A coal miner with a history of rheumatoid arthritis reports pain, swelling, and a limited range of motion in the knee joints. Which diagnosis does the nurse suspect?
Bursitis is the inflammation of the bursae located near the joints. Rheumatoid arthritis causes inflammation in the joints, resulting in friction between joint surfaces. The repetitive kneeling involved in occupations such as coal mining may result in bursitis. A shin splint are is inflammation along the anterior aspect of the calf due to periostitis. A rotator cuff tear is a muscle tear around the shoulder joint. Impingement syndrome is also a shoulder injury.
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A patient experiences tearing of a ligament as a result of shearing applied to a joint. which diagnosis does the nurse suspect
Ligament injury
The nurse provides education for a patient who has injured the anterior crucial ligament (ACL) and scheduled for reconstructive surgery. The nurse recognizes that the patient who is a soccer player, needs more teaching when the patient makes which statement?
I am so anxious to play soccer in the next tournament in three months
The nurse is completing discharge teaching with an older patient who underwent a right total hip arthroplasty he. The nurse identifies a need for further instruction if the patient states they need to do what?
Avoid crossing his legs
Use a toilet elevator on toilet seat
Notify future caregivers about the prosthesis
Maintain hip in adduction and internal rotation
The patient should not force the hip into adduction, or force the hip into internal rotation, because these movements could displace the hip replacement. Avoiding crossing the legs, using a toilet elevator on a toilet seat, and notifying future caregivers about the prosthesis indicate understanding of discharge teaching.
A patient experiences a greenstick fracture. The nurse reviews the patients X-Ray results and expects which finding?
An incomplete fracture with one side splintered and the other side bent
A greenstick fracture is an incomplete fracture with one side splintered and the other side bent. A comminuted fracture is a fracture with more than two fragments; the smaller fragments appear to be floating. An oblique fracture is when the line of the fracture extends across and down the bone. A spiral fracture is when the line of the fracture extends in a spiral direction along the bone shaft.
A patient is hospitalized with severe injuries to the ligament surrounding the hip joint. The patient can develop which syndrome if the fascia surrounding the muscle has limited ability to stretch?
Compartment syndrome
Severe injuries to the ligament surrounding the hip joint may result in compartment syndrome if the articular surface of the joint is completely separated. Overuse syndrome results from repetitive movements and awkward postures. Impingement syndrome is the entrapment of soft tissue structures under the coracoacromial arch of the shoulder. Carpal tunnel syndrome may be caused by median nerve compression; the median nerve enters the hand through the carpal tunnel’s narrow confines.
A patient reports pain and inflammation of the knee. The nurse flexes the knee by 15 to 30 degrees and also pulls the tibia forward while keeping the femur stable. The nurse feels a soft forward motion of the tibia with an indistinct endpoint. What diagnosis does the nurse anticipate?
1
Bursitis
2
Rotator cuff injury
3
Carpal tunnel syndrome
Correct4
Anterior cruciate ligament injury
The knee with an anterior cruciate ligament tear may produce a positive Lachman’s test. This test involves flexing the knee by 15 to 30 degrees and pulling the tibia forward, keeping the femur stable. It is considered positive with forward motion of the tibia with a soft feeling and indistinct endpoint. This test is not performed to assess bursitis. A rotator cuff injury may be examined by a drop arm test. Carpel tunnel syndrome may be examined by positive results for Tinel’s sign and Phalen’s sign
Rationale
Osteotomy is the removal of a slice of bone to change the alignment of the joint and to improve weight-bearing capacity. Arthroplasty is the reconstruction or replacement of a joint to relieve pain, improve or maintain a range of motion, and correct deformity. Synovectomy is the removal of synovial membrane. It is used as a prophylactic measure and as a palliative treatment for rheumatoid arthritis (RA). Debridement is the removal of degenerative debris such as loose bodies, osteophytes, joint debris, and degenerated menisci from a joint.
Which type of surgical repair is performed during hemiarthroplasty?
1
Reshaping of the femoral head
2
Repair with internal fixation devices
3
Replacement of both femur and acetabulum
Replacement of part of the femur with prosthesis
4. Replacement of part of the femur with prosthesis
Which joints is considered an ideal sight for surgical fusions?
Hip joint
Knee joint
Wrist joint
Elbow joint
Arthrodesis is the surgical fusion of a joint. Common areas of joint fusions are the wrist, ankle, and cervical spine. The hip, knee, and elbow joints are not considered ideal sites for surgical fusion, because fusion of those joints will lead to immobility.
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