FREE Ultimate Orthopaedic Nurse Questions and Answers
A multiple myeloma patient has acquired a bone metastasis. Which kind of medical care is recommended to help avoid fractures?
Explanation:
Because lytic tumors caused by multiple myeloma destroy bone, bisphosphonates are recommended as a treatment to stop fractures. Bisphosphonates are frequently used in conjunction with other treatments for multiple myeloma, a bone marrow cancer, to delay bone resorption, lessen pain, and avoid fractures because up to 85% of patients with the disease develop bone metastases. Lytic bone cancers frequently co-occur with hypercalcemia. Pamidronate and zoledronic acid are two types of bisphosphonates used to treat bone metastases; both are similarly effective, however, pamidronate has fewer side effects.
A stable pelvic fracture patient is permitted to lean to one side. The nurse estimates that a patient can tilt their head a maximum of _________ degrees in any direction.
Explanation:
Patients with stable fractures may be able to tilt up to 45 degrees safely, generally to either side, depending on the site of the fracture. Patients with unstable pelvic fractures are not permitted to turn from side to side due to the risk of displacement and internal damage. In order to prevent any twisting, the patient should be gently logrolled with the back supported by pillows or rolled with a pillow between the legs.
Osteomyelitis in the right knee and distal femur of a 48-year-old patient. Which of the ROM exercises for the right leg should the patient be instructed to perform?
Explanation:
While immobilization devices, like a knee brace, are typically used to prevent stress on the bone and osteomyelitis joints must be rested because the bone is weak from the infective process, the patient should perform range-of-motion (ROM) exercises of the joints above and below the affected part of the leg. To maintain strength and mobility in the scenario outlined in the question, the patient should perform regular ROM exercises for the hip and ankle. To keep their muscles toned, the patient can also perform isometric workouts.
A 10-year-old girl has a 15-degree scoliosis. Which of the following therapies is best to start with?
Explanation:
Physical rehabilitation is typically used to treat mild scoliosis (10–20 degrees), with an emphasis on posture, muscle tone, and spinal flexibility. The kid must be closely watched, though, as bracing, most frequently with a Boston brace, will be necessary if scoliosis advances to intermediate scoliosis (20–40 degrees). Surgery and spinal fusion, frequently involving bone grafting, are typically necessary for severe curvatures (40 degrees or more). There are many surgical techniques employed, but the majority call for segmental instrumentation of the spinal cord.
When a patient utilizes a walker to get around, the walker's height should be
Explanation:
When a patient uses a walker to get around, the height of the walker should be just below the waist to allow for a tiny amount of elbow flexibility. The patient will have to lean forward while using a walker that is too low, and the patient will become unstable if the walker is too high. The patient should be advised to grasp for the arm of the chair instead of using the walker as support when seated. Additionally, the patient shouldn't lean on the walker to support themselves while standing as this could tip the walker over and cause the patient to trip.
Which of the following scenarios most frequently results in stiffness for a patient with osteoarthritis?
Explanation:
Osteoarthritis stiffness is particularly noticeable after periods of rest, such as early in the morning. After 15 to 30 minutes, stiffness frequently starts to loosen up. To ease stiffness, patients should be urged to perform easy range-of-motion exercises on their affected joints before rising. Temporary stiffness may be brought on by periods of overactivity, such as when a joint is stressed during arduous exercise. Additionally, if cartilage fragments become loose inside a joint, stiffness may result. This and joint crepitation are frequently linked.
Which period of the bone healing process allows the patient to resume bearing weight?
Explanation:
Because the bone is not strong enough in earlier stages of bone healing, a patient cannot resume weight-bearing until the remodeling stage of bone healing. A hematoma forms around the fracture ends during the inflammatory stage, helping to hold the bone ends together. The hematoma then transforms into granulation tissue, laying a fibrin network for osteoblasts. A week after the damage, a fibrocartilaginous (soft) callus starts to develop. The soft callus hardens to form the bony callus that connects and fuses the ends of the bones. Remodeling is the last stage when extra callus is reabsorbed and the bone is strengthened.