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Pregnancy risk also first line and cost effective.
ask about iodine or shellfish allergy
No metal objects, ask about implants such as pacemakers
looking into the joint, monitor site of incision
S&S of fractures
- Obvious deformity
- loss of function
Bone healing times
- neonatal 2-3 weeks
- early child hood 4 weeks
- later child hood 6-8 weeks
- adolescence 8-12 weeks
- adults 12 weeks
- circulation-C1-C4. C3,4,5 Keep the phrenic nerve alive.
Loss of 20% of blood or more will lead to decompensated shock
Hemoglobin and Hematocrit
Adults every 10 years. possible prophylaxis booster at 5 years if needed-break in skin.
Realign bones to restore neurovascular function. Under conscious sedation at times.
Splints, casts, ORIF-Open reduction internal fixation.
Crush injuries-shattered bone-
External fixator and pin care risks
Osteomyelitis-Infection of the bone- Proper cleanliness for pins in order to prevent this.
Of major long bones for pain relief and to help neurovascular.
ESR (erythrocyte sedimentation rate)
Early indicator of widespread inflammatory reaction due to infection or autoimmune disordersUsually normal in OA
HS-CRP (high sensitivity C-reactive protein)
Non-specific response to acute inflammationIncrease after surgery indicates possible infectionShows inflammation earlier than ESR
Serum chemistry for bones
- 99% of calcium stored in bones and teeth
- 85% of phosphorous stored in bones and teeth
- Bone disease can lead to an increase in the blood of hypercalcemia and hyperphosephatemia
Lab values for Muscle
- CK-Creatine Kinase for skeletal and cardiac muscle
- CPK-MM-Creatine phosphokinase for skeletal muscle
- LDH- HS-CRP (high sensitivity C-reactive protein)
- AST (liver, kidney, heart, skeletal muscles)
- Early treatment-Rx for swelling, PT, Waterarobics, RICE for trauma, Injections of corticosteroid.
- Late treatment-TKA
OA Nursing care
- Degeneration of the articular cartilage in the joints caused by prolonged wear & tear of joint surfaces
- designed to prevent narcotic overdoses
DVT post surgery
- increased calf pain
- increased tenderness above or below the knee
- Veins you can see
- Warmth and redness
- Primary-part of aging
- Secondary-Medical conditions, drug therapy-prednisone leads to this condition-prolonged immobility-not weight bearing.
Test for Osteoporosis
DEXA scan-duel energy x ray measures bones mineral density.
Nursing care for osteoporosis
Teach importance of wt Bearing exercise
Risks associated with osteoporsis
- excessive caffeine-calcium loss in urine
- lack of vitamin D for calcium uptake
- high phosphorus intake-low calcium levels
- protein intake too high or too low
- excessive alcohol and tobacco use
- eating disorders and female athletes-triad.
percutaneous-injection of bone cement into vertebra which reduces pain, increases function, restores strength.
example of a pathologic fracture leading to a fall in a geriatric patient.
- Autoimmune disorder-women more prone
- Chronic systemic disease of autoimmune cause with recurrent inflammation involving the synovium or lining of the joints
rheumatoid arthritis labs
- rheumatoid factor RF
- antinuclear titer ANA
- Erythrocyte sedimentation rate ESR
- High sensitivity C-reactive protein hsCRP
Nursing Care for RA
- Assess pain and stiffness
- administer anti-inflammatory medications
- aspirin, nsaids,corticosteroids
- implement strategies to protect joints-water aerobics
Vitamin D importance
- synonym=cholecalciferol=vitamin D3 sunlight
- VIT D +Parathyroid Hormone+Calcitonin regulate calcium metabolism and osteoblasts.
- Ergocalciferol=Vitamin D2 absorbed from plants
deficiency Leads to increase risk of heart attack, fractures, hypertension and autoimmune diseases.
- Deposit of urate (uric acid) crystals in & around joints; hereditary error in purine metabolism
- Tophi (deposits of crystals on skin) present near joints & on outer ear; renal calculi
- Meds to treat Uric acid build up.
- Colchicine for acute treatment
- NSAIDS for inflammation
- Allopurinol for chronic treatment
Gout Lab tests
- Serum Uric acid Levels
- 20% of patients develop kidney stones
- club foot-congenital twisting of the foot
- developmental dysplasia of the hip DDH- Congenital hip-Spica cast
Avascular necrosis of the femoral heads occurs in childhood
Osteomalacia and rickets
Softening of the bones due to demineralization-due to a deficiency of calcium and vitamin D. chronic renal failure also a risk factor.
Avulsion: tearing away by force-ex. skateboard tricks or a sprined ankle.
Communited: broken into pieces-ex. gunshot wound or crush injury.
Greenstick: One side of bone, not a complete break. ex-bending a live tree branch vs a dead one.
Compression: squeezed together leading to Fx.
Depressed:Below normal level
Displaced: removed from normal
Impacted: packed together
Simple: Closed fracture/ not displaced
Spiral: like a thread of a screw
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