Musculoskeletal Flashcards
What position should an amputated limb be in?
-Never elevate the limb after amputation
- keep in dependent downward position for more blood flow
How should a pt with an amputated limb lay?
-prone for 30 min 3x a day to prevent hip stiffness
- push stump into bed to increase circulation
Teaching for amputations
- wash limb everyday, expose with air
- change dressing daily
What is osteoporosis?
porous, brittle bones
look like Swiss cheese
Causes of osteoporosis
steroids, excessive caffeine use, smoking, hyperparathyroidism- PTH puts calcium in the blood by draining from the bones
Treatment for osteoporosis
vitamin D and calcium
weight bearing exercise
Gout
uric acid buildup
inflammation in the joints destroy cartilage
causes from high purine foods- red meat, organ meat, alcohol, seafood, sweetened beverage
Treatment for Gout
- lose weight
- avoid high purine foods
- high fluid intake to flush out uric acid
Allopurinol
prevents gout attacks
Colchicine
use to treat acute attacks for gout
Rheumatoid Arthritis
Autoimmune disorder that attacks joints, causes pain and inflammation
- deformities in the hands, fatigue, and stiffness in the morning
What type of pain does RA have?
Pain at rest, relieved with activity
Osteoarthritis
loss of cartilage causing bone on bone pain- crepitus
What type of pain does OA have
pain with activity, relieved at rest
Education for RA and OA
don’t elevate knees with pillows
encourage warm showers or bath before bed
flex foot every hours to prevent dvt for knee replacement
What is present with skull fractures
rhinorrhea- csf leaking from nose
Spinal fracture causes what
T6 or higher causes neurogenic shock
low bp and bradycardia
Hip fracture
shortening in leg on the affected side, muscle spasms and ecchymosis in groin
ORIF
open reduction internal fixation realigns hip
Buck’s traction
free hanging weights that pulls bones into place
- must be free hanging, not on floor or bed
- traction ropes must be tight
- limb should be in neutral position
- keep supine or flat, HOB never above 25*
- neuro checks on limbs
- diminished pulse okay, absent not
Position of legs for hip fracture
Abducted not together
never cross legs
don’t lean forward
don’t sit at 90*
Cast Care
- elevate above heart for 48hrs
- hairdryer on cool setting to relieve itching
Hotspots
indicates infection on casts
hot areas with foul odor report
Compartment syndrome
swelling that cuts off circulation= dead tissue
indicators- pain unrelieved with morphine, unable to move fi angers or toes, tingling, numbness
