msk system Flashcards
strain
muscle gets stretched
nursing for strain
cold/heat application, exercise, meds (pain)
sprain
stretching of ligament
nursing for sprain
rest, ice, elevation, cast
simple fracture
skin over fracture is intact
open fracture
skin over fracture is not intact and bone is exposed
complete fracture
bone is broken into 2 parts
compression fracture
bone is compressed by other bone
greenstick fracture
one side of bone broken, other side broken
impacted bone fracture
one bone into another bone
incomplete fracture
crack in bone
oblique fracture
break is on an angle
tranverse fracture
break is straight across bone
pathological fracture
break in bone due to disease
treatment for fractures
cast, Buck’s traction, open or closed reduction, internal or external fixation
Buck’s Traction
proper alignment of bone
nursing for Buck’s Traction
instruct pt not to do heavy lifting, ensure proper alignment, elevate foot of bed
open reduction
surgery to put bone back together
closed reduction
put bone back together without surgery to allow to grow back naturally
complications of fractures
emboli, compartment syndrome, infection, avascular necrosis
nursing for fractures
immobilize, monitor NV
nursing for casts
keep elevate, allow up to 3 days for cast to dry, don’t use heat on cast, monitor for infection, keep clean, turn affected area to allow air circulation
nursing for crutches
when ambulating put pressure on affected side, if numbness in upper extremities do not ambulate
compartment syndrome
pressure increases in an area and can cause damage to muscle
s/s of compartment syndrome
5 P’s: pain, pale, pulselessness, paresthesia, paralysis
nursing for compartment syndrome
notify doctor as irreversible after 4-6 hours, fasciotomy to relieve pressure build-up, loosen cast
fat embolism
can occur after fracture
what bone more likely to have complication of fat embolism?
long bone
s/s of fat embolism
SOB, change in LOC, low BP, high HR
nursing for fat embolism
O2, IV fluids, monitor resp
avascular necrosis
when fracture disrupts blood flow to bone leading to death of bone
gout
urate crystals in joints
cause of gout
high uric acid in body
s/s of gout
pain, hardness at area,
nursing for gout
low purine diet, high fluid intake, no alcohol, heat/cold application for pain
low purine diet
no organ meats, no wine, no cheese
risk for osteoporosis
smoking, earlier menopause, alcohol use, family history, female, higher age, low calcium intake, sedentery life, small frame, race of white or asian
nursing for amputation
monitor bleeding, client education about phantom limb pain, do not elevate amputated on pillow, elevate foot of bed to reduce edema for first 24 hours and then after keep flat to avoid contracture
nursing for hip surgery post op
monitor for hemorrhage, avoid weight bearing or too much activity on that hip, monitor NV status of side of hip
RA
chronic inflammation which destroys connective tissue
nursing for RA
rheumatoid factor blood test to diagnose, exercise, avoid weight bearing on that area, PT/OT,
OA
deterioration of articular cartilage in peripheral and axial joints
s/s of OA
pain increases with activity, increases when temperature changes, Heberden’s nodes: bumps on joint closest to fingernail, Bouchard’s node: bumps on middle joint
nursing for OA
meds (pain, corticosteroid), cold application,
fall prevention
orient to room, teach how to use call bell, keep bed in lowest position, raise 3 of 4 side rails, lock wheels on all equipment, keep floor dry, wear slip resistant footwear, stay with pt during shower
deep tendon reflexes
0 = no response 1+ = diminished 2+ = active/normal 3+ = slightly hyperactive 4+ = hyperactive
ambulating with cane on stairs
going up stairs:
strong leg –> cane –> weak leg
going down stairs: cane –> weak leg –> strong leg
*cane always before weak leg
