Musculoskeletal system & problems
a place where the ends of two bones are in proximity and move in relation to each other.
How to prevent compartment syndrome?
Early diagnosis and treatment helps prevent many of the complications.
Warm up exercises and stretching
Strength, balance, and endurance exercises.
What are some important data to ask a patient regarding musculoskeletal system?
Past health history, including surgery or other procedures.
Medications they are currently taking (OTC, prescribed, herbal supplements, vitamins...).
ADLs they are able to perform or that are impacted.
PQRST if pain is present.
xray, CT/MRI, CT myelogram, bone scan, bone mineral density measurements...
Hinge, ball and socket, pivot, condyloid, gliding.
Risk factors for back pain?
Lack of muscle tone
Excess body weight
Pregnancy
Stress
Poor posture
Cigarette smoking
Prior compression fractures
Congenital spinal problems
Family history of back pain
Occupational risk factors
Repetitive lifting
Vibration
Extended periods of sitting
Health care personnel engaged in patient care
Manifestations of fractures.
Edema and swelling
Pain and tenderness
Muscle spasm
Deformity
Contusion
Crepitation
Guarding
What should you as the nurse report when it comes to casts, splints, or braces?
Complaints of pain or unrelieved pain
Drug therapy for osteoporosis.
Bisphosphonates, monoclonal antibodies, recombinant parathyroid hormones, SERM
Define muscular dystrophy.
A group of genetically transmitted
diseases marked by progressive
symmetric wasting of skeletal
muscles and increasing disability
without neurologic involvement.
What to teach after hip replacement?
Use elevated toilet seat
Use pillow between legs for the first 6 weeks when lying down
Keep hip in neutral position when sitting, walking, or lying
Notify PCP if experiencing severe pain.
What are some age related musculoskeletal considerations?
•Decrease in bone density
•Narrowing of intervertebral spaces
•Loss of fluid from disks between vertebrae
•Loss in height and postural changes
•Atrophy of muscle and muscle wasting
•Loss of strength and flexibility
•Loss of elasticity in ligaments and tendons
•Increased risk for cartilage erosion
Name some health promotions regarding musculoskeletal trauma.
Wearing seatbelts, follow speed limits, avoid distracted driving, no driving under the influence, warm up before exercising, use protective athletic equipment, use proper safety equipment at work.
Treatment for osteomyelitis.
Aggressive, prolonged IV antibiotic therapy
Cultures or bone biopsy
Surgical debridement and decompression
IV antibiotics via CVAD
IV antibiotics 4-6 weeks or longer
Name 5 of the 15 synovial joint movements.
Abduction, adduction, circumduction, dorsiflexion, eversion, extension, external rotation, flexion, hyperextension, internal rotation, inversion, opposition, plantar flexion, pronation, supination.
What should you teach your patient about back pain?
Sleep in a side-lying position with knees and hips bent
• Sleep on back with a lift under knees and legs or back with 10-inch-high pillow under knees to flex hips and knees
• Prevent lower back from straining forward by placing a foot on a step or stool during prolonged standing
• Maintain appropriate body weight
• Exercise 15 minutes in the morning and evening regularly
• Carry light items close to body
• Use local heat and cold application
• Use a lumbar roll or pillow for sitting
What are some you can educate on musculoskeletal problems in the elderly?
Wear functional, nonskid, hard-soled shoes.
Remove throw rugs.
Ensure adequate lighting.
Maintain clear pathways throughout the home.
Avoid walking on uneven or wet surfaces.
Appropriate exercise.
What are the 6 P's you should report?
Paresthesia, pain, pressure, pallor, paralysis, and pulselessness.
Some surgical therapy for intervertebral disc disease.
IDET, radio frequency discal nucleoplasty, discectomy, spinal fusion...
Reasons for amputations.
What to teach patient about cast care?
Keep it dry; do not cover with plastic.
Elevate the affected arm using slings.
Keep it clean.
Do not scratch or stick anything in the cast
Use blow dryer on cool to help with itching
Report any signs of pain, swelling, changes in sensation, skin color or temp, or signs of infection.
What is compartment syndrome?
Elevated intracompartmental pressure within a confined myofascial compartment.
Compromises neuromuscular function of tissues within that space.
What should you monitor for with tractions?
Define mirror therapy.
Helps reduce phantom pain in some patients.
The success of rehabilitation is dependent on patients physical and emotional health.