Musculoskeletal and Orthopedic Conditions Flashcards

A patient returns from surgery for an open reduction and internal fixation (ORIF) of the femur. The nurse assesses the 5 Ps of neurovascular status. Which finding requires immediate intervention?

Answer: Pulselessness and pallor of the affected extremity

Pulselessness and pallor indicate arterial compromise or compartment syndrome, which are surgical emergencies requiring immediate action.

A patient with a hip replacement is being repositioned by the nurse. Which action should be AVOIDED to prevent hip dislocation?

Answer: Adducting the leg across the midline

After total hip arthroplasty, adduction beyond midline, extreme flexion >90°, and internal rotation are the three movements most likely to cause dislocation.

A patient in a long leg cast complains of intense pain when the nurse passively extends the toes. This finding is most consistent with:

Answer: Compartment syndrome

Pain with passive stretch of muscles in a casted extremity is a hallmark sign of compartment syndrome, an orthopedic emergency.

Which laboratory value is most important to monitor following a total joint replacement due to intraoperative blood loss?

Answer: Hemoglobin and hematocrit

Hemoglobin and hematocrit are monitored post-arthroplasty to detect significant blood loss requiring transfusion.

A patient with rheumatoid arthritis (RA) is prescribed methotrexate. The nurse should teach the patient to avoid:

Answer: Alcohol and NSAIDs

Alcohol combined with methotrexate greatly increases hepatotoxicity risk; NSAIDs increase methotrexate toxicity by reducing renal clearance.

A patient with osteoporosis is starting alendronate (Fosamax). The nurse should instruct the patient to:

Answer: Take it with a full glass of water and remain upright for 30 minutes

Bisphosphonates like alendronate must be taken with a full glass of water, and the patient must remain upright for at least 30 minutes to prevent esophageal irritation and ulceration.