Musculoskeletal Flashcards
Manifestations of sprains & strains
Pain, edema, decreased function, and bruising
Health promotion
i. Warm up exercises and stretching
ii. Strength, balance, and endurance exercises
Acute care of sprains & strains
i. RICE: rest, ice, compression, and elevation
ii. Rest: Stop activity and limit movement
iii. Ice: 24 to 48 hours; 20 to 30 minutes at a time
iv. Compression: elastic bandage; apply distal to proximal
v. Elevate: above the heart
vi. Analgesia
Injuries from prolonged force or repetitive movements and awkward postures
Repetitive Strain Injury (RSI)
repetitive trauma disorder, overuse syndrome
At risk for RSI & example
those who perform repetitive motions without sufficient muscle rest
dancers, butchers, athletes, keyboard operators
S/S of RSI
Inflammation, swelling, and pain in muscles, tendons, and nerves of the neck, spine, shoulder, forearm, and hand
RSI treatment
i. Identify precipitating activity
ii. Modify equipment or activity
iii. Pain management
iv. Rest
v. Physical therapy
Carpal Tunnel Syndrome often caused by (6 things)
Trauma Edema Cancer RA Soft tissues masses hormones
CTS is increased incidence with
diabetes, PVD, RA, and women
Manifestations with CTS
- Impaired sensation, pain, numbness, or weakness; clumsiness
- Tinel’s/Phalen’s sign
Late stages of CTS
Atrophy, recurrent pain, and dysfunction of hand
CTS Prevention (10 things)
a. Identify risk factors
b. Adaptive devices
c. Ergonomic changes
d. Acute Care—relieve compression
e. Rest/splints @ night
f. PT
g. Corticosteroid injection
h. Change in occupation
i. Surgery
j. Open or endoscopic
Cap refill:
Greater than 3 seconds indicates arterial insufficiency
Pallor and cool/cold
indicates poor arterial insufficiency
Overall goals for musculoskeletal treatment
- Healing with no associated complications
- Satisfactory pain relief
- Maximal rehabilitation potential
Surgical goal of amputation
Preserve as much extremity length and function as possible while removing infected, pathologic, or ischemic tissue
Nursing assessment of amputation
i. Assess for preexisting illnesses
ii. Assess vascular and neurologic condition
Priority problems for amputation
i. Disturbed body image
ii. Impaired tissue integrity
iii. Chronic pain
iv. Impaired mobility
Goals for a patient with an amputation will
i. Have adequate relief from underlying health problem
ii. Have satisfactory pain management
iii. Reach maximum rehabilitation potential
iv. Cope with body image change
v. Make satisfying lifestyle adjustments
Pt and caregiver education
i. Examine lower extremities daily
ii. Report changes in feet or toes
iii. Review safety precautions related to recreational activities or hazardous work
Phantom limb sensation
- Shooting, burning, or crushing pain and feelings of coldness, heaviness, and cramping
- May subside or be chronic
Pt & caregiver education post op
Residual limb care, ambulation, contracture prevention, recognition of complications, exercise, and follow-up care
Specific caregiver education post op
- Frequent movement: laying on abdomen
- Vitamin A & C
- Wash limb @ night & air it out for 20 minutes, put clean sock on
- No lotion, alcohol, powders, or oils
Rehabilitation
i. Success depends on physical and emotional health
ii. Physical and occupational therapy involvement important
iii. Flexion contractures (e.g., hip) delay rehabilitation
iv. Proper bandaging important for prosthesis fitting
v. Should not sit in a chair for more than an hour
Amputation expected outcomes
i. Accept changed body and integrate changes into lifestyle
ii. Have no evidence of skin breakdown
iii. Have reduction of absence of pain
iv. Become mobile within limitations imposed by amputation
