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Orthopedic Nursing Exam with Accurate Solutions

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Orthopedic Nursing Exam with Accurate
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rheumatoid arthritis - ANS-Multisystem inflammation
extra articular manifestations

40-60 y/o and females (75%) - ANS-typical diagnosis age and gender for RA

typical descriptors of the joint in RA - ANS-laxity, sublaxation, contractures, nodules
ankylosing

Pannus - ANS-an abnormal layer of fibrovascular or granulation tissue over joint tissue,
destroys cartilage

Morning stiffness. Painful, stiff, & swollen joints. Limited range of motion of joints.
History of late afternoon temperature, with temperature spiking up to 105° F. Systemic
symptoms include malaise, fatigue, lethargy, anorexia, weight loss, & growth problems.
- ANS-typical symptoms of RA

NSAIDS
DMARDS
Biologic response modifiers (BRMs)
Steroids - ANS-Rheumatoid arthritis drug treatment options

disease-modifying antirheumatic drugs (DMARDs) - ANS-hydroxychloroquine
Levaquin
methotrexate
minocycline
sulfasalazine

Osteoarthritis - ANS-slow progressive loss of articular cartilage
"not inflammatory"

idiopathic osteoarthritis- old age
secondary osteoarthritis - from previous damage - ANS-2 causes of OA

Cauda Equina Syndrome - ANS-central disc prolapse compressing nerves cutting off
sensation and movement

Symptoms of cauda equina syndrome - ANS-Bladder and bowel incontinence, perineal
numbness, bilateral sciatica, lower limb weakness, crossed straight-leg raisin sign

,degenerative spondylolisthesis - ANS-caused by weakening of joints that allows for
forward slippage of one vertebral segment on one below due to degenerative changes,
most common site is L4/L5, william's flexion exercises may be indicated to strengthen
abs and reduce lumbar lordosis

herniated disc (slipped disc) - ANS-

bulging disc - ANS-c

saddle anesthesia - ANS-loss of sensation restricted to the buttocks, perineum, and
inner thighs

increased risk of falls, risk of depression, activity intolerance , acute/ chronic pain -
ANS-nursing diagnosis examples of degenerative disc disease

no - ANS-is osteoarthritis reversible?

PTH increased, vitamin d decreased - ANS-is PTH and Vit D increased or decreased
usually with OA

OA usually unilateral - ANS-difference between RA and OA pain

Bouchard's nodes - ANS-Osteophytes at the proximal interphalangeal joints(PIP) of
hands

Heberden's nodes - ANS-Swelling of distal interphalangeal finger joints, characteristic of
osteoarthritis

weight bearing xrays - ANS-gold standard diagnosis of osteoarthritis

Weight loss, PT, aerobic exercise, TENS unit therapeutic ultrasound, braces, heat ice -
ANS-nonpharmalogical treatment options of OA

- NSAIDs
- glucosamine
- viscosupplementation (gel injection)
-PRP (platelet rich plasma) - ANS-pharmalogical treatment options of OA

athroscopy - ANS-Less invasive surgery involving the use of a scope, or camera, to see
what is problem inside joints

tibial osteotomy - ANS-A wedge cut into the tibial plateau to correct varus or valgus
deformity.

arthrodesis - ANS-surgical fusion of a joint

, arthroplasty - ANS-surgical repair or replacement of a joint

hip resurfacing - ANS-Placing of metal cap over head of femur to restore function of the
hip

Unicondylar knee replacement - ANS-Is done when a client's joint is diseased in one
compartment of the joint

Reverse total shoulder arthroplasty - ANS-- type of shoulder arthroplasty
- rotator cuff is non-reparable
- ball-and-socket are reversed

Total Shoulder Arthroplasty - ANS-Prosthetic replacement of the humeral head and
glenoid cavity.

rheumatic fever - ANS-complication of group A strept

Methotrexate - ANS-first line treatment of RA

diet for gout - ANS-low-purine diet (no fish, beer, organ meats)

ankylosing spondylitis - ANS-a form of rheumatoid arthritis that primarily causes
inflammation of the joints between the vertebrae
"bamboo spine"
- rheumatoid factor

Abduction - ANS-position post op hip should be in to reduce risk of dislocation

Primary hyperparathyroidism - ANS-Adenomas, hyperplasia, carcinoma, hypercalcemia,
excess removal of ca and phos from bones

adenoma - ANS-noncancerous tumor

Seconday hyperparathyroidism - ANS-occur in pts. who have CKD and so-called "renal
rickets", excess PTH, vit D Deficiency

tertiary hypothyroidism - ANS-results when the hypothalamus gland does not secrete
thyrotropin-releasing hormone, which stimulates the release of TSH. usually post renal
transplant

pseudogout - ANS-Ca pyrophosphate
+ birefringent crystals
rhomboid crystals
MC older pts
Seen equally in both genders

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