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Musculoskeletal Disorders Part I

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Gout. Musculoskeletal. Disorders. Part II. Fractures. Amputations. Manifestations of Fractures ... Nursing Care for External Fixation Devices. Maintain Alignment ... – PowerPoint PPT presentation

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Title: Musculoskeletal Disorders Part I


1
Musculoskeletal Disorders Part I
Osteoporosis Osteomyelitis Osteoarthritis Rheumato
id Arthritis Gout
2
Musculoskeletal Disorders Part II
Fractures Amputations
3
Manifestations of Fractures
  • Pain
  • Swelling
  • Deformity
  • Numbness
  • Hematoma Formation
  • Muscle spasm

4
Emergency Care of Fractures
  • Neurovascular Assessment
  • Five Ps
  • Pain
  • Pulses
  • Pallor
  • Paralysis
  • Paresthesia
  • Immobilization
  • Alignment
  • Wound Care

5
Diagnosis of Fracture
  • X-ray
  • Bone Scan
  • Lab Studies
  • CBC
  • Coagulation studies

6
Factors Which Promote Bone Healing
  • Local
  • Good emergency care and fracture setting
  • Ice
  • Systemic
  • Ca, Vitamin D, Growth Hormone
  • Adequate Blood Supply
  • Young and Active
  • No Infection

7
Fracture Treatments
  • Medications
  • Surgery
  • Fixation Devices
  • External
  • Internal
  • Traction
  • Casts

8
Medications
  • Analgesics
  • Antibiotics
  • Anticoagulants
  • GI Meds
  • Constipation
  • Ulcer prevention

9
Surgical Treatment
  • External Fixation

10
Nursing Care for External Fixation Devices
  • Maintain Alignment
  • Frequent Neurovascular and Skin Assessments
  • Infection Prevention
  • Skin care per policy

11
Surgical Treatment
  • Internal Fixation (ORIF)

12
Nursing Care for Internal Fixation Devices
  • Neurovasuclar Assessment
  • PAIN
  • Suture Care
  • Hemovac?
  • Hazards of Immobility
  • Lungs, heart, bowels, legs

13
Traction
  • Manual

14
Traction
  • Bucks also called Straight Traction

15
Traction
  • Balanced
  • Suspension

16
Care of the Client in Traction
  • Maintain alignment
  • Let weight hang free
  • Maintain ropes free
  • Position client
  • Skin Traction
  • NO more then 6 pounds of traction per extremity

17
Casts
  • Immobilizes Body Part
  • Note Composition
  • Plaster
  • Fiberglass
  • Teaching
  • No objects in cast
  • Keep Dry
  • Assess Neurovascular
  • Position Sling to prevent neck injuries
  • Even distribution of weight
  • Alignment
  • ID wrinkles in fabric
  • Check skin

18
Nursing Care of Client with a Cast
  • Neurovascular Checks
  • Assess for Infection
  • Crutch Walking
  • Two Point Gait
  • Four Point Gait
  • Swing to Gait
  • Swing through Gait

19
Complications Related to Fractures
  • Compartment Syndrome
  • Fat Embolism Syndrome
  • Deep Vein Thrombosis
  • Reflex Sympathetic Dystrophy

20
  • Compartment Syndrome (CS)
  • Fascia Lines the Compartment within the limb
  • Increased pressure from hemorrhage or edema
  • Pressure from cast being too tight
  • Results
  • Nerve, vessels, muscles are damaged

21
COMPARTMENT SYNDROME
22
  • Fat Embolism Syndrome
  • Globules of fat, released from fractured bone
  • Fat mixes with platelets
  • Emboli travel to lungs, brain, or other areas.
  • Clotting cascade activated petechiae

23
Assessment of Fat Embolism Syndrome
  • Notify MD Immediately
  • Dyspnea
  • Confusion
  • Pulmonary complications
  • Pulmonary Edema
  • ARDS
  • Petechiae

24
Treatment of Fat Embolism Syndrome
  • Maintain Pulmonary Function
  • Intubation
  • Ventilation
  • Fluid Balance
  • Steroid Treatment
  • Stabilize Long Bone Fractures

25
  • Deep Vein Thrombosis

26
  • Reflex Sympathetic Dystrophy
  • Posttraumatic Condition
  • Persistent Pain
  • Hyperesthesias
  • Swelling
  • Skin color changes
  • Temperature changes

Treatment Sympathetic Nervous System Blocking
Agent (Alpha or Beta Blocker)
27
Hip Fracture
28
Nursing Care of Client with Hip Fracture
  • Neurovascular Assessment
  • Nursing Diagnosis
  • Acute Pain
  • Risk for Infection
  • Impaired Mobility
  • Impaired Sensory Perception

29
Amputations
30
Amputations
  • Causes
  • PVD
  • Trauma
  • Infections
  • Tumors

31
Teaching Principals For Clients with an Amputation
  • Wrap Stump
  • Positioning of the Stump
  • Stump Exercises
  • Physical Activities
  • Household modifications
  • Referrals for Social Services

32
The End
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