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83 Cards in this Set

  • Front
  • Back
Strain:

Can be Muscles or Tendons
-Pulling or tearing of a muscle or tendon.
can be caused by overuse, or overextension of joint
-Soft tissue swelling and pain
-Use ice and compression
Sprain:

Strictly Ligaments (join the bones of a joint together)
-Tearing of Ligaments
-Three different grades of a sprain
1-mild
2-moderate
3- severe complete tearing
Tx: RICE
Dislocation:
Can be full or partial
-Subluxation and dislocation
of shoulder, knee, and temporomandibular joint.

Tx: Reduction of Displacement
- Rest, Pain control, and heat or cold
-Fix and replace
HOw long should you leave heat or cold tx on a pt for?
15-20 mins every hour make sure you remember to go back to check on the pt after this time.
Bursitis:

Overuse of Joint
Mild-Moderate aching pain, localized to the joint, and swelling.
Tx: Rest, anti-inflammatory agents, ice, massage, compression wrap.
Also cortisone injections
Rotator Cuff Tear:
Your rotator cuff is made up of the muscles and tendons in your shoulder. connect your upper arm bone with your shoulder blade. hold the ball of your upper arm bone firmly in your shoulder socket. The combination results in the greatest range of motion of any joint in your body.
-Tear caused by repetitive activity
-Cannot abduct or externally rotate shoulder**
-Tx: rest, nsaids, steroid injections, or anti-inflammatory injections.
-Gentle exercise (ease back into this) and heat applied to joint before.
-Surgical repair
Anterior Cruciate Ligament (ACL) Injury:
- Injury sounds like a loud pop
-Arthoscopy
-TX: Immobilze, reduce swelling, and pain, continuous passive motion.
-Leg brace, with fixed knee flexion
-Quadriceps setting, bent knee leg exercises, and foot exercises.
( they can use a continuous active motion machine on these pts)
Meniscal Injury:

In the knee and cushions the joint (the padding btw bones)
-Called schock absorber of the knee
-May accompany an ACL injury
-Fixed foot rotation in weight bearing with knee flexed with mild swelling and joint pain.
-Physical Examination to elicit a "click" and localized pain with particular movements of the joint
-MRI and arthoscopy
-Postop pain management and muscle strengthening during recovery
Achilles Tendon Rupture:
-Arthrits, diabetes, and some pt's taking antibiotics
-Sudden pain at the back of the ankle or calf, a loud pop, or snap sound.
-Pain, swelling, stiffness
-PE and squeezing the calf muscle while pt is in prone posistion
-Splinting, casting, or a combination with surgery
Tourniquet: does what?
Its put in place during surgery to cut off blood supply to where the surgery is taking place. This results in no blood gushing out of the open wound and so you can see properly.
People with carpal tunnel should take what vitamin?
B6
also steroid injections help
Bunion( Hallax Vagus):
Painful Swelling of the bursa
-Hereditary
-Can be caused by bad shoes
-Corticosteroid injections
-Analgesics
-Bone realignment of the big toe with removal of bony overgrowth
Complications of Fractures:
-Infection *
-Osteomyelitis
-Fat embolism (fat tissue coming from yellow marrow from long bones)
-Venous Thrombosis- DVT
-Compartment Syndrome
What is compartment Syndrome:
Is a restriction of Blood Flow that occurs in one or more muscle compartments of the extremities.
-Can be caused by internal or external pressure that seriously restricts the circulation to the area.
Assess by the 6 P's:
Pain, Pallor, Paresthesisa, pulselessness, paralysis, and Poikilothermia (cold to touch)
Danger of a Fat embolism:
Safety Alert:
Watch for signs like: Change in mental Status followed by reap. distress, tachypnea, rapid pulse, fever, and petechiae (measles like rash over chest, neck, upper arms, or abdomen)
Signs should be reported immediately.
-80% mortality rate from this complication
Lyme disease:
Aka: Borrelia burgdorferi
-Flulike symptoms, and Bulls Eye rash with pain and stiffness in the joints and muscles.
-Permanent damage to the nervous system and Joints.
Osteoarthritis:
-Noninflammatory degenerative joint disease
-any weight bearing joint

Signs:
-Joint Deformity and the pressure of the nodules
Tx and Nursing care of osteoarthritis:
- Pain management
- Exercise, weight reduction, and maintenance of joint function
-Surgurey or joint replacement.
-Teaching
Rheumatoid Arthritis:
-Abnormal tissue response
-Remissions and exacerbations (Causing illness or disease to become worse)

Signs and Symptoms:
-Joint pain, warmth, edema, limitation of motion
-Joint stiffness usually in the morning
-Low grade fever, anorexia with weight loss, malaise, and an iron deficiency
-History, examination, rheumatoid factor(RF), and x-rays
Treatment of Rheumatoid Arthritis:
Releive Pain
-Minimize joint destruction
-Promote Joint Function
-Preserve ability to perform self care
Surgical Intervention and orthopedic devices:
-surgical repair of a hip joint
-Casts or braces or Splints (orthoses)
-Joint Replacement
-Total Hip Replacement
-Knee Replacement
Precautions with a hip abductor wedge:
Circulation should be checked after each application of the wedge to be certain that the straps are not to tight.
-Skin should be assessed every shift on the surface of the legs, with particular attention to areas over bony prominences.
Gout:
-Genetic increase in purine metabolism leading to overproduction or retention of uric acid
-consumption of a high purine (part of DNA and RNA) diet
Signs and Symptoms of Gout:
Elevated levels of serum uric acid
-tight, reddened skin over an inflamed edematous joint
-Elevated temp and extreme joint pain
INR: Internationalized normalized ratio
A blood clotting test that shows how well you clot blood.
-An INR range of 2.0 to 3.0 is generally effective for people taking warfarin who need full anticoagulation, but may need to be slightly higher in certain situations. If your INR is higher than this range, that means your blood clots more slowly than desired. A lower INR means your blood clots more quickly than desired. The INR is used only for people on oral anticoagulant therapy. It's not useful in people whose PT is higher for other reasons.
Fractures:
-Caused by trauma
-Interference with the blood supply, and disturbance of muscle activity at the site of injury

Signs and Symptoms:
-Minimal to sever pain, swelling, and bleeding into the tissues.
-Tenderness, deformity of bone, ecchymosis, crepitations with any mvmnt, and loss of function.
-PE and x-ray
Tx of Fractures:
-Preventing schock and hemorrhage
-Immediate immobilization and reduction of fracture by:
Closed Reduction
Open reduction
Internal fixation: Use bolt sets
External Fixation: Setting the bone
Closed Reduction of a Fracture:
-Manipulated into alignment
-No surgical incision
-General Anesthetic
Open Reduction of Fractures:
-Surgical Incision
-Open (compound) Fractures and comminuted fractures
-Adequate cleansing and removal of bone fragments
Internal Fixation of Fractures:
-Elderly and Brittle bones
-Open reduction and Internal Fixation (ORIF)
-Pins, nails, screws, metal plates, drains, and prosthesis
-Autotransfusion of salvaged blood
-IV antibiotics
Indications for External Fixation:
-Massive open fractures with extensive soft-tissue damage
-Infected fracture that does not heal properly
-Multiple trauma with one or more fractures and other injuries such as burns, chest injury, or head injury.
Casts:
-Leg casts, cast braces, and body or spica casts
-Rigid and immobilizes the body part that is mending while allowing movement of other body parts
-Nursing Care
Types of Fractures:
-Complete
-Incomplete
-Comminuted
-Closed (simple) Fracture
-Open (compound) Fracture
-Greenstick Fracture
Complete Fracture:
Bone breaks in 2 parts completely separated
Incomplete Fracture:
Bone breaks into two parts that are not completley separated
Comminuted fracture:
one in which the bone is broken and shattered into more than two fragments
Closed (simple) Fracture:
There is no break in the skin
Open (compound) Fracture:
A break in the skin through which the fragments of broken skin protrude
Greenstick fracture:
Common in children, bone is partially bent and partially broken.
Pathologic Fracture:
caused by a preexistent pathological bone lesion. Causes include resorption of bone mass (osteoporosis), reduction of bone quality (osteomalacia, osteonecrosis), insufficient bone production (osteogenesis imperfecta, fibrous dysplasia), augmented bone resorption (giant cell granulomas, aneurysmal bone cyst), pathological bone remodelling (Paget's disease), or local bone destruction due to tumorous growths.
Longitudinal Fracture:
A vertical Break in the bone
Spiral Fracture:
Bone is twisted apart
Oblique Fracture:
Bone is completely Separated
Log rolling:
Best for people who are in traction it helps maintain everything within the same plane.
Comminuted Fracture:
Broken into pieces
Traction:
Two types: Skeletal and Skin
-Continuous and Intermittent
-Types of Traction and Devices
-Nursing care of Traction devises.

Traction is used because you don't want the bones to overlap, you want them to set evenly.
Bucks Traction:
-Simple traction used to tx muscle spasms from fractures
Russels Traction:
Uses a knee sling to provide support of the affected leg
Cervical Traction:
Use of a halo device or head halter
-Tongs are inserted into the skull
Pelvic Traction:
- pelvic belt or swing although rarely used
Assessing Neurovascular Status: BY?
-Skin Color
-Skin Temp
-Pulses
-Mvmnt
-Pain
-Capillary Refill
-
Smoking and Musculoskeletal Health:
Smoking has significant impact on the bones and joints in that it:
-Increases risk for osteoporosis
-Increases risk for fractures
-affects wound healing
-Associated with lower back pain and arthritis
Bone Marrow produces what?
RBS's
WBC's
Bone markings:
Projections for articulation
Projections for muscle attachment
Depressions, openings, and cavities
The aging Musculoskeletal System:
Decreases bone density
Brittle and less compact bone
Slow bone repair
Kyphosis (Dowagers hump)
Crepitation
decreased joint motion
Calcified ligaments
Function of the bones:
-Provide framework
-Protects internal organs
-Produces red bone marrow, RBC's,WBC's, and platelets
-Store and release minerals
-Transport nutrients to the bone cells and remove wastes
-Remodeling
Functions of the muscles:
Synchronized contraction of many muscle fibers
Maintain Posture
Produce body heat
Causes of Musculoskeletal disorders:
-Disease, trauma, malnutrition, and aging
-Decrease in estrogen production after menopause.
Prevention of muscoloskeletal Disorders:
-Early Diagnosis and tx of cancer in other parts of the body
-Osteoporosis, fractures, and long term steroid use
-Weight training and exercise
-Calcium, Vit D, and Protein Intake
Diagnostic Tests, and Procedures:
Not going to be tested over
Bld counts
Erythrocyte sedimentation rate (ESR)
Serum levels
ROM testing
Physical assessment Of musculoskeletal system:
-Posture
-Gait
-Mobility
-ROM
-Spine
-Appearance of Joints
-Skeletal Muscle appearance
-Ability to Perform Activities
Nursing Diagnosis:
-Impaired physical Mobility
-Activity Intolerance
-Pain
-Disturbed body image
-Self care Deficit
-Risk for Disuse syndrome
-Impaired Home maintenance
Planning:
-Physical and Occupational Therapy
-Lifting and Turning
-Orthopedic bed making
-Preventing Disability
-Preventing Disability:
-Gradual mobilization
-Exercise Program
-Proper Positioning and instruction
Foot drop:
Results from improper support of the feet while confined to bed.
Can happen within 3-7 days
Can prevent person from walking again
Pathologic Changes associated with lack of motion:
-Contractions
-Loss of muscle tone
-Ankylosis (permanent fixation of a joint)
Preventing Contractures:
-Adaptive Shortening
-Begins within 3-7 days after immobilization
-Completed within 6-8 weeks
-Footdrop, knee and hip flexion contractures, wrist drop, and contractures of the fingers and arms.

To prevent use Pillows to support, and ROM excercises
Loss of Muscle Tone:
-Beyond normal limits
-Loss of ability to contract and relax
-Footdrop
-Inability to produce motion
-Perform ROM excersises
Preventing Ankylosis:
-Joint replaced by a bony overgrowth that completely obliterates the joint
-Proper positioning and mvmnt. Of joint passively
-Brace the joint in the most useful position
Gradual Mobilization:
-Cause of Immobility
-Any contraindications to mvmnt.
-Ability to understand and participate in rehabilitation activities
-Passive exercises and positioning
Exercise:
Passive and Active ROM
Isometric Exercises
Analgesic and anti-inflammatory drugs
Continuous passiv emotion (CPM)
Quadricep Setting And Gluteal Setting
Caution with Isometric Exercises:
-Isometric exercise may be contraindicated in pts w/ hypertension, increased intracraninal pressure, or Congestive Heart Failure, as there is significant increase in in BP and HR during the exercise.
Positioning:
-Routine ROM exercises
-Flaccid Paralysis
-Bed Cradle
Psycho Social Care:
-Frustration
-Feeling of Hopelessness
-Despair
Teaching Ambulation with Assistive Devices:
-Crutches and muscle strengthening exercises
-Role of physical Therapist
-Cane with intact rubber tip
-Walker Height (should be 16-20 in shorter than you)
(Advance unaffected than affected leg)
4 Pt gait:
Most stable Crutch Gait
Partial weight bearing on both legs
1) Advance L crutch
2) Advance R foot
3) Advance R crutch
4)Advance L foot
3 Pt gait:
Full weight bearing on one leg, balance and upper body strength
1) Advance both crutches forward with affected leg, and shift weight to crutches
2) Advance unaffected leg and shift weight onto it.
Advantages: Allows affected leg to be partially or completely free of weight bearing.
2 Pt Gait:
1)Advance L crutch and R foot
2)Advance R crutch and L foot

Advantages: faster version of the 4 pt, more normal walking pattern.
Partial weight bearing on both legs, balance.
Psychosocial Care:
-Frustration
-Feeling of hopelessness
-Despair
Evaluation:
-Reassessment
-Ability to acomplish ADL's
-Diagnostic test data from x rays and lab reports
-Realistic, Workable, Plan of care
Osteoporosis:
-Decrease in bone mass
-Cig smoking, alcoholism, sedentary lifestyle, body weight below 128 lb, endocrine disorders, prolonges bed rest, and liver disease
Pagets Disease:
-Unknown Cause
-Pain
-X-ray and serum alkaline phosphatase
Bone Tumors:
-Benign and Malignant Tumors
-Primary Malignant Tumors
Signs, symptoms, and Diagnosis:
-Pain, warmth, and swelling
-PE, x-ray, bone scan, and biopsy
Amputation:
Preop care
Postop care
Rehabilitation