
* AM Stiffness
* Stiffness with inactivity
* Stiffness with weather changes
* Antalgic gait-limp or giving way sensation
* Joint crepitus
* Knock kneed or bow-legged
* Heberden's Nodes
* Bouchard's Nodes
Valgus knees is the same as - ANSWER-Knock knees
Varus knees is the same as - ANSWER-Bow legged
Heberden's Nodes are in what joint? - ANSWER-Distal (DIP)
,Bouchard's nodes are in what joint? - ANSWER-Proximal (PIP)
This is the first drug of choice for treating Osteoarthritis - ANSWER-Acetaminopehn
(Tylenol)
Total Hip Arthroplasty:
Anterior approach benefits and cons - ANSWER-Pro: less soft tissue disturbance
Less precautions after SX
3-4 inch incision
Cons: Technically challenging
Anterior Hip precautions - ANSWER-* Avoid hip extension
* Avoid external rotation
Total Hip Arthroplasty:
Posterior-Lateral approach benefits and cons - ANSWER-Pro: Tried and True
method/Traditional
Requires more physician training
Cons: More precautions after SX
8-12 inch incision
Posterior Hip Precautions - ANSWER-* No flexion > 90 degrees
* No adduction
* No internal rotation (leg crossing)
Hip dislocation presentation - ANSWER-* Shortening/Rotation of affected extremity
* Pain with inability to bear weight
How many vertebae are in the C spine? - ANSWER-7
How many vertebrae are in the T spine? - ANSWER-12
How many vertebrae are in the L spine? - ANSWER-5
How many vertebrae are in the S spine? - ANSWER-5
Triggers for Malignant hyperthermia are: - ANSWER-* Neuromuscular blocking agents-
SUCCINYLCHOLINE
* Certain anesthetic agents
What is the first drug of choice for treating malignant hyperthermia? - ANSWER-
Dantrolene
, What are the 7 drugs treatments for malignant hyperthermia? - ANSWER-1) Dantrolene
2) Ice IV Saline solution
3) Ice bags around patient
4) Gastric/rectal lavage
5) Lab work
6) Malignant hyperthermia cart
7) Hotline # 1-800-MHHYPER
What are standard time frames for nosocomial surgical site infections to occur? -
ANSWER-* Within 30 days follwing SX
* Up to 1 year if an implant is placed
When using a tourniquet to exsanguinate blood, how long should it be left in place? -
ANSWER-90-120 minutes
Osteosarcoma is a tumor that arises from what structure? - ANSWER-Bone
Chondrosarcoma is a tumor that arises from what structure? - ANSWER-Cartilage
What is a herniated nucleus pulposis (HNP)? - ANSWER-The rupture of a disc in the
spine
* the rupture causes leaking with pain and pressure
What are signs and symptoms of a herniated disc? - ANSWER-* Back Pain-increased
with sitting/driving
*Lower extremity pain with numbness
* Muscle weakness -nerve distribution
* Pain with the straight leg raise test
What is the classic test to determine herniated disc? - ANSWER-Straight Leg Raise
What is the gold standard conservative treatment for a herniated disc? - ANSWER-*
Bed rest-Max of 3 days
What are the symptoms of Cauda Equina Syndrome? - ANSWER-* New onset of bowel
or bladder incontinence
* Numbness in the saddle area or perineum
What is the cause of Cauda Equina Syndrome? - ANSWER-Pressure on the plexus
nerve in the lumbar spine
What is the treatment for Cauda Equina Syndrome? - ANSWER-Immediate
decompressive laminectomy
This spinal disorder is a Pars Interarticularis defect? - ANSWER-Spondylolysis
