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Musculoskeletal System and CareMedical-Surgical Nursing-7th edition

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The best positioning strategies for any joint in order to decrease the risk of injury is?
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Supported, slightly flexed, with no pressure areas, in a 30 degree lateral position.
How should a patient with hemiplegia be supported and positioned while lying supine?
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The affected side should have a pillow under the shoulder, the affected arm should be positioned away from the body with the elbow extended and the palm placed up. The knees should be flexed in a 30 degree position.
_______ people are required to move a patient that is less than 200 lbs. and who is able to partially move themselves.
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Two to three
A patient with a spastic hand should have it positioned?
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With the wrist in a neutral position or slightly extended with the fingers and palm down
In a supported Fowler's position, the head of the bed is _______degrees.
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46 to 60 degrees
For a patient in a supported Fowler's position, where are pillows placed?
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At the lower back, under the thigh and under the ankles.
Where are pillows placed for a client in the supine position?
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Under the head, back, upper shoulders, trochanter, under the ankle, and under the arms.
A patient with a flaccid hand should have it positioned?
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With the wrist slightly extended with the fingers partially flexed
What is the difference between a Sims and a side-lying position?
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In the Sims position the patient is lying partially on their abdomen with their weight on the anterior ileum, humerus and clavicle. In the side lying position the client is fully on their side, at a 30 degree lateral position with the weight on their hip and shoulder.
Which clients require nursing supervision during transfers?
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Patients being transferred for the first time after a prolonged bed rest, surgery, those with a critical illness, or those with a spinal cord injury.
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Hand rolls maintain the thumb in slight ______ and in opposition to the fingers.
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Adduction. They are used on clients with paralyzed arms or those who are unconscious
What are the 3 factors that contribute to thrombus formation in immobilized patients?
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Damage to the vessel walls, alterations to blood flow (decreased from bed rest), and alterations of the blood constituents (increased coagulability).
What is Virchow's Triad and how does it relate to the musculoskeletal system?
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Venous stasis (decreased blood flow), endothelial injury, and hypercoagulability. These factors increase the risk of thrombus formation in patients who are immobile.
What increases the risk of falls in an immobilized patient?
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Loss of endurance, decreased muscle mass and strength, joint instability from disuse related atrophy, and the presence of orthostatic hypotension
What 2 skeletal changes occur from immobilization?
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Impaired calcium metabolism which leads to disuse osteoporosis and joint abnormalities like contractures or foot drop
How quickly can joint contractures begin to form in an older adult?
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After 8 hours
Footdrop means a client's foot is permanently fixed in the _______ position.
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Plantar flexion
What urinary elimination changes occur from immobility?
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Urinary stasis, increased risk of UTI, increased risk of renal calculi, urine reflux to the ureters.
Why are immobilized clients at risk for renal calculi?
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The frequently develop hypercalcemia
Urine becomes more concentrated within ______ days of immobilization. This increases the risk of calculi and infection.
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5 to 6 days
What 2 actions increase the risk of UTIs in an immobilized patient?
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Poor perineal care and the insertion/use of an indwelling catheter
  
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