Care of pt with musculoskeletal and connective tissue disorders: Flashcards
1
Q
Sprains:
A
- partial or complete tear of the ligaments that hold various bones together to form a joint
- a sprain occurs when a joint may be forced during trauma past its normal range of motion, or there may be twisting
- the ankle, knee and writs are the most commonly sprained
2
Q
Signs and symptoms of sprains:
A
- Grade 1 (mild):
- tenderness at site, minimal swelling
- minimal loss of function, no abnormal motion
- Grade 2 (moderate):
- more severe pain especially when weight-bearing, swelling and bleeding into joint
- some loss of function
- Grade 3: (severe, complete tearing of fibers):
- pain may be severe, but swelling, loss of function, and bleeding into joint are more marked
3
Q
Diagnosis & Treatment of sprains:
A
- physical examination
- X-ray to rule out a fracture or other pathology
- Treatment:
- Grade 1 = RICE:
- Rest
- Ice after injury and for 24-72 hours
- Compression - snug elastic bandage \
- Elevation - Grade 2 or 3: rest the joint, crutches for lower extremity sprain, NSAIDs regularly for first couple of days
4
Q
Strain:
A
- a strain is a pulling or tearing of a muscle, a tendon or both
- occurs by trauma, overuse or overextension of joint
- common muscle strains occur in the back muscles or in other muscles such as the hamstring, quadriceps, calf muscles
- S&S:
- history of overexertion
- soft tissue swelling
- pain
- bleeding if muscle is torn
5
Q
Treatment and nursing management:
A
- ice and compression should be applied immediately and should be rested
- the patient is taught to use ice for 20-60 minutes only
- heat can be applied after 48 hours
- anti-inflammatory medications are used for discomfort and when spasm is present a muscle relaxant may be prescribed
- surgical repair may be necessary
6
Q
Dislocation and Subluxation:
A
- S&S:
- history of outside force
- severe pain aggravated by movement
- abnormal joint appearance. muscle spasm
- X-ray is needed
- Treatment:
- reduction of displacement under anesthesia
- MUA - manipulation under anesthetic
- Nursing management:
- rest, pain control, heat or cold applications
7
Q
Bursitis;
A
- injury of overuse
- S&S:
- mild to moderate aching pains
- swelling, history of injury
- physical examination
- Treatment:
- rest, ice and massage
- anti-inflammatory agents
- compression wrap
- bursa cortisone injection
- Nursing management:
- assess pain and perfusion
- assist with mobilisation
- activity limitations
7
Q
Other connective tissue disorders:
A
- rotator cuff tear
- anterior cruciate ligament injury
- meniscal injury
- achilles tendon rupture
- bunion
7
Q
Bone tumors:
A
- benign (non-cancerous) and malignant tumors
- primary and secondary tumors
- osteosarcoma and pagets disease
- S&S:
- pain, warmth and swelling
- Diagnosis:
- X-ray, bone scan and biopsy
- Treatment:
- surgery, radiation and chemotherapy
8
Q
Nursing care of a pt with a musculoskeletal disorder:
A
- promote rest and relieve pain
- prevent complications of inactivity and promote movement when possible
- maintain skin integrity
- maintain or improve nutritional status
- promote rehabilitation
9
Q
General treatment of musculoskeletal disorders:
A
- promoting rest helps minimise pain and swelling
- promoting rest helps healing of injured tissues, relieves muscle spasms and prevents further tissue destruction in inflammatory conditions
10
Q
Drain tubes:
A
- during surgery a drainage tube may be placed via a separate ‘stab’ incision near the principal wound
- drainage tube promotes healing by draining blood, serum and debris that may accumulate and result in swelling, pain, infection and abscess formation
- the type of drainage tube inserted depends on the site and wound
11
Q
Nursing care of a patient with drain tubes:
A
- observe and note the location of any drain tube
- check drainage amount and type. drainage is expected to be bloodstained initially and gradually becoming serous
- report sudden change in amount of drainage or leakage
- educate patient about the drainage system
