BIO 234 uworld nclex EXAM BEST STUDY GUIDE
REVIEW 2022 UPDATE
BIO
Spinal immobilization (NSAIDS) – THINGS THAT YOU CONSIDER BEFORE
IMMOBILIZING SPINE*
Neurological examination – check for focal deficits, numbness and decreased
strength
Significant Traumatic mechanism of injury
Alertness
Intoxication – if they’re intoxicated they might lack awareness of pain
Distracting injury – another significant injury distracting them from spinal pain
Spinal examination – tenderness of spine or neck, pain on movement
Pathologic vertebral fractures are very common in people with multiple myeloma
Joint dislocations
- Can be an orthopedic emergency because the articular bone might compress
surrounding vasculature causing limb-threatening distal ischemia*
- Can cause damage to nerves and blood vessels
- Pain, deformity, decreased ROM, extremity paresthesia
- Goal is to reduce and immobilize the joint, do frequent neurovasc checks
Phalen’s test – assess for carpal tunnel syndrome
BIO 234 uworld nclex EXAM BEST STUDY GUIDE
REVIEW 2022 UPDATE
,BIO 234 uworld nclex EXAM BEST STUDY GUIDE
REVIEW 2022 UPDATE
CSF leakage through nose or ears can indicate skull fracture
- If the drainage is clear, dextrose testing can be done to identify the CSF
- Presence of blood would make this test unreliable because there is glucose in
blood
o Use gauze to do halo/ring test in the presence of blood
o Blood will clot in the center, CSF will stay surrounding the blood like
a “halo”
Racoon eyes and ecchymosis behind the ear (mastoid) – battle’s sign; basilar skull
fracture
Should patient elevate arms when they have arm cast?
- Elevating the arm for the first 48 hours after placement is okay, helps reduce
edema
- If compartment (3rd space shifting tissue compartment) syndrome
develops, keep the arm at torso level
BIO 234 uworld nclex EXAM BEST STUDY GUIDE
REVIEW 2022 UPDATE
,BIO 234 uworld nclex EXAM BEST STUDY GUIDE
REVIEW 2022 UPDATE
Long term PPI (for GERD) meds can lead to
- Osteoporosis; because it can decrease the absorption of calcium
- Can increase risk for C-diff (can get because antibodies destroy normal flora)
too somehow
Mandibular fracture
- Drooling can occur because they can’t close their mouth due to edema or jaw
misalignment
- Bleeding can occur and it can pool up in the mouth – PRIORITY IS AIRWAY!!
Suction to maintain airway patency
- Give O2 via nasal cannula, opioids for pain and ice to reduce edema
Ankylosing Spondylitis
- Inflammatory disease affecting the spine, no known cause or cure
- Axial joints fuse together, person becomes very stiff and mobility is restricted
- Low back pain can be improved with activity
- If thoracic spine is affected watch out for breathing, they can end up
hypoventilating due to limited chest wall expansion
- Tell them to fix their posture, stretch, swim, stop smoking
- NSAIDs for pain
- Sleep on a firm mattress
Pelvic fracture – WORRY ABOUT BLEEDING
- Abdominal distention
- Watch out for hgb and hct, worry about internal hemorrhage
- Assess for injury to other structures within the pelvis – bowel or bladder
- Assess for hematuria and low urine output
- Absent bowel sounds – could be paralytic ileus (no bowel sounds) due
to trauma or RETROPERITONEAL HEMATOMA
o Retroperitoneal hematoma results from ruptured organs
Hip Fracture
- Ecchymosis (bruise) over hip
- Femur is very vascular – can result in significant blood loss >1000mL
- Hip pain with weight bearing
BIO 234 uworld nclex EXAM BEST STUDY GUIDE
REVIEW 2022 UPDATE
, BIO 234 uworld nclex EXAM BEST STUDY GUIDE
REVIEW 2022 UPDATE
- Muscle spasms in the injured area – muscles surrounding the
fracture contract to try and protect and stabilize the injured area
- Affected extremity can shorten
Inferior vena cava filter
- Device inserted percutaneously via the femoral vein
- Trap blood clots from lower extremity and prevent it from migrating to
the lungs causing PE
- Usually given to pts that keep getting recurrent emboli and can’t be on
anticoags
- Report this to HCP before getting MRI
- Don’t cross the legs – restricts venous return to legs
- REPORT LEG PAIN OR NUMBNESS – can indicate impaired neurovasc status
BNP
- Used to distinguish cardiac from respiratory causes of dyspnea
- Can indicate heart failure if greater than 100
CK-MB
BIO 234 uworld nclex EXAM BEST STUDY GUIDE
REVIEW 2022 UPDATE
REVIEW 2022 UPDATE
BIO
Spinal immobilization (NSAIDS) – THINGS THAT YOU CONSIDER BEFORE
IMMOBILIZING SPINE*
Neurological examination – check for focal deficits, numbness and decreased
strength
Significant Traumatic mechanism of injury
Alertness
Intoxication – if they’re intoxicated they might lack awareness of pain
Distracting injury – another significant injury distracting them from spinal pain
Spinal examination – tenderness of spine or neck, pain on movement
Pathologic vertebral fractures are very common in people with multiple myeloma
Joint dislocations
- Can be an orthopedic emergency because the articular bone might compress
surrounding vasculature causing limb-threatening distal ischemia*
- Can cause damage to nerves and blood vessels
- Pain, deformity, decreased ROM, extremity paresthesia
- Goal is to reduce and immobilize the joint, do frequent neurovasc checks
Phalen’s test – assess for carpal tunnel syndrome
BIO 234 uworld nclex EXAM BEST STUDY GUIDE
REVIEW 2022 UPDATE
,BIO 234 uworld nclex EXAM BEST STUDY GUIDE
REVIEW 2022 UPDATE
CSF leakage through nose or ears can indicate skull fracture
- If the drainage is clear, dextrose testing can be done to identify the CSF
- Presence of blood would make this test unreliable because there is glucose in
blood
o Use gauze to do halo/ring test in the presence of blood
o Blood will clot in the center, CSF will stay surrounding the blood like
a “halo”
Racoon eyes and ecchymosis behind the ear (mastoid) – battle’s sign; basilar skull
fracture
Should patient elevate arms when they have arm cast?
- Elevating the arm for the first 48 hours after placement is okay, helps reduce
edema
- If compartment (3rd space shifting tissue compartment) syndrome
develops, keep the arm at torso level
BIO 234 uworld nclex EXAM BEST STUDY GUIDE
REVIEW 2022 UPDATE
,BIO 234 uworld nclex EXAM BEST STUDY GUIDE
REVIEW 2022 UPDATE
Long term PPI (for GERD) meds can lead to
- Osteoporosis; because it can decrease the absorption of calcium
- Can increase risk for C-diff (can get because antibodies destroy normal flora)
too somehow
Mandibular fracture
- Drooling can occur because they can’t close their mouth due to edema or jaw
misalignment
- Bleeding can occur and it can pool up in the mouth – PRIORITY IS AIRWAY!!
Suction to maintain airway patency
- Give O2 via nasal cannula, opioids for pain and ice to reduce edema
Ankylosing Spondylitis
- Inflammatory disease affecting the spine, no known cause or cure
- Axial joints fuse together, person becomes very stiff and mobility is restricted
- Low back pain can be improved with activity
- If thoracic spine is affected watch out for breathing, they can end up
hypoventilating due to limited chest wall expansion
- Tell them to fix their posture, stretch, swim, stop smoking
- NSAIDs for pain
- Sleep on a firm mattress
Pelvic fracture – WORRY ABOUT BLEEDING
- Abdominal distention
- Watch out for hgb and hct, worry about internal hemorrhage
- Assess for injury to other structures within the pelvis – bowel or bladder
- Assess for hematuria and low urine output
- Absent bowel sounds – could be paralytic ileus (no bowel sounds) due
to trauma or RETROPERITONEAL HEMATOMA
o Retroperitoneal hematoma results from ruptured organs
Hip Fracture
- Ecchymosis (bruise) over hip
- Femur is very vascular – can result in significant blood loss >1000mL
- Hip pain with weight bearing
BIO 234 uworld nclex EXAM BEST STUDY GUIDE
REVIEW 2022 UPDATE
, BIO 234 uworld nclex EXAM BEST STUDY GUIDE
REVIEW 2022 UPDATE
- Muscle spasms in the injured area – muscles surrounding the
fracture contract to try and protect and stabilize the injured area
- Affected extremity can shorten
Inferior vena cava filter
- Device inserted percutaneously via the femoral vein
- Trap blood clots from lower extremity and prevent it from migrating to
the lungs causing PE
- Usually given to pts that keep getting recurrent emboli and can’t be on
anticoags
- Report this to HCP before getting MRI
- Don’t cross the legs – restricts venous return to legs
- REPORT LEG PAIN OR NUMBNESS – can indicate impaired neurovasc status
BNP
- Used to distinguish cardiac from respiratory causes of dyspnea
- Can indicate heart failure if greater than 100
CK-MB
BIO 234 uworld nclex EXAM BEST STUDY GUIDE
REVIEW 2022 UPDATE
