Topic 1 Flashcards
Impact of Musculoskeletal conditions
-Loss of function (e.g. immobility or reduced/ impaired mobility, impaired posture or gait, reduced range of motion [ROM])
- Chronic pain
Social: isolation, inability to contribute to society
- Psychological- depression (4 times more common in people with chronic pain)
Management of Osteoarthritis
- Physical activity
- Weight management
- Joint replacement surgery (most common condition leading to hip and knee replacement surgery).
- Medication: pain management (paracetamol, non-steroidal inflammatory drugs (NSAIDs), corticosteroids & opioids).
Management of Rheumatoid Arthritis
- Physical activity
- weight management
Medication (e.g. Methotrexate) - Stress reduction
- Physiotherapy
- Massage
- Surgery
Arthritis of Osteoarthritis
- Non-Inflammatory degenerative disease
- Most commonly occurring form of arthritis
- Leading causes of pain and disability in older adults
- Cartilage becomes weak, rough, eroded and no longer protects the surface of the bone.
Arthritis of Rheumatoid Arthritis
- Common areas = hands
- Affects joints and surrounding tissue.
- Autoimmune and systemic inflammatory condition.
Management of sprains and strains (Immediate management R.I.C.E)
Rest
Ice
Compression
Elevation
(Heat should not be applied for the first 72 hrs)
Management of sprains and strains (on going management)
- Exercise (set by GP or Physio)
- Electrotherapy (E.g. TENS machine)
- Pain relief (i.e. Analgesia & NSAIDs)
- Gradual reintroduction of activities.
Sprain
Overstretching or tearing of muscles or tendons. Most common in calf, groin, hamstring and lower back.
Symptoms include muscle spasm, pain around the affected joint, swelling, limited flexibility, difficulty using the joints full range of motion.
Strain
Overstretching or tearing of ligament/s. Most common joint = ankle.
Symptoms include bruising, pain around the affected joint, swelling/ oedema. limited flexibility, difficulting using the joints full range of motion.
Care of patient with a musculoskeletal conditions
- affect 1.71 billion people
- are the highest contributor to the global need for rehabilitation.
- Often co-exist with other noncommunicable illness (e.g. cardiovascular disease, respiratory disease).
- affects joints, bones, muscles, multiple body areas/ systems.
Health and wellness across the lifespan: older adults
- Declining in strength and health
- Minimise positional changes
- Slow pave
- Allow rest periods
- Regular health checks
Health and wellness across the lifespan: early- middle adulthood (20-40-65 years)
- Physical growth complete
- Education
- Employment
- Health screening
- Immunisation status
- Lifestyle choices
Health and wellness across the lifespan: School age child (6-10/12)
- Build rapport with parent. guardian and child
- Sit child on examination table
- Use gown/ drape
- Use games/ distractions
- Demonstrate equipment
- Limit number of people in the room.
Health and wellness across the lifespan: Early childhood (1-5 years)
- Building a rapport with the child before you commence any assessment
- Use a soft tone
- Praise child
- Use appropriate language for age group
Health and wellness across the lifespan: Infant (birth to 1 year)
- Parent/guardian present (consent)
- 1-2 hours after feeding (only if unwell)
- Smile and talk to the baby and parent/ guardian
- Offer parents/ guardian opportunity to ask questions.
- Warm environment, equipment, hands
Registered nurse standards (7 standards)
Standard 1: Thinks critically and analyses nursing practice.
Standard 2: Engages in therapeutic and professional relationships.
Standard 3: Maintains the capability for practice.
Standard 4: Comprehensively conducts assessments
Standard 5: Develops a plan for nursing practice.
Standard 6: Provides safe, appropriate and responsive quality nursing practice.
Standard 7: Evaluates outcomes to inform nursing practice.
NSQHS Standards
-Clinical Governance
-Partnering with Consumers
-Preventing and controlling infections
-Medication Safety
-Comprehensive care
-Communicating for safety
-Blood management
-Recognising and responding to Acute deterioration
Vital signs
TERM: 3.5 kg, 60-105mmHG, 110-170HR, 25-60RR.
3 MONTHS: 6kg, 65-115mmHG, 105-165HR, 25-55RR.
6 MONTHS: 8kg, 65-115mmHG, 105-165HR, 25-55RR.
1 YEAR: 10kg, 10-120mmHG, 85-150HR, 20-40RR.
2 YEARS: 13kg, 70-120mmHG, 85-150HR, 20-40RR.
4 YEARS: 15kg, 70-120mmHG, 80-150HR, 20-40RR.
6 YEARS: 20kg, 80-130mmHG, 70-135HR, 16-34RR.
8 YEARS: 25kg, 80-130mmHG, 70-135HR, 16-34RR.
10 YEARS: 30kg, 80-130mmHG, 70-135HR, 16-34RR.
12 YEARS: 40kg, 95-140mmHG, 60-120HR, 14-26RR.
14 YEARS: 50kg, 95-140mmHG, 60-120HR, 14-26RR.
17+ YEARS: 70kg, 95-140mmHG, 60-120HR, 14-26RR.
Primary Survey/Assesment
CRITERIA:
Airway
ASSESMENT CONSIDERATIONS
*Is the patient talking?
*Are they able to speak in full sentences?
*Are their abnormal breath souths (e.g. stridor, gurgling)?
CRITERIA
Breathing
ASSESMENT CONSIDERATIONS
*What is the patient’s respiratory rate (RR)?
*What is the patient’s O2 saturations?
*What is the patient’s effort of breathing?
*Are their abnormal breath sounds (e.g. wheezing)?
*Do they seem irritable or confused (e.g. as seen with cyanosis)?
CRITERIA
Circulation
ASSESMENT CONSIDERATIONS
*What is the patient’s heart rate (HR) and do they have a palpable radial pulse?
*What is the patient’s blood pressure (BP)?
*Is the patient dizzy (lying/standing)?
CRITERIA
Disability
ASSESMENT CONSIDERATIONS
*What is the patient’s level of consciousness (AVPU)?
*What is the patient’s mental health status (e.g. behaviour, appearance, cognition)?
*Is the patient communicating/answering questions appropriately?
*What medications is the patient currently prescribed?
CRITERIA
Exposure
ASSESMENT CONSIDERATIONS
What is the patient’s temperature?
Head to toe examination to check for bleeding, wounds, bruising etc.
Physical Assessment
TECHNIQUE
Inspection
CONSIDERATIONS
*Use of senses (visual, olfactory, touch).
*Compare sides (symmetry).
*Look for signs of inflammation, infection or alterations to perfusion (colour such as redness, pale, mottled, cyanotic).
*Look for alterations to skin integrity - rashes, moisture (e.g. dryness), abrasions, wounds)
*Look for distension, swelling/oedema.
TECHNIQUE
Palpation
CONSIDERATIONS
*Use of touch (usually light touch)
*Feel for signs of inflammation or infection (warmth/cold, clammy etc.)
*Feel for any masses, lumps, pulsation, pain and tenderness.
*Feel for rigidity, spasticity and crepitation.
*Feel for organs
TECHNIQUE
Percussion
CONSIDERATIONS
*Mapping location and size of organs
*Signalling density of a structure by a characteristic note
*Detecting a superficial abnormal mass
*Eliciting pain if underlying structure is inflamed
*Eliciting deep tendon reflex using percussion hammer
TECHNIQUE
Auscultation
CONSIDERATIONS
*Listening to sounds produced by the body (e.g. adventitious breath sounds, bowel sounds)
Palpation Techniques
Fingertips: Used for skin texture, swelling and pulsation.
Fingers and Thumb: Used for detecting position, shape and consistency of and organ or mass.
Dorsa of hands and fingers: used for determining temp because skin is thinner here.
Base of fingers or ulna surface of hands: used for vibration.
