Musculoskeletal Disorders Overview

Musculoskeletal Disorders

Osteoarthritis

• It is a chronic condition where joints break down over time causing pain, stiffness, and decreased range of motion (ROM).
• It is also known as "rusty hinges" and is associated with old age and lacks redness.
• Degenerative joint disease leads to the breakdown of cartilage.
• Manage pain using NSAIDs and acetaminophen
• Manage weight, physical therapy, and joint protection are Nursing interventions.

Osteoporosis

• A condition where bones become weak and brittle, increasing the risk of fractures, especially in the hip, wrist, and spine.
• It involves pores in the bones that make them fragile.
• Loss of bone density increases fracture risk.
• Symptoms include fragile bones, fractures, and kyphosis
• Nursing interventions focus on calcium and vitamin D supplementation, weight-bearing exercises, and fall prevention.

Gait Disturbances

• Occurs when someone deviates from typical walking due to injuries, medical conditions, or neurological issues which can lead to falls and reduced quality of life
• Neurological or musculoskeletal conditions can cause this.
• Physical therapy, assistive devices (walkers, canes), and fall risk precautions are nursing interventions

Rheumatoid Arthritis (RA)

• The body's immune system mistakenly attacks the lining of the joints causing pain, swelling, & stiffness.
• Achy joints happen rapidly
• Autoimmune disease results in joint inflammation.
• Symmetrical issues involving joint pain, swelling, and morning stiffness.
• DMARDs, NSAIDs, corticosteroids, pain management, and energy conservation are nursing interventions.

Neurological Disorders

Stroke with Dysphagia

• Difficulty swallowing is common after a stroke, leading to aspiration (food or liquid entering the lungs), pneumonia, and malnutrition
• Cerebral infarction is a cause of neurological deficits
• Symptoms include facial droop, weakness, and difficulty swallowing (dysphagia)
• Include swallow precautions, thickened liquids, speech therapy, and aspiration prevention.

Parkinson's Disease

• It affects movement, causing tremors, stiffness, slow movements, and balance problems due to the loss of brain cells that produce dopamine.
• TRAP: tremor, rigidity, akinesia (slowness of movement), postural instability.
• Neurodegenerative disorder affecting dopamine levels.
• Symptoms involve tremors, bradykinesia, rigidity, postural instability
• Medications (levodopa/carbidopa), fall precautions, and physical therapy should be implemented as needed.

Autonomic Dysreflexia

• Occurs in people with spinal cord injuries where the body's involuntary systems react to pain or discomfort below the level of injury, causing a dangerous spike in BP and other symptoms.
• It is a life-threatening overreaction of the autonomic nervous system commonly seen in spinal cord injuries above T6.
• Symptoms include sudden hypertension, headache, and sweating.
• Identify and remove the cause (bladder/bowel distension, tight clothing), elevate HOB, administer antihypertensives if needed.

Dementia (with Urinary Incontinence)

• Common in people with dementia due to cognitive and physical challenges
• Can be managed with strategies like regular toileting reminders and environmental modifications
• Cognitive decline affects daily functions.
• Symptoms may include memory loss, disorientation, and loss of bladder control.
• Nursing interventions include scheduled toileting, skin care, and cognitive therapy.

Cardiovascular Disorders

Deep Vein Thrombosis (DVT)

• Usually occurs in the leg, potentially blocking blood flow and causing pain and swelling
• Blood clot formation occurs in deep veins.
• Leg pain, swelling, and redness are typical symptoms.
• Anticoagulants, compression stockings and early ambulation.

Gastrointestinal Disorders

Constipation

• Infrequent or difficult bowel movements, resulting in hard, dry stools that are painful to pass, can lead to bloating & discomfort
• Slowed bowel movements lead to hard stools
• Symptoms include hard stools, straining, and bloating.
• Nursing Interventions: Increase fiber and fluids, encourage mobility, stool softeners.

C. diff Infection

• Can cause colitis (inflammation of the colon)
• Bacterial infection can cause severe diarrhea.
• Watery diarrhea, fever, and abdominal cramps
• Nursing interventions include contact precautions, handwashing with soap and water, and administer antibiotics (metronidazole, vancomycin)

Cirrhosis of the Liver

• Occurs when scar tissue replaces healthy liver tissue, long term (chronic) liver disease
• Chronic liver scarring causes portal hypertension and liver failure.
• Symptoms include jaundice, ascites, and hepatic encephalopathy.
• Monitor liver function, fluid restriction, and administer of lactulose for encephalopathy and bleeding as needed

Stomatitis

• Swelling and redness of the lining of the mouth
• Inflammation in the mouth can be caused by infection or irritation.
• Symptoms include painful sores, redness, and difficulty eating.
• Nursing interventions include oral hygiene, saline rinses, and avoiding irritants (spicy foods, alcohol) while providing pain relief.

Integumentary Disorders

3rd Degree Burns

• Burned areas may be black, brown, or white, and the skin may look leathery
• Full-thickness burns damage the skin, nerves, and blood vessels.
• Symptoms include white or charred skin, absence of pain (nerve destruction).
• Nursing interventions include fluid resuscitation, wound care, infection prevention, and pain management

Herpes Zoster (Shingles)

• Is a painful rash caused by the chickenpox virus, often appearing as a stripe of blisters on one side of the body
• Reactivation of the varicella-zoster virus.
• Symptoms include a painful, vesicular rash along a dermatome.
• Nursing interventions include antivirals (acyclovir), pain management, and isolation if lesions are open.

Respiratory Disorders

COPD (Chronic Obstructive Pulmonary Disease)

• Caused by damage to the lungs that makes it hard to breathe.
• Progressive lung disease limiting airflow
• Symptoms include chronic cough, dyspnea, and wheezing.
• Nursing interventions include oxygen therapy (low-flow to prevent CO2 retention), bronchodilators, smoking cessation, and breathing exercises.

Genitourinary Disorders

Urinary Incontinence due to Dementia

• Incontinence occurs due to loss of bladder control caused by cognitive impairment.
• Symptoms include urinary leakage, confusion, and inability to recognize the urge.
• Nursing interventions include scheduled toileting, skin care and absorbent products

Study Tips

• Use mnemonic devices (e.g., "FAST" for stroke: Face drooping, Arm weakness, Speech difficulty, Time to call 911).
• Practice NCLEX-style questions to reinforce learning.
• Focus on prioritization and safety interventions.
• Create flashcards for key medications and interventions.
• Teach back concepts to someone else to solidify your understanding.