ONP-C flashcards
ONP-C · Build recall with a focused review session.
34 cards. Read the term and the definition here. The deck at the top of this page is optional.
- Five Ps of neurovascular assessment
- Pain, pallor, pulselessness, paresthesia, and paralysis. Paresthesia and disproportionate pain often signal early compartment syndrome before pulse loss.
- Ottawa Ankle Rules
- Ankle X-ray is indicated with malleolar pain plus bone tenderness at the posterior lateral or medial malleolus, or inability to bear weight four steps.
- Cauda equina red flags
- Saddle anesthesia, new bowel or bladder dysfunction, bilateral sciatica, and progressive motor deficit. These require emergent MRI and surgical evaluation.
- Osteoporosis DXA threshold
- A T-score of -2.5 or lower at the hip or spine defines osteoporosis. Scores between -1.0 and -2.5 define osteopenia.
- Osteoarthritis radiographic features
- Joint space narrowing, subchondral sclerosis, osteophytes, and subchondral cysts. Symptoms correlate poorly with radiographic severity.
- Carpal tunnel syndrome findings
- Median nerve numbness, positive Phalen and Tinel tests, and late thenar atrophy. Night splints and steroid injection are first-line conservative measures.
- Rheumatoid arthritis hallmarks
- Symmetric small-joint polyarthritis, morning stiffness over one hour, and positive anti-CCP or rheumatoid factor. Early DMARD therapy limits joint erosion.
- Avascular necrosis risk factors
- Corticosteroids, alcohol use, sickle cell disease, and trauma. Early MRI is the most sensitive imaging test before collapse occurs.
- Gustilo-Anderson classification
- Grades open fractures: I under 1 cm clean; II 1-10 cm; IIIA adequate coverage; IIIB needs flap; IIIC has arterial injury requiring repair.
- Compartment syndrome pressure threshold
- A compartment pressure above 30 mmHg, or within 30 mmHg of diastolic pressure, supports fasciotomy when paired with clinical findings.
- Fat embolism syndrome triad
- Hypoxemia, petechiae, and neurologic confusion occurring 24-72 hours after long bone fracture. Treatment is supportive.
- Salter-Harris classification
- Physeal fracture types I through V: through physis, physis plus metaphysis, physis plus epiphysis, both, and crush injury. Type V has worst prognosis.
- Multimodal analgesia principle
- Combining acetaminophen, NSAIDs, regional blocks, and limited opioids targets multiple pain pathways and reduces opioid dose and adverse effects.
- NSAID contraindications
- Avoid or use caution with renal impairment, GI ulcer history, heart failure, and anticoagulation. COX-2 inhibitors carry cardiovascular risk.
- Acetaminophen dosing limit
- Maximum 3-4 grams daily in healthy adults. Lower limits apply with hepatic disease, alcohol use, or malnutrition.
- Tramadol safety concerns
- Lowers seizure threshold and increases serotonergic risk. Avoid with MAOIs and use caution with SSRIs or seizure history.
- Periprosthetic joint infection workup
- Erythrocyte sedimentation rate, C-reactive protein, and synovial fluid cell count and culture. Chronic infection may require two-stage revision.
- Surgical site infection prevention
- Preoperative antibiotics within 60 minutes, chlorhexidine skin preparation, normothermia, glucose control, and avoiding unnecessary hair removal.
- External fixation indications
- Damage-control stabilization in polytrauma, open fractures, and unstable pelvis injuries. Pin site care prevents infection.
- Intramedullary nailing risks
- Standard for femoral and tibial shaft fractures. Monitor for fat embolism, compartment syndrome, and malalignment.
- Weight-bearing status categories
- Non-weight-bearing, touch-down, partial, weight-bearing as tolerated, and full. Always follow surgeon orders and verify with therapy.
- Postoperative neurovascular checks
- Assess circulation, sensation, motor function, and pain every 1-2 hours initially, then per protocol. Report changes immediately.
- Early mobilization benefits
- Reduces delirium, venous thromboembolism, and length of stay after arthroplasty. Begin within 24 hours when medically stable.
- Return-to-sport criteria
- Functional milestones, not fixed timelines: pain-free motion, strength symmetry, and sport-specific testing before clearance.
- Teach-back method
- Ask patients to explain instructions in their own words. This confirms understanding and identifies gaps before discharge.
- DVT warning signs
- Unilateral calf pain, swelling, warmth, and redness. Instruct patients to seek urgent evaluation rather than massage the leg.
- Osteoporosis prevention counseling
- Weight-bearing exercise, adequate calcium and vitamin D, smoking cessation, limited alcohol, and fall prevention reduce fracture risk.
- Opioid patient education
- Teach secure storage, disposal, constipation prevention, sedation awareness, and no driving while impaired. Include naloxone information when appropriate.
- Informed consent elements
- Requires capacity, disclosure of risks, benefits, and alternatives, and voluntary decision. The performing surgeon obtains consent.
- Just culture principle
- Distinguishes human error from reckless behavior. Encourages event reporting and system improvement rather than blame.
- SCFE presentation
- Slipped capital femoral epiphysis causes hip or referred knee pain and limited internal rotation in adolescents. Treatment is surgical stabilization.
- Delirium prevention in elders
- Orientation, sleep hygiene, early mobility, hydration, pain control, and minimizing anticholinergic medications reduce postoperative delirium risk.
- Pelvic fracture instability management
- Apply pelvic binder, activate massive transfusion protocol, and consider angioembolization or external fixation for hemodynamic instability.
- Septic arthritis management
- Joint aspiration before antibiotics when feasible, empiric intravenous antibiotics, and urgent drainage. Do not delay treatment for imaging.