Chapter 27 Davis Flashcards
What testing for Musculoskeletal Conditions are used:
●X-rays
●MRI
●CT scans
●Bone scans
Types of Immobilization:
Wedge-shaped foam pillow, often with Velcro straps, placed between the legs of patients who have had total hip replacement surgery; keeps hips abducted while patient is in bed; straps keep the pillow in place and prevent shifting
Abductor pillow
Types of Immobilization:
Hard plaster or fiberglass encasement for a limb; used to immobilize joints, usually to stabilize fractures until they heal; sometimes used to immobilize severely sprained joints until healing can occur; often used after musculoskeletal surgeries to stabilize the joint and surgical sites
Cast
Types of Immobilization:
Woven bandage containing elastic to stretch as it is wrapped around an injured area; elastic helps compress the area to decrease edema
Elastic bandages
Types of Immobilization:
Also called a “shrinker sock”; elastic sock or sleeve that fits snugly over a stump to help decrease edema and help it heal in a shape to fit in the prosthesis
Amputee compression sock
Types of Immobilization:
Soft fabric with firm internal stays; opens and closes with Velcro fasteners; used to protect an injured limb and to keep its joints from flexing; often a “boot” for foot and ankle injuries
Immobilizer
Types of Immobilization:
Firm plastic molded form used to keep a joint or joints from flexing; may be applied to a limb and wrapped in place with gauze or an elastic bandage; sometimes “air splints” are used when transporting injured patients; can be slipped beneath the injured limb, wrapped around it, then inflated to immobilize the joint
Splint
Types of Immobilization:
Involves the use of ropes, pulleys, and weights to align bone ends after a fracture; weights are attached to a frame held in place with elastic bandages or other wrap on the skin; may be used to prevent severe muscle spasm due to displaced bones until surgery can be performed
Skin traction:
Types of Immobilization:
Uses wires, rods, or tongs that penetrate the skin and subcutaneous tissue and are inserted into the bone; these are then attached to a frame with weights or only to a frame to hold the bone in place or move the bone with the weights
Skeletal traction
This type of immobilization device is a firm plastic mold form used to keep a joint or joints from flexing
Splint
Caring for Patients With Musculoskeletal Immobilization: Casts
●Support limb on pillows
●Avoid touching wet or damp cast
•Use palms of hands if you must touch the cast
●Teach patient to avoid putting anything between cast and skin
●Observe for any drainage and odors
●Assess circulation
●Place tape “petals” over edges of the cast
Caring for Patients With Musculoskeletal Immobilization: Tractions (Skin traction)
•The limb is wrapped with an elastic bandage or fitted with Velcro wrap to which the frame is attached
‒One or more ropes are attached to the frame where a weight is attached
‒Trapeze bar: Use as a hand grip when moving in bed
Caring for Patients With Musculoskeletal Immobilization: Traction (Skeletal traction)
External fixators: Pins, screws, or tongs are surgically inserted into the bone
Pin site care
Caring for Patients With Musculoskeletal Immobilization: Joint Hip Replacement(Total hip replacement)
Arthroplasty
-Direct anterior approach
The head and neck of the femur is removed and replaced with a titanium implant
Abductor pillow
Caring for Patients With Musculoskeletal Immobilization:(Knee replacement)
•Top and bottom of the joint are replaced with titanium implants
•Continuous passive motion (CPM) machine
What kind of device is used to accomplish flexion of the new knee joint?
CPM machine
machine is designed to gently flex the patient’s knee according to the number of degrees of flexion on the setting and then to gently extend the knee
CPM machine
Caring for Patients With Musculoskeletal Immobilization: Amputation
●Prosthesis
•Wound must heal properly so that a prosthesis can be placed
●Initially, observe the sutures or staples in the residual limb to ensure that all edges of the wound are approximated and growing together well
●Wrapping of the stump (compression sock)
Assistive Devices for Ambulation: Crutches
●Ensure the patient is bearing weight on hands and wrists
●Instruct the patient on how to walk upstairs and downstairs using crutches
●Assist the patient to use the appropriate crutch-walking gait
●Remind the patient to keep the affected foot slightly forward
Assistive Devices for Ambulation: Canes
●Single prod, multi-prod (4 tips), tripod
●A cane is the correct height when the top of it is even with the patient’s hip joint as the tip is positioned 4 inches (10 cm) away from the side of the foot
●Ensure that the patient holds the cane on the unaffected side
●Remind the patient to remain erect, rather than leaning over the cane
●Ensure that the patient moves the affected leg and the cane forward together, then moves the unaffected leg forward
Assistive Devices for Ambulation: Walkers
●Walkers are used by patients who can bear full weight on both legs but need assistance to maintain balance
-Several styles of walkers are available
●Ensure that the patient stands between the back legs of the walker
●Ensure that the patient sets the walker down and steps forward into it
●Ensure that the brakes are set
●Instruct the patient to move the affected leg forward with the walker and then move the unaffected leg
Assistive Devices for Ambulation: Knee Walkers
●Platform for the knee or the knee and lower leg
-Front post with handlebars for steering
-Three or four wheels
●Helpful for patients who cannot bear weight on the lower leg or ankle
-Helps improve patients’ mobility and decreases energy requirements compared with using crutches
Common Musculoskeletal Conditions:
●Sprain
●Fractures
●Joint replacement (arthroplasty)
●Advanced osteoarthritis
●Amputation
•Rest
•Ice
•Compression
•Elevation
Sprain
