Week 2 Power Point Musculoskeletal Disorders recorded.pptx

HLTENN044 IMPLEMENT AND MONITOR CARE FOR A PERSON WITH CHRONIC HEALTH PROBLEMS • Chronic Musculoskeletal, integumentary and sensory disorders. Diploma of Nursing HLT54121 Image sourced from https:// www.needpix.com/photo/download/1186669/anatomy-female-muscles-skeleton-tissue-organs-internal-orga...

HLTENN044 IMPLEMENT AND MONITOR CARE FOR A PERSON WITH CHRONIC HEALTH PROBLEMS • Chronic Musculoskeletal, integumentary and sensory disorders. Diploma of Nursing HLT54121 Image sourced from https:// www.needpix.com/photo/download/1186669/anatomy-female-muscles-skeleton-tissue-organs-internal-organs-endoskeleton-bone - Free to use and share WARNING This material has been reproduced and communicated to you by or on behalf of Swinburne University of Technology in accordance with Section 113P of the Copyright Act 1968 (the Act). The material in this communication may be subject to copyright under the Act. Any further reproduction or communication of this material by you may be the subject of copyright protection under the Act. Do not remove this notice. Acknowledgement of Country We respectfully acknowledge the Wurundjeri People of the Kulin Nation, who are the Traditional Owners of the land on which Swinburne’s Australian campuses are located in Melbourne’s east and outer-east, and pay our respect to their Elders past, present and emerging. We are honoured to recognise our connection to Wurundjeri Country, history, culture, and spirituality through these locations, and strive to ensure that we operate in a manner that respects and honours the Elders and Ancestors of these lands. We also respectfully acknowledge Swinburne’s Aboriginal and Torres Strait Islander staff, students, alumni, partners and visitors. We also acknowledge and respect the Traditional Owners of lands across Australia, their Elders, Ancestors, cultures, and heritage, and recognise the continuing sovereignties of all Aboriginal and Torres Strait Islander Nations. What do we already know about the musculo-skeletal system? Osteoarthritis • Most common chronic arthritis (85%) • Cartilage on bone wears down mainly affecting fingers, spine and weight bearing joints (hips / knees) causing friction, inflammation and development of bony spurs • related to aging • Wear and tear arthritis • More women than men • Exacerbated by excess weight and injury • Causes stiffness and pain • Treated with heat, analgesia • May require aids i.e. walker Osteoarthritis – case study You are the enrolled nurse caring for Joan a 70 year old women who is has been admitted to the ward for treatment of a wound that won’t heal. Joan has a BMI of 32. She also has arthritis in the right hip and informs you that she has been finding it increasingly difficult to ambulate and that she is in pain all day. She currently takes paracetamol 1000mg QID for the pain. What risk factors did Joan present with that would have contributed to the development of osteoarthritis? Develop two nursing diagnoses for Joan related to her arthritis and devise two nursing interventions for each. List three appropriate referrals you could make for Joan and provide rationale https://www.youtube.com/watch?v=R7pDSqEwahs CHRONIC PAIN Pain lasting longer than 3 months Acute pain can transition into chronic pain if it is untreated or poorly treated. Neuroplastic changes occur within the nervous system, which make the body more sensitive to pain and can create sensations of pain even without external pain stimuli. For example, people can feel pain from a breeze or clothes touching their skin. https://www.youtube.com/watch?v=ELpfYCZa87g&list=PLDA6A3 YGGKKa-HpZt_kZkgXtuyxsZtnM9 https://www.youtube.com/watch?v=eakyDiXX6Uc Painful Facts:3.24 million Australians live with chronic pain (2018) For the majority (56%) of Australians living with chronic pain, their pain restricts what activities they can undertake. What conditions could cause chronic pain? WHO IS LIKELY TO HAVE CHRONIC PAIN???? • Musculoskeletal pain is most common especially in the back • Older people and those living with a disability have the highest rates of chronic pain in our community • 1/3 people aged over 65 • 1/4 people with a profound disability • 2/3 people with a spinal cord injury • In residential aged care, 92% of people are taking at least one analgesic medication daily and 80% of people report pain as a problem. Why is chronic pain a serious issue in people with impaired cognitive function? https://www.painaustralia.org.au/about-pain/who-it-affects/olde r-people-and-those-living-with-a-disability/lyn2 https://www.painaustralia.org.au/about-pain/who-it-affects/olde CHRONIC PAIN MANAGEMENT Referrals to pain specialists occur in less than 15% of GP consultations where pain is managed, medications are used in approx 70% of GP consultations eg opioids, NSAIDS, paracetamol Best Practice does not support long term use of medication for chronic pain management People with chronic pain who actively manage their pain on a daily basis do better than those who rely on passive therapies, like medication or surgery. Most people benefit from a range of different treatments and self-management, such as: • psychological techniques — you can see a psychologist or use online self-help sites pacing your activities • physiotherapy • relaxation techniques such as meditation • exercise such as walking, swimming, cycling or tai chi • improving your sleep AFFECTS OF CHRONIC PAIN ON MENTAL HEALTH • 44.6% of patients living with chronic pain also experience depression or anxiety • suicide is reported to be two to three times higher in those suffering chronic pain compared to the general population. • Major depression in patients with chronic pain is associated with reduced functioning, poorer treatment response and increased health care costs • High rates of generalised anxiety disorder, posttraumatic stress disorder and substance misuse are also reported in people with chronic pain MULTIDISCIPLINARY PAIN MANAGEMENT • a combination of medical, physical and psychological therapies and is the most effective way to improve function and mood, and reduce disability. • a team of health professionals who will comprehensively assess the condition and work with the client to achieve their goals—such as being able to return to work, or just being able to walk the dog—using a range of treatments and strategies. • offer support and treatment, but the client is required to take responsibility for their health and wellbeing on a day-to-day basis. https://www.youtube.com/watch?v=kVYGNrJLX4I SELF-MANAGING CHRONIC PAIN • best way to improve your level of activity, reduce disability and keep pain to a minimum. • When people take control over their pain, they feel empowered and able to resume normal activities Steps: 1. Accept the pain. Accept that the pain is unlikely to disappear, but recognise that you can do things to minimise its impact on your life and reduce the severity of the pain. 2. Change the way you think about pain. When you realise that pain in itself is not harmful and learn not to react to it in a negative way you can “retrain your brain”. 3. Pace yourself. Incorporate a sufficient amount of activity every day and keep it at an even level throughout the day. This will help keep your body conditioned, keep your pain to a minimum and reduce the risk of flare-ups sparked by overactivity. https://www.painaustralia.org.au/static/uploads/files/painaust-factsheet10-fin al-wflqlkrsmylh.pdf https://www.youtube.com/watch?v=jIwn9rC3rOI Chronic back pain “Usually defined as lower back pain that lasts over 3 months, this type of pain is usually severe, does not respond to initial treatments, and requires a thorough medical workup to determine the exact source of the pain.” National Institute of Neurological Disorders and Stroke. Pain: Hope Through Research Causes: • Rheumatoid/ Osteo Arthritis • Muscle and ligament strains • Osteoporosis • Sciatica/ Disc problems • Stress • Structural problems • Fracture# • Lack of exercise • Overweight • Posture Which of the causes are modifiable risk factors? Chronic back pain –signs and symptoms Click icon to add picture Chronic back pain - Management Chronic back pain – Management Which of the following would assist someone with chronic back pain? Why? • Physiotherapy • Occupational therapy • Hydrotherapy • Pilates massage • Art and music therapy What other referrals would be useful to someone with chronic back pain? Integumentary Disorders : Eczema (Atopic Dermatitis) • Chronic disorder of the skin • Exact cause unknown but appears to involve a genetically determined skin barrier defect which makes the skin more open to allergens and irritants and overactive response by the body's immune system to an irritant. This triggers the skin to release chemicals that make the skin itchy. Scratching itchy skin causes more chemicals to be released, making the skin feel itchier. • Skin also does not retain moisture very well, which causes it to dry out easily. • Many infants with moderate or severe eczema will also have an allergy to food/s • presents as an itchy, red, scaly and inflamed rash, which can also become infected, weeping and crusty. • Eczema is commonly seen on the face in infants and behind the knees and inside the elbows. • https://www.youtube.com/watch?v=97LjZ2XAtfY Eczema: Treatment Apply moisturiser to the face and body twice a day (avoid creams that contain food products). Avoid known triggers and irritants, which may include: • Scratching (night gloves and clipped fingernails may be needed by young children). • Swimming in chlorinated swimming pools. • Sitting directly on carpets or grass. • Inhalant allergens in spring and summer • Food intolerances to artificial colours and preservatives. • Irritants such as perfumes, soap, chemicals, woollen or synthetic fabrics. • Temperature changes, such as overly heated rooms. • Stress, which can make it worse, • Contact with animals or house dust mite allergen. • Constant exposure to water, soap, grease, food or chemicals, that can damage the protective barrier function of the skin. Once the protective barrier of the skin is lost, eczema frequently develops. Eczema: Treatment Eczema flares or severe eczema: • Use topical corticosteroids or topical calcineurin inhibitors to actively treat redness and inflammation. • Apply moisturiser after corticosteroid cream has been applied. • If prescribed, use immune modulating treatments for severe eczema. Control Itch: • Cold compresses and wet wraps may help reduce itch. • Antihistamines may also help reduce itch. Prevent and Treat Infection: • Eczema is very prone to infection with bacteria like Staph (Staphylococcus aureus), and viruses such as the cold sore virus. • Long term oral antibiotics can be helpful for people who suffer from recurrent infected eczema. • https://www.youtube.com/watch?v=EsqZaP3YqfY CHRONIC SENSORY DISORDERS. Chronic sensory disorder may affect how your brain processes sensory information . Sensory information includes things you can see, hear smell, taste and touch. One or more senses may be affected. Common Sensory disorders are : *Blindness, cataracts, Glaucoma. *Deafness or decreased hearing. *Loss of taste. Ageusia is the complete loss of taste and is quite rare. Dysgeusia is more common and can cause a persistent taste in the mouth that masks others tastes, so that all foods taste the same. *Loss of smell. ( Anosmia) There are many medications, diseases, hormonal disturbances and chemicals that can disrupt the sense of smell. Sometimes this is permanent. People do get less sensitive to smell as they get older. *Loss of sensation ( Hypothesia) Numbness ( Paresthesia) Hypothesia usually occurs as a result from damage to the nerve, and from blockages in blood vessels. It could also be the result of a neurological injury such as a stroke. What nursing interventions might you initiate for a patient who is vision impaired? What are some actual and potential risks for this patient? If a patient was completely deaf, how might you communicate? MUSCULOSKELETAL DISORDERS . Common examples of Musculoskeletal disorders include: *Carpel Tunnel Syndrome *Tendonitis *Muscle/ tendon strain *Ruptured/ herniated disc /back injury CARPAL TUNNEL SYNDROME •Carpal tunnel syndrome is a painful disorder of the hand caused by pressure on nerves that run through the wrist. •Anything that aggravates and inflames the tendons can cause carpal tunnel syndrome, including repetitive hand movements, pregnancy and arthritis. •Carpel tunnel can be caused by repetitive hand movements such as typing, using a computer mouse . •Arthritis, pregnancy and wrist fractures have also been said to cause carpal tunnel syndrome. •Some people may no longer be able to work in their profession because of this disorder. •Treatment options include rest, splinting, cortisone injections, fluid tablets and surgery. •Carpal tunnel syndrome - causes, symptoms, diagnosis, treatment & pathology - YouTube TENDONITIS. Tendonitis is when a tendon is inflamed. These bands, that connect muscles to bones help the body move. Patients may experience pain, swelling , weakness or a decreased range of motion. It can be treated with rest, ice and pain relief. It may reoccur. NAME PRESENTATION 2019 HERNIATED DISC The spinal disc has a soft jelly like centre (nucleus) Surrounded in a tougher, rubbery exterior ( annulus) A herniated disc is when some of the nucleus pushes out through a tear in the annulus Depending on the disc location, this can result in pain, numbness and weakness in the extremities. NAME PRESENTATION 2019 REFERENCE LIST. Alila Medical Medica ( 2016) Eczema Animation Oct 24, Available at : Eczema, Animation. - YouTube Accessed 19/02/22 Brainman (2014) Understanding Pain : Brainman Chooses. Oct 13 . Available at : Understanding Pain: Brainman chooses - YouTube Accessed 19/02/22 SENSORY LOSS - Advocates for Independent Living Accessed 19/02/22 HSS (2019) Osteoarthritis Treatment, Oct 26. Available at: Osteoarthritis Treatment - YouTube Accessed 19/02/22Koutoukidis,G,.Stainton,K,.(2020) Tabners Nursing Care: Theory and Practice. 8th edition. National Jewish Health 92019) What is Eczema and how is it treated, Jan 22 Available at : What is Eczema and How Is it Treated? - YouTube Accessed 19/02/22 NIH 92019) Pain: Considering Complementary Approaches. Available at: Pain: Considering Complementary Approaches (nih.gov) Accessed 19/02/22 Pain Australia (2015) Managing Chronic Pain – Part 2, Aug 27Available at: Managing chronic pain – part 2 HD - YouTube Pain Australia (2016) Self Managing Chronic Pain. Available at: painaust-factsheet10-final-wflqlkrsmylh.pdf (painaustralia.org.au) Accessed 19/02/22 Robert, Lyn., (2020) Lyn. Available at: Lyn (painaustralia.org.au) Accessed 19/02/22 Robert, Lyn., (2020) Robert : Available at : Robert (painaustralia.org.au) Accessed 19/02/22 Sentis (2012) Neuroplasticity, Nov 7. Available at: Neuroplasticity. Accessed 19/02/22 Ted-Ed (2019) The mysterious Science of pain – Joshua W. Pate, May 21. Available at: The mysterious science of pain - Joshua W. Pate - YouTube. Accessed 19/02/22 HLTENN044 2022