Examl 4:l NSGl 320/l NSG320l (Latestl 2025/l
2026l Update)l Adultl Healthl Nursingl Il Completel Guide|l Questionsl &l Answers|l Gradel A|l 100%l Correctl (Verifiedl Solutions)-l GCU
Q:l hipl fracture
Answer:
-commonl inl OA -resultl ofl falls -fracturel inl thel upperl 1/3l ofl thel femur
MANIFESTATIONS
-severel painl andl tenderness,l externall rotation,l musclel spasm,l shorteningl ofl extremityl -displacedl femorall head->disruptsl bloodl tol femorall head->avascularl necrosis CARE wel wantl immediatel surgery
1.l initial:l
-immobilizationl wl bucksl traction:l tol stabilizel ptl forl surgery,l tol decreasel musclel spasmsl forl 24-48l hours
2.l surgery:
-closedl reductionl wl percutaneousl pinningl (CRPP) -repairl wl internall fixation -replacel femorall headl wl prosthesisl (hemil arthroplasty) PREl OP -teachingl inl thel ED -mayl havel tol waitl tilll stable -beginl dischargel planningl bcl ofl shortl hospitall stayl (3-4l days) -managel painl andl musclel spasms:l musclel relaxants,l analgesia,l positioning,l traction POSTl OP -vitall signs,l I&O,l respiratoryl (coughl andl deepl breathe),l neurovascularl assessment,l assessl forl bleeding -dontl layl onl operativel side,l maintainl limbl alignmentl -elevatel legl forl edema -maintainl abduction -usel trapezel barl tol reposition -workl wl PT,l ambulationl typicallyl firstl dayl postl op -weightl baringl activity 1 / 4
-do:l placel pillowl bwl legs,l sitl onl chairl inl shower,l elevatedl toiletl seat -dont:l adductl hipl (bringl kneesl together),l crossl legs,l flexl hipl morel thanl 90l degreesl AMBULATORYl CARE -rehabl ifl livel alone -homel healthl carel nursel wl PT -exercises:l swimmingl andl stationaryl cycling,l avoidl highl impactl activityl -homel safetyl tol avoidl falls:l betterl lighting,l railsl onl stairsl andl shower,l removel trippingl hazards
Q:l arthroplasty
Answer:
reconstruction/replacementl ofl al jointl tol relievel pain,l correctl deformity,l andl improvel ROM
-types:l reshaping,l replacementl ofl partl ofl joint,l orl totall replacement
TOTALl HIPl ARTHROPLASTY -decreasesl painl andl improvesl functioningl inl al fracturedl hipl orl deterioratingl jointl
-replacel balll andl socketl wl prosthesis:
>cement:l bondsl tol thel bonel tol holdl inl place
>cementless:l bonel tissuel growsl intol prosthesis.l goodl forl young,l activel peoplel wl goodl bonel healthl TOTALl KNEEl ARTHROPLASTY -indicated:l severel deteriorationl ofl cartilagel andl unrelievedl painl andl instability
-postl op:
>kneel immobilizationl inl extensionl wl compressionl dressing >painl managementl importantl forl rehab >physicall therapy:l exercisesl tol progressl tol 90l degreel flexion.l Activel ROMl orl contl passivel machinel motion.l earlyl ambulationl wl fulll weightl baringl beforel discharge.
Q:l nursingl carel arthroplasty
Answer:
PREl OP
-patientl freel of:l infection,l acutel jointl inflammation,l skinl breakdown
-explainl postl opl info:l VTEl prophylaxis,l mobilization,l hydration,l PT
POSTl OP -neurovascularl assessmentsl -givel anticoagulantl andl antibiotics:l teachl theml tol contl itl atl home,l coagulantl studiesl -VTEl prophylaxis:l hydration,l earlyl ambulation,l anticoagulants,l shorterl surgeryl time
-painl management:l analgesia 2 / 4
-exercisel andl mobilityl AP -assistl wl hydration,l elimination,l andl hygienel needs -maintainl bodyl positionl andl assistl wl ambulation -intakel andl output -reportl tol nursel ifl tingling,l pain,l decreasedl sensation
Q:l osteomyelitis
Answer:
severel infectionl ofl thel bone,l bonel marrow,l andl surroundingl softl tissue -typicallyl causedl byl S.l Aureusl -riskl factors:l oldl age,l debilitation,l hemodialysis,l sicklel celll disease,l IVl drugl use ACUTEl OSTEOMYELITIS -lessl thanl 1l month -local:l constantl painl thatl isl worsel wl activityl andl unrelievedl byl rest,l swelling,l tenderness,l warmth,l restrictedl movement
-systemic:l fever,l chills,l nightl sweats,l malaise,l nausea,l restless
-late:l drainagel froml skin,l sinuses,l fracturel site
CHRONICl OSTEOMYELITIS -greaterl thanl 1l monthl orl doesn'tl respondl tol antibioticsl -itl isl eitherl continuousl andl persistentl orl recurrentl wl periodsl ofl exacerbationl andl remission -lessl systemicl signs,l morel locall signs -granulationl tissuel turnsl intol avascularl scarl tissuel
DIAGNOSE
-culture -bonel orl softl tissuel biopsy -WBCl count -bonel scan,l MRI,l xray,l CTl scan -increasedl cl reactivel protein
Q:l osteomyelitisl treatment
Answer:
ACUTEl
-prolongedl antibioticl treatment:l
>IVl antibioticsl mayl havel tol continuel atl homel forl 4-6l weeks,l somel mayl needl itl forl 3- 6l mo -softl tissuel abscessl orl ulcerationl needl debridementl orl drainagel 3 / 4
CHRONIC
-surgicall removall ofl poorlyl perfusedl tissuel andl deadl bonel
-extendedl antibioticl use:
>orall fluoroquinolonel forl 6-8l weeks >IVl antibioticsl forl acutel mustl bel followedl wl 4-8l weeksl ofl oral HEALTHl PROMOTION -treatl otherl concurrentl infections -educatel atl riskl peoplel ofl s/s ACUTEl CARE -immobilizationl andl carefull handlingl ofl limb -bedl restl initially
-meds:l nsaids,l musclel relaxants,l opioids
-teachl theml abtl sidel effectsl ofl antibiotics -contactl precautions -sterilel dressingl changesl -teachl theml nonl drugl painl managementl AP -carefull handlingl ofl limb -assistl wl activel ROMl ofl unaffectedl limbl andl passivel ROMl ofl adjacentl jointsl tol thel affectedl partl
AMBULATORY
-takel fulll coursel ofl antibiotics
Q:l osteoporosis
Answer:
chronic,l progressivel metabolicl bonel diseasel characterizedl byl lowl bonel massl andl deteriorationl ofl bonel tissue->l fragilel bone RISKl FACTORS -women,l increasingl age,l lowl bodyl weight -familyl history,l smoking,l alc -lowl Cal andl Vitl D -lowl estrogenl andl testosterone -sedentaryl lifestylel
MANIFESTATIONS
-mcl inl thel hips,l wrists,l andl spine -backl pain -spontaneousl fractures
-late:l lossl ofl heightl andl kyphosisl (humpedl spine)
DIAGNOSIS
-xl rayl studiesl dontl detectl untill 25-40%l ofl bonel Cal isl lost -bonel minerall density:l testl wl DEXAl (duall energyl xrayl absorptiometry)
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