Muskuloskeletal Disorders Flashcards
2 best txt for lower back pain
Good body mechanics and losing weight
5 P’s for neurovascular assessment
- Pain
- Paralysis
- Parasthesia
- Pallor
- Pulselessness
Risk factors for osteoporosis (modifiable)
Decrease in calcium and/or vit D, caffeine, nicotine, alcohol, medications
Meds for osteoporosis
Calcitonin, Fosamax
Contraindications for calcitonin
Seafood allergy
Administration of Fosamax
- Do not take with calcium or vit D supplements!
- Take on empty stomach with full glass of H2O
- Sit up for 30-60 mins after taking
Osteomalacia
Vit D is deficient and the none cannot use Ca and phosphorus adequately
Bone becomes weak and soft
Hallmark sign of osteomalacia
Decreased serum Ca and phosphorus
Treatment for osteomyelitis
IV abx 3-6 weeks, then PO up to 3mo
Septic/infectious arthritis
- Usually caused by staph
- warm, painful, red, edematous joint
- decreased ROM and systemic signs of infection
Contusion
Bruising
Strain
PULLED muscle or tendon
Sprain
Injury
Why is a joint dislocation an orthopedic emergency?
It can cause AVN-bone becomes necrotic from lack of blood flow
Nursing mgmt of fractures
- Assess 5 P’s
- Remove constrictive clothing and cover open areas with sterile dressing
- Immobilize extremity
- Safety!
S/Sx of fat embolism
Hypoxia Tachypnea Tachycardia Chest pain Fever AMS Cough w thick white sputum
What do you do if you suspect a fat embolism?
- Place in high-Fowlers
- Put on O2
- Call for help- do not leave your pt!
2 hallmark signs of compartment syndrome
- pain that is unrelieved by meds
* pain with passive ROM
Mgmt of compartment syndrome
- Unwrap any compression dressings immediately!
- Elevate
- Notify surgeon
What should you do before placing a Foley in a pt with a pelvic fracture?
CT should be done ASAP to assess internal damage
How should the HOB be positioned with a thoracolumber spine fracture?
Less than 30 degrees
NSG care of casts/splints/braces
5 P’s assessment
Support cast on smooth, firm surface while drying
Ice for pain ONLY AFTER cast is FULLY DRY
S/sx of pressure ulcer under cast
Area of warmth on cast, drainage, odor
Pin care
Sterile procedure
1-2X/day
Can use chlorhexidine, hydrogen peroxide, or saline
Levels of amputation
Syme: removes foot @ ankle level
BKA- below knee
AKA-above knee
Upper extremity
Complication after amputation- what do you NOT do that could cause a contracture?
DO NOT place residual limb on pillow as it can form a hip flexion contracture
Mgmt for phantom limb pain
Increase activity
Tell pt this is very common
goals of joint replacement (arthroplasty)
Pain relief and maximization of ROM
NSG mgmt of a joint replacement
Ambulatory/PT needs to begin w/in 24hrs
Special post-op precautions to avoid dislocation in a pt with a total hip arthroplasty (THA)
- do not bend hip >90 degrees
- no sitting >45 mins
- do not turn affected leg inward or cross center of body
- no flexion, internal, or external rotation
- abduction pillow and raised toilet seat
Normal post-op drainage for a THA
- 200-500mL for first 24 hrs
* 30mL/8hr at 48hrs post-op
Care for post-op TKA
Compression bandage and ice
Normal post-op drainage for a TKA
No more than 400mL for first 24hr
<25mL by 48hrs
