Muscukoskeletal 3 Flashcards
Osteomyelitis
An acute or chronic infection of the bone or bone marrow and surrounding soft tissue
Can result for vascular compromise and ischaemia which can be avascular necrosis and bone death
Medical management osteomyelitis
Iv antibiotics therapy (4-6 weeks), oral antibiotic (3-6 months)
Immobilisation of affected limb
Nutrias diet
Vitamins
Osteomyelitis surgical management
Debridement of dead bone and tissue
May include removal of prosthetic devices, insertion of antibiotic beads
May include bone and skin graft, vac dressing
Compartment syndrome
Acute compartment- sudden and severe disease in blood flow to the tissues distal to an area of injury
Results in ishaemic necrosis without prompt interventions
The body has 46 anatomical compartments
6 p’s characteristics of impending compartment syndrome
Paraesthesia Pain Pressure Pallor Paralysis Pulselessness
Compartment sydrome present of p
May be present with one or all p’s accurate diagnosis with appropriate treatment can avoid permanent damage to muscles and nerves
Compartment syndrome treatment
Requires immediate attention
Do nor elevate extremity above heart or apply ice to affected area
Surgical decompression
Amputation may be required
Joint replacement
Used to treat severe joint pain and disability and for repair and management of joint fracture or joint necrosis
Frequently replaced joints include hip, knee and fingers
Joints including the shoulder, elbow , wrist and ankle may also be replaced
Nursing process assessment and diagnosis orthopaedic surgery
Pain assessment Vital signs including respiration Levels of consciousness Neurovascular assessment Sign of bleeding Urinary output Mobility Bowel sounds
Acute pain
Nursing interventions
Pain relief Drain care Monitoring and maintaining neurovascular function Skin care measures Monitor and managing complications -urinary retention, infection, constipation ,dvt Mobility abs ambulation Patient education
Knee prostheses
Encourage active flexion exercises
Use of continuous passive motion device
Avoiding hip prosthesis dislocation
Positioning of the leg in abduction to prevent dislocation
Do not flex hip more than 90 degrees
Protective positioning
Avoid internal rotation
Keep knees apart
Pillow between legs when sleeping
Use of high-seated chairs, raised toilet seats
Amputation
The removal of a body part usually extremity
Various clinical indicators such as trauma, injury, infection, malignant tumours or peripheral vascualr disease
Objective of surgery : to conserve as much extremity length
Level of surgery determined by: circulation, type of prothesis, function of part and muscle balance
Nursing care amputation
Diagnosis may include: acute pain
Multidisciplinary teamwork: helping patient achieve physical mobility and promoting self care -rehabilitation
Nursing management : residual limb bandaging
Fosters shaping and moulding for later prosthesis
Supports soft tissue, reduces oedema, hastens healing, minimises pain and promotes shrinking of residual limb
Initially worn continuously for bathing and physio
Ensure bandage is not applied too tightly to interfere with circulation
