Nursing Care of Musculoskeletal and Connective Tissue Disorders

Question 1

Strain

Answer 1

Soft tissue injury due to muscle or tendon being excessively stretched

Question 2

Cause of strains

Answer 2

Falls
Excessive exercise
Lifting heavy items

Question 3

Severe strain is due to

Answer 3

the muscle or tendon being ruptured, with separation of muscle from muscle, tendon from muscle, or tendon from bone

Question 4

RICE

Answer 4

Rest
Ice
Compression
Elevation

Question 5

Sprain

Answer 5

Excessive stretching of one or more ligaments usually resulting from twisting movements during a sports activity, exercise, or fall

Question 6

Severe sprain causes

Answer 6

instability of the joint and usually requires surgical intervention for repair or grafting of the tissue

Question 7

Dislocations

Answer 7

Ends of the bones are forced from normal position

Question 8

Bursitis

Answer 8

Inflammation of the bursa due to arthritis, gout, repetitive movement, or sleeping on one’s side

Question 9

Bursitis symptoms

Answer 9

Achy pain
Stiffness
Burning pain over joint area worsens with activity

Question 10

Rotator Cuff Injury symptoms

Answer 10

Shoulder aching 
⬆️ pain with lifting the arm 
Greater pain at night 
Weakness 
Sometimes limited ROM

Question 11

Carpal Tunnel Syndrome

Answer 11

Compression of the median nerve within the carpal tunnel when swelling in the tunnel occurs

Question 12

S&S of Carpal Tunnel Syndrome

Answer 12

Slow-onset finger, hand, and arm pain and numbness

Painful tingling and parasthesia possibly

Question 13

Treatment for Carpal Tunnel Syndrome

Answer 13

Focus is on relieving inflammation and resting wrist 
Splint 
Medications such as aspirin
Cortisone maybe 
Surgery for some

Question 14

Fracture

Answer 14

Break in bone

Question 15

Hematoma forms how long after a fracture?

Answer 15

48-72 hours

Question 16

Osteoclasts

Answer 16

Bone destroying cells

Question 17

What is the use of Buck’s traction for?

Answer 17

Hip fractures

To prevent further trauma

Question 18

Open Reduction with Internal Fixation (ORIF) of the hip allows:

Answer 18

Early mobilization while the bone is healing

Question 19

Avulsion fracture

Answer 19

Piece of bone torn away from the main bone while still attached to a ligament or tendon

Question 20

Comminuted fracture

Answer 20

Bone splintered or shattered into numerous fragments

Most often in crushing injuries

Question 21

Impacted fracture

Answer 21

Bone is forcibly pushed together causing the bone to be pushed into bone

Question 22

Greenstick fracture

Answer 22

Bone is bent and fractures on the outer arc of the bend

Often in children

Question 23

Interarticular fracture

Answer 23

Fracture within a joint

Question 24

Displaced fracture

Answer 24

Bone pieces out of normal alignment

Question 25

Pathological (neoplastic) fracture

Answer 25

Bone is weakened by either pressure from a tumor or an actual tumor within the bone

Question 26

Spiral fracture

Answer 26

Fracture curves around shaft of bone

Question 27

Longitudinal fracture

Answer 27

Fracture occurs along length of bone

Question 28

Oblique fracture

Answer 28

Fracture occurs diagonally or at an oblique angle across the bone

Question 29

Stress fracture

Answer 29

Bone is fractured across one cortex | Incomplete fracture

Question 30

Transverse fracture

Answer 30

Bone fractured horizontally

Question 31

Depressed fracture

Answer 31

Bone pushed inward | Often seen with skull and facial fractures

Question 32

Urgent Management of Fractures

Answer 32

1. Immobilize affected limb stat 2. If no bleeding, apply splint and padding above and below fx over clothing If bleeding is present, apply pressure 3. If leg is fractured, use other leg as a splint by bandaging them together Arm can be bandaged to the chest 4. Assess CWCM (color, warmth, circulation & movement) of the limb distal to fx 5. If open fx, protruding bone should be covered with a clean dressing (sterile preferred) 6. Do not attempt to straighten or realign

Question 33

Assessing patient with a cast

Answer 33

- CWCM - color, warmth, circulation, movement every 1-2 hours for 24 hours, then qid and prn - Tightness (ask patient) - Rough or frayed edges - Make sure patient can move all digits distal to cast

Question 34

NI for patient with new (wet) cast

Answer 34

-Never grasp wet cast to move or hold it or place on any surface that can cause indentation - use only palms of hands -Turn patient every 1-2 hours -With hip spicas or any cast with an abductor bar, do not use bar to move limb or help with turns -

Question 35

What do you clean a prosthesis socket with?

Answer 35

Water | Let it dry completely

Question 36

Replace prosthetic liners and worn inserts when:

Answer 36

They become too soiled to clean adequately

Question 37

Gout patients should avoid:

Answer 37

``` High purine foods such as organ meats, shellfish, and sardines Alcohol Diuretics Aspirin Excessive physical or emotional stress ```

Question 38

As a nurse, what is recommended protocol for caring for a severed body part that may be replanted?

Answer 38

Wrap in a cool moist cloth

Question 39

What lab values should be monitored for a gout patient?

Answer 39

Uric acid

Question 40

What type of skin traction involves using a foam boot with Velcro fasteners for a fractured hip?

Answer 40

Buck's traction

Question 41

When treating a patient with gold therapy for RA, what 2 following interventions are essential?

Answer 41

Giving a test dose of gold | Monitoring patient after injection

Question 42

What is the purpose of an erythrocyte sedimentation rate (ESR) test?

Answer 42

To identify presence of systemic inflammation

Question 43

A common nursing diagnosis for a patient with lupus is:

Answer 43

Fatigue

Question 44

Fasciotomy

Answer 44

Surgical procedure performed by cutting back the fascia to relieve stiffness and pressure (fascia is thin connective tissue covering the muscles and may be injured due to continuous strain or trauma)

Question 45

Hemarthrosis

Answer 45

Bleeding into a joint

Question 46

Crepitation

Answer 46

Dry, cracking sound or sensation produced by grating ends of fractured bone

Question 47

Gout

Answer 47

Common group of arthritic disorders marked by decomposition of monosodium urate crystals in joints and other tissues

Question 48

Avascular necrosis

Answer 48

Limited blood supply to an area such as the hip after a fracture or dislocation causing death to the bone tissue

Question 49

Colles fracture

Answer 49

Broken end of the radius tilts upward (most common distal radius fracture)