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PVN 135E Review #2

PVN 135E Review #2. True/False. Mark a “T” if the statement is true; an “F” if the statement is false: A “contusion” is from a blow or blunt force trauma that causes local bleeding under the skin A “sprain” causes microscopic muscle tears as a result of overstretching muscles and tendons

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PVN 135E Review #2

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  1. PVN 135E Review #2

  2. True/False • Mark a “T” if the statement is true; an “F” if the statement is false: • A “contusion” is from a blow or blunt force trauma that causes local bleeding under the skin • A “sprain” causes microscopic muscle tears as a result of overstretching muscles and tendons • A “strain” refers to the wrenching or hyperextension of a joint

  3. Multiple Response (MR) • RICE is an acronym referring to what action is appropriate when soft tissue injury occurs? • R= • I= • C= • E=

  4. Multiple Choice (MC) • A temporary displacement of a bone from its normal position is called a: • A. Whiplash • B. Sprain • C. Dislocation • D. Fracture

  5. T/F • A dislocation usually involves tearing of the joint capsule ___ • Subluxations are partial or incomplete dislocations ___

  6. MR • From the list below, indicate which symptoms are usually present with a dislocation: • A. Pain • B. Deformity or shortening of the extremity • C. Limitation of movement • D. Edema

  7. Other • List 3 goals for nursing interventions related to dislocations: • 1. • 2. • 3.

  8. MC • Compression of the median nerve between the carpal ligament and other structures occurs with which condition? • A. Volkman’s contracture • B. Fractured wrist • C. Carpal tunnel syndrome • D. Brachial plexus injury

  9. MR • Which of the following clinical manifestations would occur with carpal tunnel syndrome? • A. Burning pain or tingling in the affected hand • B. Inability to grasp or hold small objects • C. Depressed appearance at the base of the thumb on the palm side • D. Edema of the hand, wrist or fingers

  10. Other • List 2 diagnostic tests used to determine Carpal Tunnel Syndrome.

  11. MR • Treatment of Carpal Tunnel Syndrome could include which of the following: • A. Use of immobilizer • B. Hydrocortisone injection • C. ROM exercises • D. Surgery

  12. Other • List 3 topics to be covered in the nurse’s patient teaching session(s):

  13. Other • List 5 nursing interventions for post operative care of a patient who had carpal tunnel surgery for decompression of median nerve:

  14. MC • When given the medical diagnosis of “herniated nucleus pulposus”, the doctor is describing: • A. Removal of a part of the vertebrae • B. A traumatic injury to the vertebrae or disk in which the continuity of the tissue is disrupted • C. Pressure on the median nerve • D. Rupture of the fibrocartilage surrounding an intervertebral disk, releasing the nucleus pulposus that cushions the vertebrae above and below

  15. Other • Which 2 areas of the body are affected by a herniated nucleus pulposus?

  16. MR • Which of the following diagnostic tests would be used to determine nerve involvement with a herniated nucleus pulposus? • A. Myelography • B. EMG • C. CT scan • D. Physical Exam

  17. Other • Describe what “conservative” treatment for a herniated nucleus pulposus would involve.

  18. MR • Which surgeries would a physician choose that would be appropriate for treating HNP? • A. Laminectomy • B. Spinal fusion • C. Diskectomy • D. chemonucleolysis

  19. Other • List 2 preoperative care actions that could be performed by the nurse for a pt. awaiting a laminectomy:

  20. MR • Two overriding nursing goals for post operative care of the pt. who had a laminectomy include: • A. Remove pressure on spinal nerves • B. Provide ongoing assessment of neurological status • C. Promote healing of operative site • D. Reduce headaches and pain

  21. Other • List 5 post op nursing interventions for a pt. who had a laminectomy:

  22. MC • Back “precautions” for a post op laminectomy patient would include which appropriate “bed” position: • A. Bed position should be completely flat at all times • B. HOB and FOB should be elevated 45⁰ at all times • C. HOB should be flat or slightly elevated; may use a small pillow under knees prn • D. Pt. must lie on left or right side at all times

  23. T/F • Pt./cgr./nurse must maintain a soft collar for cervical laminectomy ___ • For laminectomy pt., pt./cgr./nurse should ensure use of back brace as ordered ___

  24. MR • Maintaining good alignment post laminectomy includes: • A. keeping back straight with movement • B. avoid twists and turns when getting out of bed • C. turn to side and lower legs to floor when getting out of bed • D. use the overhead trapeze to swing out of bed

  25. Other • Amputations are performed for a number of reasons. List 3 reasons for performing an amputation:

  26. MC • One surgical technique used to treat a severed limb is called “replantation”. This refers to: • A. using a cadaver limb and attaching it to the injured person • B. using a healthy limb from an organ donor • C. using the injured person’s own limb that has been kept sterile and in ice water in a plastic bag • D. Using an artificial limb

  27. MR • Medical goals for managing a patient scheduled for amputation or presenting with an injury that included loss of limb would include: • A. Measures to restore circulating blood volume • B. Control pain • C. Prevent wound infection • D. Maintain adequate urinary output

  28. Other (Amputation cont.) • List 4 items of subjective data that the nurse would obtain:

  29. Other (Amputation cont.) • List 3 items of objective data related to the affected extremity:

  30. MC • After surgical repair of an amputated lower extremity, one important nursing intervention would include: • A. Ensuring sufficient visitors for moral support • B. Coordinating with Physical Therapy • C. Ensuring menu delivery daily • D. Providing diversional activities

  31. Other • List 5 post op nursing interventions r/t amputation:

  32. MC • When a person experiences pain in the missing extremity as though it were still present, this is called: • A. Nerve Track syndrome • B. Phantom Limb pain • C. Chronic recurrent neurovascular spasms • D. Impulse message deficit

  33. Other • Why does phantom limb pain occur?

  34. MC • Nursing intervention related to phantom limb pain would be aimed at: • A. Effective pain management • B. Referral to staff psychologist • C. Early ambulation and use of unaffected extremity • D. Assisting pt. to adjust to a new normal

  35. Complete • __________ begins in physical therapy and ________ according to prosthesis situation.

  36. Other • Define “fracture” according to our text/lecture notes.

  37. MR • Identify which of the following is a type of fracture: • A. open • B. compound • C. greenstick • D. comminuted

  38. Other • List 6 clinical manifestations of a fracture:

  39. MC • Which is the most significant diagnostic test that can confirm fracture in most cases? • A. Ultrasound • B. Serum Calcium level • C. Radiographic exam (xray) • D. Palpation

  40. Other • List 6 interventions that a physician would do immediately once a fracture is confirmed:

  41. MR • For a person with a “closed” fracture, optimal reduction is obtained through: • A. Open surgery • B. manual manipulation (closed reduction – no surgery) • C. Internal Fixation • D. Traction

  42. Other • List 6 nursing interventions for a patient with a fracture:

  43. Other • List 6 items to be included in patient teaching for a patient with a fracture:

  44. Identify each of the following fracture types:

  45. Identify the types of hip fractures:

  46. MR • Clinical manifestations of a hip fracture include: • A. Severe pain at the site • B. Inability to move the leg voluntarily • C. Shortening and/or external rotation of the leg • D. Sustained plantar flexion

  47. Other • Medical management of a hip fracture may include traction pre-operatively. Which traction is the most common one used for this purpose? • A. skeletal traction • B. Buck’s traction • C. Crutchfield tongs • D. Bryant’s traction

  48. MR • In preparing to repair Mrs. M’s fractured hip, the choice of fixation devise that the doctor will use depends on which 2 factors: • A. How much mobility is hoped for post operatively for the patient • B. The location of the fracture • C. The potential for avascular necrosis of the femoral head and neck • D. How much osteoporosis may be present

  49. MR • Before surgery, the nurse will be assessing Mrs. M. regularly every 4 hrs. Two overriding goals will guide these assessments. These are: • A. Preventing shock and further complications • B. Pt. education re: ambulation post-op • C. Maintaining proper alignment through traction and abduction of the hip when turning patient • D. Maintaining balanced diet

  50. Other • Post operatively, what is the single most significant behavior to teach the patient to ensure success of the hip replacement surgery and reduce possibility of dislocation of the prosthesis?

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