MS HESI Study Guide student
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Hesi Med/Surg 2 Study Guide
Musculoskeletal
Care of patient with a fracture
Types-
Closed/simple- skin over the fractured area remains intact
Comminuted- bone is splintered or crushed, creating
numerous fragments.
Complete- bone is separated completely by a break into 2
parts. Compression- a fractured bone is compressed by other
bone Depressed- bone fragments are driven inward.
Greenstick- one side of the bone id broken and the other is bent; these
fractures occur most commonly in children
Impacted- a part of the fractured bone is driven onto another bone.
Incomplete- fracture line does not extend through the full
transverse width of the bone.
Oblique- the fracture line runs at an angle across the axis of the
) bone Open/compound- bone is exposed to air through a break in
the skin; soft tissue injury and infection are common.
Pathological- fracture results from weakening of the bone structure
by pathological processes such as neoplasia; also called spontaneous
fracture.
) Spiral- break partially encircles bone
Transverse- bone is fractured straight
across
Assess for
Pain or tenderness
Decrease or loss of muscular strength or function
Obvious deformity
Crepitation, erythema, edema, or bruising
Muscle spasm and neurovascular
impairment
Nursing Interventions
Immobilize affected extremity
Assess neurovascular checks
Reduction, fixation, traction, or
cast
Complications
Fat embolism- originates from bone marrow; long bone fractures are
at greatest risk; can occur within the 1st 48-72 hrs
Avascular Necrosis- occurs when fracture interrupts the blood
supply to a section of bone, leading to bone death; notify MD
immediately
Compartment Syndrome- ↑ pressure that ↓ blood flow; assess
neurovascular checks; notify MD immediately
,MS HESI Study Guide student
Infection and Osteomyelitis
, MS HESI Study Guide student
Pulmonary Embolism
Skin Color
Skin temperature
Movement
Sensation
Pulses
Capillary Refill
Pain
Rheumatoid arthritis/Osteoarthritis
OA-involves the formation of new joint tissue in response to cartilage destruction.
Not a normal part of aging. The pathogenesis is complex, metabolic, and local factors
that interact wand cause a process of cartilage deterioration.
RA-Chronic, systemic autoimmune disease characterized by inflammation of
connective tissue in synovial (disarthrodial) joints. Characterized by periods of
remission and exacerbation. Can occur at any time in life.
Assessment: (signs and symptoms)
1. OA-Heberden’s and Bouchard’s nodes are red, swollen, and tender.
2. RA-fatique, weight loss, anorexia, generalized
stiffness. Diagnosing Tools (tests or lab values)
1. MRI
2. CT scan/X-ray
3. ESR, ANA titers, CRP
Collaborative Treatment: (e.g. medical or surgical)
1. Treatment with splint and braces, ROM
2. Heat and cold applications (OA) whirlpools, US, paraffin wax baths
3. Acupuncture (alternative therapy OA),
PT/OT Drugs:
1. NSAIDS (both) glucosamine and chondroitin
2. RA (DMARD therapy with Rheumatrex)
3. Corticosteroids, intraarticular injections
(RA) Nursing Interventions:
Pain management, splints, cold application, TAI chi
PT/OT referral for assistive devices
3. Administer medications as prescribed, teach about any side effects
4. Encourage stress
management Teaching:
1. Pt should take meds per MD order
2. Follow prescribed diet, weight management
3. Assistive devices, grab bars, night lights (safety precautions)
Acute and chronic kidney disease- symptoms, signs, lab values, causes, diet,
management
-signs/sx of hyperkalemia, foods high in potassium
.
.
Hesi Med/Surg 2 Study Guide
Musculoskeletal
Care of patient with a fracture
Types-
Closed/simple- skin over the fractured area remains intact
Comminuted- bone is splintered or crushed, creating
numerous fragments.
Complete- bone is separated completely by a break into 2
parts. Compression- a fractured bone is compressed by other
bone Depressed- bone fragments are driven inward.
Greenstick- one side of the bone id broken and the other is bent; these
fractures occur most commonly in children
Impacted- a part of the fractured bone is driven onto another bone.
Incomplete- fracture line does not extend through the full
transverse width of the bone.
Oblique- the fracture line runs at an angle across the axis of the
) bone Open/compound- bone is exposed to air through a break in
the skin; soft tissue injury and infection are common.
Pathological- fracture results from weakening of the bone structure
by pathological processes such as neoplasia; also called spontaneous
fracture.
) Spiral- break partially encircles bone
Transverse- bone is fractured straight
across
Assess for
Pain or tenderness
Decrease or loss of muscular strength or function
Obvious deformity
Crepitation, erythema, edema, or bruising
Muscle spasm and neurovascular
impairment
Nursing Interventions
Immobilize affected extremity
Assess neurovascular checks
Reduction, fixation, traction, or
cast
Complications
Fat embolism- originates from bone marrow; long bone fractures are
at greatest risk; can occur within the 1st 48-72 hrs
Avascular Necrosis- occurs when fracture interrupts the blood
supply to a section of bone, leading to bone death; notify MD
immediately
Compartment Syndrome- ↑ pressure that ↓ blood flow; assess
neurovascular checks; notify MD immediately
,MS HESI Study Guide student
Infection and Osteomyelitis
, MS HESI Study Guide student
Pulmonary Embolism
Skin Color
Skin temperature
Movement
Sensation
Pulses
Capillary Refill
Pain
Rheumatoid arthritis/Osteoarthritis
OA-involves the formation of new joint tissue in response to cartilage destruction.
Not a normal part of aging. The pathogenesis is complex, metabolic, and local factors
that interact wand cause a process of cartilage deterioration.
RA-Chronic, systemic autoimmune disease characterized by inflammation of
connective tissue in synovial (disarthrodial) joints. Characterized by periods of
remission and exacerbation. Can occur at any time in life.
Assessment: (signs and symptoms)
1. OA-Heberden’s and Bouchard’s nodes are red, swollen, and tender.
2. RA-fatique, weight loss, anorexia, generalized
stiffness. Diagnosing Tools (tests or lab values)
1. MRI
2. CT scan/X-ray
3. ESR, ANA titers, CRP
Collaborative Treatment: (e.g. medical or surgical)
1. Treatment with splint and braces, ROM
2. Heat and cold applications (OA) whirlpools, US, paraffin wax baths
3. Acupuncture (alternative therapy OA),
PT/OT Drugs:
1. NSAIDS (both) glucosamine and chondroitin
2. RA (DMARD therapy with Rheumatrex)
3. Corticosteroids, intraarticular injections
(RA) Nursing Interventions:
Pain management, splints, cold application, TAI chi
PT/OT referral for assistive devices
3. Administer medications as prescribed, teach about any side effects
4. Encourage stress
management Teaching:
1. Pt should take meds per MD order
2. Follow prescribed diet, weight management
3. Assistive devices, grab bars, night lights (safety precautions)
Acute and chronic kidney disease- symptoms, signs, lab values, causes, diet,
management
-signs/sx of hyperkalemia, foods high in potassium
