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Applied Clinical Veterinary Nursing > Orthopaedic Rehabilitation > Flashcards

Orthopaedic Rehabilitation Flashcards

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1
Q

why is it important to know and understand the stages of tissue healing?

A

for avoidance of excessive stress and strain

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2
Q

what are the stages of healing?

A

post-operative
regeneration
remodelling

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3
Q

when is classed as the post-operative healing phase?

A

24-48hours post-op

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4
Q

when is classed as the regeneration phase of healing?

A

day 5 - 3 weeks +

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5
Q

when is classed as the remodelling phase of healing?

A

6 weeks - 1 year

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6
Q

what occurs in the post-operative stage of healing?

A

pain
oedema
healing tissues

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7
Q

what care should be provided during the post-op stage of healing?

A

reduce pain - multimodal analgesia
cryotherapy
rest
easy movement only - NWB/supported WB

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8
Q

what happens in the regeneration stage of healing?

A

new collagen fibres are forming
still fragile so requires ‘relative rest’

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9
Q

what care should be provided in the regeneration phase of healing?

A

controlled lead exercise
passive/active ROM exercises

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10
Q

what happens in the remodelling phase of healing?

A

consolidation and maturation

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11
Q

what occurs during the remodelling phase of bone healing?

A

regeneration and remodelling

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12
Q

what occurs during consolidation of tissues?

A

cellular into fibrous tissue, increasing strength and alignment

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13
Q

what occurs during maturation of tissues?

A

vascularity and metabolic rate returns to normal (between 10 weeks - 1 year)

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14
Q

what occurs during the regeneration phase of bone healing?

A

bridging callus forms

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15
Q

what occurs during the remodelling phase of bone healing?

A

clinical union of bone

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16
Q

what can occur once the remodelling phase of bone healing is completed?

A

gradual return to normal exercise

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17
Q

what is a common first intervention for cruciate disease cases?

A

weight loss programmes - obesity is common in patients with cruciate disease

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18
Q

what does the recovery of fractures depend on?

A

degree of fractures and site
pre-existing disease
degree of soft tissue damage
presence of open wounds

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19
Q

what should be involved in a rehabilitation plan for a fracture patient?

A

adequate analgesia

restricted exercise

cold compresses

encourage use of the limb

supportive dressing if applicable

20
Q

why should we encourage use of the limb with fracture patients?

A

will help to start regain ROM

21
Q

how can we encourage use of the limb in fracture patients?

A

can start doing PROM exercises - must be minimal to start to avoid further damage

22
Q

what is the main difficulty nursing patients with external fixators?

A

difficulty in applying treatments

23
Q

how can we aid recovery in patients with external fixators?

A

cryotherapy
passage/PROM
active exercises (physio)

24
Q

what type of physiotherapy is important in patients with external fixators?

A

extension of the distal limb to avoid contracture of the muscles - the limb is usually held in a flexed position

25
Q

what are the main aspects of managing patients after joint surgery?

A

main management - multimodal analgesia

pressure dressing 12-24 hours

cryotherapy

PROM

massage can reduce oedema

26
Q

what are the benefits of PROM after joint surgery?

A

maintenance of normal ROM
stimulation of blood and lymphatic circulation
stimulation of sensory awareness

27
Q

what specific management should be considered for patients who have had a THR?

A

management by experienced staff only - clear signage required

walked slowly in a controlled manner

must be kept settled and calm - mild sedation may be required

28
Q

when can PROM be started for tendon injuries?

A

after 3 weeks rest

29
Q

how long should exercise be limited for tendon injuries/rupture?

A

3-6 weeks

30
Q

what are the primary goals of rehabilitation for orthopaedic patients?

A

weight bearing
regain active range of movement
muscle building

31
Q

what is the most important aspect of the post-operative period after orthopaedic surgery?

A

multimodal pain relief - rehabilitation can cause stress on the tissues

32
Q

what is the function of rehabilitation?

A

assists with return to function, minimising stress on the surgical site

33
Q

how can we aid rehabilitation of orthopaedic injury pre-emptively/pre-surgical management?

A

cryotherapy
support dressings
weight bearing as much as possible
good pain management
assessment of other conditions/lifestyles which may affect treatment

34
Q

when is cryotherapy most effective?

A

initial 72hour period

35
Q

what are the advantages of cryotherapy?

A

vasoconstriction - reduced inflammation
analgesic effect
reduced tissue oedema

36
Q

what is the idea application of cryotherapy?

A

15 mins 3x daily

37
Q

what temperature is appropriate for heat therapy?

A

46 degrees C

38
Q

when might heat therapy be beneficial?

A

before exercise - increased blood flow = increased elasticity

39
Q

what are the advantages of massage as a rehabilitation technique?

A

increases blood flow –> improves oxygen supply and aids removal of waste products –> helps muscle work more efficiently

good enrichment for patient

stimulates venous and lymphatic return

mobilises adhesions

prepares muscles for exercise and aids recovery after

40
Q

when is the ideal time to perform massage as part of rehabilitation?

A

as a warm up for physiotherapy session

41
Q

what assisted therapeutic exercises might be done with orthopaedic patients?

A

assisted standing

weight shifting

side bending and cervical flexion/extension

balance boards/swiss balls

muscle stimulation (TENS, e-stim)

42
Q

which active therapeutic exercises might be done with orthopaedic patients?

A

slow walks

stair climbing

sit to stands, down to sits,

treadmill walking

advanced exercises - dancing, wheelbarrowing, hydrotherapy

43
Q

when should hydrotherapy be started for orthopaedic patients?

A

6-12 weeks post-op

44
Q

how can we best communicate when nursing orthopaedic patients?

A

record clear and precise details or progress andn any procedures

take videos walking/of wound to show progress

ensure rehab plans discussed as a team and communicated with all involved

45
Q
A

Applied Clinical Veterinary Nursing (31 decks)

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