CHAPTER 14 MUSCULOSKELETAL, PN 111 INTEGUMENTARY AND HEENT, PN 111 CH. 6, 7, 8, PN 111 CHAPTERS 1-4, PN 111 CH 16 AND 17, PN 111-CARDIAC AND GI, PN 111 RESPIRATORY AND NEURO SYSTEMS, CRANIAL NERVES ALL QUESTIONS AND VERIFIED CORRECT ANSWERS LATEST UPDATE

CHAPTER 14 MUSCULOSKELETAL, PN 111 INTEGUMENTARY AND HEENT, PN 111 CH. 6, 7, 8, PN 111 CHAPTERS 1-4, PN 111 CH 16 AND 17, PN 111-CARDIAC AND GI, PN 111 RESPIRATORY AND NEURO SYSTEMS, CRANIAL NERVES ALL QUESTIONS AND VERIFIED CORRECT ANSWERS LATEST UPDATE What is carpal tunnel syndrome? -Caused by inflammation of the median nerve at the wrist -Causes numbness, tingling, and pain in thumb index and first three fingers How does the nurse assess for carpal tunnel syndrome? By tapping on the medial nerve at the wrist and asking the patient if discomfort is felt and where--Tinel test By asking the patient to put the wrist together with the hands pointing to the ground and ask if discomfort is felt and where-Phalen's Test/Manuever How does the nurse test for muscle strength? By asking the patient to hold out the arm or leg and the nurse applies pressure to the arm or leg while the patient resists the pressure. Strength is graded on a scale of 0-5 What is gout? A hereditary disorder with increase in serum uric acid due to increased production, or decreased excretion of uric acid and urate salts. What are the manifestations of gout? Somatic pain causing swelling, redness and tenderness in the joints, often the joint at the base of the big toe. An attack of gout can occur suddenly What is osteoarthritis? Degenerative change in articular cartilage. Related to overuse of weight bearing joints. Affects weight-bearing joints (vertebrae, hips, knees, and ankles); also hands and fingers. •R/t overuse of weight bearing joints Joint involvement may be unilateral or bilateral. What are the manifestations of osteoarthritis? joint edema and aching pain What is rheumatoid arthritis? A chronic, autoimmune inflammatory disease of connective tissue. What are the manifestations of rheumatoid arthritis? Joint involvement is bilateral. Symptoms are pain, edema, and stiffness of fingers, wrists, ankles, feet, knees., low-grade fever and fatigue. As disease continues, ulnar deviation, swan-neck deformity, and boutonnière deformity may be observed. Where is the temporomandibular joint located and how does the nurse assess it? The nurse will place two fingers in front of each ear and ask the patient to open and close mouth and move mouth side to side. Joint should move freely and smoothly. What are abnormal findings when assessing movement of a joint? The joint should flex and extend freely without crepitus--rubbing/grating feeling (depending on age of patient), subluxation--popping, erythema (redness, edema, heat) , or tenderness. How does the nurse assess for eversion and inversion of a clients ankle/foot? *To assess for eversion ask the patient to turn the foot outward with the small toe facing up *To assess for inversion ask the patient to turn the foot inward at the ankle with the big toe facing up How does the nurse instruct a patient to dorsiflex or plantarflex the foot? •Dorsiflexion-flexing of the ankle and pointing of the toes toward the nose •Plantar Flexion- when the foot is bent at the ankle away from the body What is muscle atrophy? Loss of muscle size and strength What is scoliosis? abnormal curvature of the spine Which joints are able to move in a full circle? Shoulder and hip joints Where are the metatarsals located? foot Where are the metacarpals located? hand What is jaundice A yellowing of the skin and eyes Where does the nurse assess for jaundice sclera, soles of the hands and bottoms of the feet What is petechiae? pin point purplish or red discoloration of an area of the skin. How does the nurse assess nevus (moles) or lesions for possible skin cancer (melanoma) By using the ABCDEF rule---F stands for Familiar What are the four stages of a pressure ulcer? ◦Stage I = prolonged redness with unbroken skin ◦Stage II = partial-thickness skin loss appears as a superficial abrasion, blister, or excoriation ◦Stage III = full-thickness skin loss with damage to subcutaneous tissue (may note serosanguineous drainage) ◦Stage IV = full-thickness skin loss with invasion of deeper tissue into muscle and/or bone; wound appears as an open ulceration with purulent drainage and peripheral crusting ****Some are unstageable with tunnels and discoloration What is impetigo? A highly contagious bacterial infection (easily passed to others) caused by staphylococcal or streptococcal pathogens. Very common in children and crowded living conditions §Usually appears as red sores on the face, especially around a child's nose and mouth, and on hands and feet. The sores burst and develop honey-colored crusts Why does the nurse need to use caution when assisting or moving an elderly patient? Care should be taken when moving older adults or placing adhesives on the skin. Due to thinning (atrophy) of the skin—skin is much easier to tear What is an ecchymosis? §Ecchymosis (bruise)-vascular skin lesion--the passage of blood from ruptured blood vessels into subcutaneous tissue, marked by a purple discoloration of the skin. Can indicate a bleeding disorder, trauma, or abuse--specifically if there are multiple bruises in different stages of healing What does the mnemonic PERRLA stand for and what does is it used for? It used to assess pupillary response and accommodation of the eyes. It stands for Pupils, Equal, Round, Reacti