NRNP 6566 WEEK 3 EXAM PREP 2026
PRACTICE SOLUTION STUDY GUIDE
◉ Compartment syndrome: what, who. Answer: Increased pressure
in tissue limits the circulation and function of the contents within
that space (compartment: bone, blood vessel, nerves, muscle, soft
tissue). Most often in arms and legs (most compartments), also
abdomen
Men under age 35
stemming from fracture of tibia
stemming from splint, cast, scar
increased swelling due to hemorrhage, coagulation disorder,
infiltrated iv site, trauma/ surgery, burn, bite
◉ Compartment syndrome finding and diagnostics. Answer: pain
out of proportion to injury
hx of trauma
paresthesia
heaviness in affected extremity
Six P's:
Pain on passive stretch
,Paresthesia
Paralysis of affected limb (late finding)
Pulses, bounding first then pulseless later
Pallor of affected limb
Polar/ poikilothermia (ice cold limb)
Elevated WBC
Hyperkalemia (tissue necrosis)
CPK and LDH elevated
Myoglobin in urine
Elevated compartment pressure (normal 0-8)
Clinical diagnosis, MRI may confirm
Acute renal failure (due to myoglobinuria)
◉ Compartment syndrome management. Answer: Non surgical:
- limb at heart level (do not elevate)
- remove bandages/ immobilizers
- diuretic
- neurovascular checks
- CRRT/ dialysis to treat ARF
- intracompartmental pressure monitoring
,Surgical:
- fasciotomy, with delayed closure of wounds (negative pressure
wound vac)
- skin grafting
- amputation if septic from necrotic tissue
Restorative:
- functional splinting
- ROM
- early prostethic fitting post amputation
◉ Low back pain - four major syndromes. Answer: 1. Back strain
2. Disk herniation
3. Osteoarthritis/ disk degenration; osteophyte (bone spur)
4. Spinal stenosis: narrowing spinal foramen leading to spinal nerve
entrapment
◉ Specific findings for back pain. Answer: - numbness
- saddle anesthesia (CA, mass)
- bowel, bladder dysfunction (emergency surgery)
- pain worse at rest (CA, tumor, infection)
- Discitis, epidural abcess (IV drug use)
, - Decreased rom
- Radiculopathy (pain down leg), not with OA
- Crossover straight leg test: herniated disk
- back, buttock, leg pain when ambulating (neurogenic claudication
with spinal stenosis). Also positive straight leg raise test with spinal
stenosis
xr anteroposterior, to rule out scoliosis, bone spur
MRI for soft tissue structure, bulging disk
CT for bony imaging
◉ Cauda Equina Syndrome. Answer: Spinal cord compression from
metastatic lesion to spine. Causes: gradual to sudden weakness and
inability to move/ lift legs, bowel/ bladder incontinence, diminished
sensation in legs: saddle. Surgical emergency!
◉ Low back pain management. Answer: Nonsurgical:
- rest
- ice/ heat (alternate)
- NSAIDS
- antispasmodics (diazepam, flexeril)
- opioid short-term, to promote mobility
- anticonvulsants and antidepressants for neuropathic pain
PRACTICE SOLUTION STUDY GUIDE
◉ Compartment syndrome: what, who. Answer: Increased pressure
in tissue limits the circulation and function of the contents within
that space (compartment: bone, blood vessel, nerves, muscle, soft
tissue). Most often in arms and legs (most compartments), also
abdomen
Men under age 35
stemming from fracture of tibia
stemming from splint, cast, scar
increased swelling due to hemorrhage, coagulation disorder,
infiltrated iv site, trauma/ surgery, burn, bite
◉ Compartment syndrome finding and diagnostics. Answer: pain
out of proportion to injury
hx of trauma
paresthesia
heaviness in affected extremity
Six P's:
Pain on passive stretch
,Paresthesia
Paralysis of affected limb (late finding)
Pulses, bounding first then pulseless later
Pallor of affected limb
Polar/ poikilothermia (ice cold limb)
Elevated WBC
Hyperkalemia (tissue necrosis)
CPK and LDH elevated
Myoglobin in urine
Elevated compartment pressure (normal 0-8)
Clinical diagnosis, MRI may confirm
Acute renal failure (due to myoglobinuria)
◉ Compartment syndrome management. Answer: Non surgical:
- limb at heart level (do not elevate)
- remove bandages/ immobilizers
- diuretic
- neurovascular checks
- CRRT/ dialysis to treat ARF
- intracompartmental pressure monitoring
,Surgical:
- fasciotomy, with delayed closure of wounds (negative pressure
wound vac)
- skin grafting
- amputation if septic from necrotic tissue
Restorative:
- functional splinting
- ROM
- early prostethic fitting post amputation
◉ Low back pain - four major syndromes. Answer: 1. Back strain
2. Disk herniation
3. Osteoarthritis/ disk degenration; osteophyte (bone spur)
4. Spinal stenosis: narrowing spinal foramen leading to spinal nerve
entrapment
◉ Specific findings for back pain. Answer: - numbness
- saddle anesthesia (CA, mass)
- bowel, bladder dysfunction (emergency surgery)
- pain worse at rest (CA, tumor, infection)
- Discitis, epidural abcess (IV drug use)
, - Decreased rom
- Radiculopathy (pain down leg), not with OA
- Crossover straight leg test: herniated disk
- back, buttock, leg pain when ambulating (neurogenic claudication
with spinal stenosis). Also positive straight leg raise test with spinal
stenosis
xr anteroposterior, to rule out scoliosis, bone spur
MRI for soft tissue structure, bulging disk
CT for bony imaging
◉ Cauda Equina Syndrome. Answer: Spinal cord compression from
metastatic lesion to spine. Causes: gradual to sudden weakness and
inability to move/ lift legs, bowel/ bladder incontinence, diminished
sensation in legs: saddle. Surgical emergency!
◉ Low back pain management. Answer: Nonsurgical:
- rest
- ice/ heat (alternate)
- NSAIDS
- antispasmodics (diazepam, flexeril)
- opioid short-term, to promote mobility
- anticonvulsants and antidepressants for neuropathic pain
