Musculoskeletal Conditions Worksheet NUR 170 KEY.docx

+-------------+-------------+-------------+-------------+-------------+ | | **Patho:** | **Symptoms: | **Medical | **Nursing | | | | ** | Management: | interventio | | | | | ** | ns:** | +===========...

+-------------+-------------+-------------+-------------+-------------+ | | **Patho:** | **Symptoms: | **Medical | **Nursing | | | | ** | Management: | interventio | | | | | ** | ns:** | +=============+=============+=============+=============+=============+ | **Low back | Often due | Pain that | OTC | - Prevent | | pain** | to: | can radiate | analgesics | ion | | | | **down the | | teachin | | | - Muscle/ | leg** with | Opioids | g: | | | ligament | possible | (**short** | | | | strain | paresthesia | term only) | - Stretch | | | | in the | | ing | | | - Disk | affected | Muscle | | | | degener | leg. | relaxants | - Change | | | ation | | (**cycloben | positio | | | or | **More | zaprine**) | ns | | | herniat | severe | | often | | | ion | symptoms:** | For chronic | | | | | | back pain: | - Avoid | | | | Leg | | **stand | | | | weakness | Tricyclic | ing** | | | | | antidepress | in one | | | | Bowel & | ants | place | | | | bladder | | for a | | | | issues | SSRI's | long | | | | | | time. | | | | | Anticonvuls | | | | | | ants | - Knees | | | | | | **bent* | | | | | Ice/heat | * | | | | | | when | | | | | Massage/chi | lifting | | | | | ropractic |. | | | | | | | | | | | Yoga | - Lift | | | | | | objects | | | | | **Corticost | **close | | | | | eroid** | ** | | | | | injections | to the | | | | | | body. | | | | | | | | | | | | - Avoid | | | | | | twistin | | | | | | g, | | | | | | bending | | | | | | , | | | | | | and | | | | | | reachin | | | | | | g. | +-------------+-------------+-------------+-------------+-------------+ | **Osteoarth | **Wear** & | Joint pain | **Goal:** | **Patient | | ritis** | **tear** on | -- can be | decrease | education:* | | | the joints | **unilatera | pain and | * | | | causes the | l** | **stiffness | | | | joint | or | ** | - Exercis | | | structures | **bilateral | and | e | | | to degrade | **. | increase or | -- walk | | | and | | maintain | daily | | | breakdown. | Joint | mobility. | to | | | The | stiffness | | maintai | | | decreases | | OTC | n | | | the cushion | Functional | analgesics: | joint | | | and | impairment | | motion. | | | lubrication | | - NSAIDS | Use | | | within the | Pain | (watch | **assis | | | joint and | **increases | for | tive** | | | causes the | ** | **GI | devices | | | bones to | with | bleed** | to | | | rub | exercise | ). | decreas | | | together. | and | | e | | | | **decreases | - APAP | joint | | | | ** | (Watch | stress. | | | | with rest. | for | | | | | | signs | - Take | | | | | of | pain | | | | | liver | medicat | | | | | toxicit | ion | | | | | y. | prior | | | | | Max | to | | | | | dose of | exercis | | | | | **4 G** | e. | | | | | /day.) | | | | | | | **Postop | | | | | Opioids | teaching:** | | | | | | | | | | | Steroid | - Ambulat | | | | | injections | ion | | | | | | **early | | | | | **Surgery:* | ** | | | | | * | | | | | | **Arthro**p | - Avoid | | | | | lasty | bending | | | | | | \> | | | | | | **90** | | | | | | degrees | | | | | |. | | | | | | | | | | | | - **Abduc | | | | | | tor** | | | | | | pillow | | | | | | will be | | | | | | used. | +-------------+-------------+-------------+-------------+-------------+ | **Osteomyel | Three areas | - Fever | Antibiotics | **Patient | | itis** | of origin: | (usuall | --given for | education | | | | y \> | **6** | on risk | | | **1) | **101** | weeks. | factors:** | | | Exogenous** | ) | | | | | -- direct | | Debridement | - IV | | | exposure of | - Constan | | **drug | | | the bone to | t | | abuse** | | | **bacteria* | **throb | | | | | *. | bing** | | - History | | | | pain | | of | | | **2) | over | | diabete | | | Endogenous | the | | s | | | --** | affecte | | | | | bacteria | d | | - Infecte | | | travels | area | | d | | | through the | | | **wound | | | **bloodstre | - Swellin | | ** | | | am** | g | | | | | to the | around | | - Orthope | | | bone. | affecte | | dic | | | | d | | surgery | | | **3) | area | | | | | Contiguous | | | | | | --** | | | | | | Bacteria | | | | | | travels | | | | | | from an | | | | | | infected | | | | | | area | | | | | | **adjacent* | | | | | | * | | | | | | to the bone | | | | +-------------+-------------+-------------+-------------+-------------+ | **Osteomala | Bone | - Muscle | **Vitamin | **Patient | | cia** | softening | weaknes | D** | education:* | | | due to a | s | supplementa | * | | | lack of | | tion | | | | **vitamin | - Gait: | | Increase | | | D**. | **Waddl | | **sunlight* | | | | ing** | | * | | | | | | exposure. | | | | - Leg | | | | | | appeara | | Eat foods | | | | nce: | | rich in | | | | **bowed | | **vitamin | | | | ** | | D**\_ | | | | | | | | | | | | - Cheeses | | | | | | | | | | | | - Egg | | | | | | **yolks | | | | | | ** | | | | | | | | | | | | - Dairy | | | | | | product | | | | | | s | | | | | | | | | | | | - Fish | | | | | | with | | | | | | bone in | | | | | | | | | | | | - **Mushr | | | | | | ooms** | | | | | | (one of | | | | | | the | | | | | | only | | | | | | non-ani | | | | | | mal | | | | | | natural | | | | | | sources | | | | | | of | | | | | | vitamin | | | | | | D.) | | | | | | | | | | | | - Fortifi | | | | | | ed | | | | | | cereals | | | | | | , | | | | | | juices | +-------------+-------------+-------------+-------------+-------------+ | **Osteoporo | Increased | Usually | Vitamin D | **Patient | | sis** | **osteoclas | **asymptoma | and calcium | education:* | | | t** | tic**. | supplementa | * | | | activity | | tion | | | | (bone | May | | **Biphospho | | | resorption/ | **fracture* | Biphosphona | nate | | | loss) | * | tes | education:* | | | and | easily. | (**alendron | * | | | decreased | | ate)** | Take on an | | | **osteoblas | Decrease in | -- because | **empty** | | | t** | height. | they | stomach | | | activity | | decrease | with a full | | | (bone | | bone | glass of | | | building). | | **resorptio | water and | | | This leads | | n** | sit up for | | | to | | and | **30** | | | decreased | | increase | minutes | | | bone | | bone | after to | | | **density** | | **building* | help | | |. | | *. | prevent | | | | | | **esophagit | | | Risk | | | is**. | | | factors: | | | | | | | | | Advise | | | Advanced | | | **DEXA** | | | **age** | | | scan to for | | | (men & | | | early | | | women) | | | detection | | | | | | | | | Menopause | | | Walk 30min | | | | | | 3-5 | | | Smoking & | | | times/week | | | alcohol | | | for | | | | | | **weight-be | | | **Thin** | | | aring** | | | build | | | exercise. | | | | | | | | | Sedentary | | | Diet rich | | | lifestyle | | | in calcium | | | | | | and vitamin | | | Use of | | | D | | | corticoster | | | | | | oids | | | Minimize | | | | | | alcohol and | | | | | | **caffeine. | | | | | | ** | +-------------+-------------+-------------+-------------+-------------+ | **Gout** | Accumulatio | Swelling, | Goal: | Teach | | | n | warmth, | Maintain | patient to | | | of **uric | redness, | uric acid | avoid or | | | acid** in | and pain in | level \< | limit the | | | the body | joints | 6mg/dL | following: | | | that | especially | | | | | collects in | smaller | Decrease | Meat types: | | | the | joints like | inflammatio | | | | joints**.** | the **great | n | **Red** | | | | toe**. | (acute): | | | | The | | | **Organ** | | | accumulatio | Tophi: | NSAIDS | | | | n | Urate | | **Shellfish | | | is usually | deposits | **colchicin | ** | | | due to an | under the | e** | | | | error in | skin | | Drink: | | | **purine** | | Decrease | **Alcohol** | | | metabolism. | | uric acid | | | | | | levels | Medication: | | | | | (chronic): | **thiazide | | | | | | diuretics** | | | | | probenecid | | | | | | | | | | | | allopurinol | | +-------------+-------------+-------------+-------------+-------------+ | **Carpal | Compression | Paresthesia | NSAIDS | Encourage | | Tunnel** | of the | , | | appropriate | | | **median | numbness, | Steroid | **ergonomic | | | nerve**.in | and aching | injections | s**. | | | the wrist. | pain | | | | | | affecting | Hand/wrist | **Postop | | | | the | brace | teaching:** | | | | **thumb**, | | | | | | index, | Surgery: | Priority | | | | middle, and | ligament | assessment: | | | | half of the | pressing | **neurovasc | | | | **ring** | the nerve | ular | | | | finger. | is **cut or | checks** | | | | | lasered** | | | | | Positive | to relieve | Report | | | | **Phalen** | pressure. | increased | | | | maneuver: | | **pain** to | | | | paresthesia | | provider. | | | | within 60 | | | | | | seconds of | | Avoid hand | | | | pressing | | movements | | | | backs of | | and | | | | hands | | **lifting** | | | | together | | for 4-6 | | | | with bent | | weeks. | | | | wrists. | | | +-------------+-------------+-------------+-------------+-------------+ | **Amputatio | Can be | Phantom | Phantom | **Watch for | | ns** | elective or | limb pain- | limb pain | and prevent | | | traumatic. | burning | management | complicatio | | | | crushing, | (all | ns:** | | | Most | twisting | decrease | | | | elective | | nerve | \- Impaired | | | are due to | | **excitabil | tissue | | | this | | ity**): | perfusion- | | | condition: | | | | | | **periphera | | - Example | \- | | | l | | s- | Infection | | | vascular | | | | | | disease** | | - Gabapen | \- Flexion | | | | | tin | contracture | | | | | | s | | | | | - Calcito | | | | | | nin | - **Prone | | | | | | ** | | | | | TENS unit | positio | | | | | | ning | | | | | | 20-30 | | | | | | min | | | | | | several | | | | | | times/d | | | | | | ay | | | | | | | | | | | | - ROM | | | | | | exercis | | | | | | es | +-------------+-------------+-------------+-------------+-------------+ | **Rheumatoi | **Patho:** | **Symptoms: | **Medical | **Nursing | | d | | ** | Management* | Interventio | | Arthritis** | **Autoimmun | | * | ns** | | | e** | Symptoms | | | | | condition | are often | NSAIDS -- | Physical | | | where the | bilateral | decrease | and | | | immune | and | **inflammat | **occupatio | | | system | **systemic* | ion**. | nal** | | | attacks the | *. | | therapy. | | | joints | | Methotrexat | | | | causing | **Early | e | **Paraffin* | | | inflammatio | symptoms:** | -- | * | | | n | fever, | Suppresses | dips to | | | | weight | the | help with | | | | **loss**, | **immune | comfort. | | | | fatigue. | system**. | | | | | | | | | | | Joint pain | | | | | | | | | | | | Joint | | | | | | stiffness | | | | | | (esp.in the | | | | | | **hands**.) | | | | | | | | | | | | **Late | | | | | | stages:** | | | | | | | | | | | | Joint | | | | | | **deformity | | | | | | **. | | | | | | | | | | | | Other | | | | | | **organs** | | | | | | may become | | | | | | involved. | | | +-------------+-------------+-------------+-------------+-------------+ | **Fracture* | **Symptoms* | **Intervent | **Complicat | | | * | * | ions** | ions** | | | | | | | | | | Edema | Assessment | **[Fat | | | | | priority: | Embolism]{. | | | | Ecchymosis | **neurovasc | underline}* | | | | | ular**. | * | | | | Deformity | | | | | | | Remove any | Usually | | | | Limited | **jewelry.* | results | | | | **mobility* | * | from a | | | | * | | fracture of | | | | near | Xray to | a large or | | | | fracture | determine | **long** | | | | | type/extent | bone. | | | | | of | | | | | | fracture. | Occurs | | | | | | 12-48 hours | | | | | Cover any | after | | | | | **open | **fracture* | | | | | wounds** | *. | | | | | with | | | | | | sterile | Sudden | | | | | gauze. | onset low | | | | | | **O2 | | | | | Immobilize | saturation* | | | | | **above** | *. | | | | | and | | | | | | **below** | **High** | | | | | the | respiratory | | | | | fracture. | rate. | | | | | | | | | | | **[Traction | Shortness | | | | | :]{.underli | of breath | | | | | ne}** | | | | | | | Restlessnes | | | | | The purpose | s | | | | | is to align | & confusion | | | | | the bone | | | | | | and reduce | **Petechiae | | | | | **pain** by | ** | | | | | reducing | (late sign) | | | | | muscle | | | | | | spasm. | **[Compartm | | | | | | ent | | | | | Weights | Syndrome]{. | | | | | should | underline}* | | | | | always be | * | | | | | **free-hang | | | | | | ing**. | Swelling | | | | | | within a | | | | | Patient's | muscle | | | | | body is the | compartment | | | | | counterweig | causes | | | | | ht. | increased | | | | | | pressure on | | | | | **Skin | **blood | | | | | Traction:** | vessels** | | | | | | and | | | | | Utilizes a | **nerves**. | | | | | boot or | | | | | | **dressing* | Commonly | | | | | * | caused by | | | | | to hold | fractures | | | | | traction in | or | | | | | place. | **crush** | | | | | | injuries. | | | | | **Skeletal | | | | | | Traction:** | **Early | | | | | | symptoms**: | | | | | Pins | **pain** | | | | | inserted | (typically | | | | | into | unrelieved | | | | | **bone** | by | | | | | are used to | medications | | | | | hold | ) | | | | | traction in | and | | | | | place. | paresthesia | | | | | |. | | | | | Pin care is | | | | | | a | **Late | | | | | **sterile** | symptoms**: | | | | | procedure. | pulselessne | | | | | | ss | | | | | **Bone | and | | | | | fixation:** | **paralysis | | | | | Rods, pins | **. | | | | | or | | | | | | **screws** | Loosen any | | | | | are used to | dressings | | | | | hold bones | and prepare | | | | | in place. | patient for | | | | | | **fasciotom | | | | | Two types | y**. | | | | | of | | | | | | fixation: | | | | | | **internal* | | | | | | * | | | | | | and | | | | | | **external. | | | | | | ** | | | +-------------+-------------+-------------+-------------+-------------+