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Fundamentals Chp 27 Musculoskeletal Care > Chp 27 > Flashcards

Chp 27 Flashcards

1
Q

Amputate

A

To remove a limb surgically

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2
Q

Continuous passive motion (CPM) machine

A

A machine designed to gently flex the patient’s knee according to the number of degrees of flexion on the setting and then gently extend the knee

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3
Q

External fixators

A

The wires, pins, tongs, and rods that may be used in skeletal traction

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4
Q

Fracture

A

A break in a bone

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5
Q

Joint Replacement (Arthroplasty)

A

Surgery to remove damaged articular bone surfaces and replace them with metal and plastic surfaces

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6
Q

Osteoarthritis

A

A disorder that causes degeneration and inflammation of joints over time

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7
Q

Physical Therapist

A

A health care team member responsible for assessing musculoskeletal deficiencies and developing the plan of care to strengthen muscles and restore motility

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8
Q

Prosthesis

A

An artificial limb, such as an arm or leg

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9
Q

Skin traction

A

A type of traction in which the limb is wrapped with an elastic bandage or fitted with a velcro wrap to which the frame is attached

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10
Q

Skeletal traction

A

A type of traction in which pins, screws, or tongs are surgically inserted into the bone

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11
Q

Spica

A

A cast that encases the hips and one both legs

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12
Q

Sprain

A

An injury to a joint that results in damage to muscles and ligaments. Severe sprains may cause ligaments to be completely

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13
Q

Stump

A

The remaining portion of a limb after amputation

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14
Q

Immobilization Devices

A
  • Abductor pillow
  • Cast
  • Elastic bandages
  • Amputee compression sock
  • Immobilizer
  • Splint
  • Traction
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15
Q

Abductor pillow

A

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

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16
Q

Cast

A

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

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17
Q

Elastic Bandages

A

Woven bandage containing elastic to stretch as it is wrapped around an injured area; elastic helps compress the area to decrease edema

18
Q

Amputee Compression Sock

A

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 the prosthesis

19
Q

Immobilizer

A

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 or ankle injuries

20
Q

Splint

A

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

21
Q

Traction

A

Skin traction: Involves the use of ropes, pulleys, and weights to align bone ends after a fracture
Skeletal traction: Uses wires, rods, or tongs that penetrate the skin and subcutaneous tissue and inserted into the bone

22
Q

Common crutch walking gaits

A 
Two-point gait
Three-point gait
Four-point gait
Swing-to gait
Swing-through gait
23
Q

Two-point gait

A

For patients who are able to bear partial weight on the affected limb; patient moves one foot and the opposite crutch forward at the same time , and then moves remaining foot and crutch forward

24
Q

Three-point gait

A

For patients who are unable to bear weight on the affected limb; patient moves both crutches and the affected foot forward at the same time without touching down or placing weight on it, and then brings the unaffected foot forward

25
Q

Four-point gait

A

For patients able to bear weight on the affected limb; patient moves the first crutch forward and then the opposite food forward ; patient then moves the remaining crutch forward and then the remaining affected food forward

26
Q

Swing-to gait

A

For patients able to bear weight on the affected limb; patient stands on both feet and moves both crutches forward at the same time; patient then swings both feet forward to the level of the crutches

27
Q

Swing-through gait

A

This is the same as the swing-to gait except that the patient swings both feet forward beyond the level of the crutches

28
Q

Three types of ambulatory devices

A
  • Crutches
  • Canes
  • Walkers (knee walkers)
29
Q

Crutches

A
  • Used when a patient is unable to bear full weight on a lower limb
  • Patient may be restricted to partial weight bearing or no weight bearing
  • 3 finger breadths below the axilla
  • Tips 4 to 6 inches to the side of the heel
30
Q

Canes

A
  • A cane is used when a patient can bear weight on the affected leg but needs extra support while ambulating
  • Ensure that the patient holds the cane on the unaffected side
  • Ensure patient moves affected leg and the cane forward and then the unaffected leg
  • Erect not leaning over the cane
  • A single prong cane,Multi prong canes: three pronged tip- tripod, four pronged tip- quad cane
31
Q

Walkers

A

-Used by patients who can bear full weight on both legs but need assistance maintaining balance

32
Q

Knee Walkers

A

Helpful for patients who can’t bear weight on a foot or an ankle

33
Q

Nursing interventions related to the care of a client in traction

A
  • Pin site care
  • Ensure that the weights hang freely and do not rest on the floor
  • Ensure that ropes pull in a straight line without crossing one another
  • Assess for skin breakdown beneath the external traction devices
  • When turning a patient in traction, have another person lift up on the weights, causing slack in the ropes while the patient is turned. After the patient is supported and aligned , the second person then slowly and gently releases the weights to hang freely
  • Ensure that the patient’s body is in proper alignment so that the traction pulls correctly
34
Q

Applying an elastic bandage

A

Skill 27.3 (pg 571)

35
Q

Guidelines for Caring for Patients With Partial and Total Knee Replacements

A
  • Ensure that the patients pain is managed
  • Set the degrees of flexion on the CPM machine according to the physicians orders
  • Follow orders exactly regarding the length of time the CPM machine is to be in use and advancing the degrees of flexion
  • Assist the patient in and out of bed using a walker or other assistive device
  • Follow the physicians orders regarding the amount of weight bearing allowed on the operative knee
36
Q

Guidelines to follow when caring for patients who have had total hip replacements

A
  • Avoid hip flexion beyond 90 degrees
  • Keep the abductor pillow in place while patient is in bed
  • Avoid turning patient on operative side, according to physician orders
  • Assist patient out of bed carefully
  • Ensure patient calls for help if any items are dropped and that the patient does not lean forward
  • Assist patient to get up from chair or bedside commode without leaning forward
37
Q

Caring for a patient after amputation

A
  • physical care: rehabilitation
  • emotional support
  • Observe to make sure it is healing well
38
Q

Guidelines for Nursing Care of Dry Casts

A
  • Teach the patient to avoid putting anything between the cast and the skin beneath, especially to scratch
  • Observe for any drainage staining the cast or any malodorous discharge, which indicates infection.
  • Asses circulation to the casted limb
  • Place tape “petals” over the edge of the cast if they begin to crack or crumble over time.
  • Cast of all materials are being used less, with removable boots and splints favored more by HCP and patient
39
Q

Guidelines for Nursing Care of a Plaster Cast that is not yet dry

A
  • Support the limb on pillows in such a way that air circulates all around the cast for even drying
  • Avoid touching the wet or damp cast with your fingers because they can leave dents in the cast, causing pressure points in the skin beneath
  • use palm of hands to touch cast
40
Q

Plaster casts or splints

A
  • Often applied initially after a fracture or surgery because they mold easier to a precise shape
  • Plaster is the material of choice when bone realignment is necessary to keep the bone in place
41
Q

Fiberglass casting

A
  • Often applied a week or two after injury because it is more durable once the bone starts
  • May also be used if the fractured bone is not out of position
  • Allows for better air circulation, is lighter in weight, and is penetrated better by x-rays for clearer visualization of the healing bone.
42
Q

List key factors regarding neurovascular checks for the client with musculoskeletal injuries

A

P570

Skill 27.1

Fundamentals Chp 27 Musculoskeletal Care (1 decks)

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