Musculoskeletal System - PowerPoint PPT Presentation

About This Presentation
Title:

Musculoskeletal System

Description:

Title: Musculoskeletal System Last modified by: Administrator Created Date: 3/1/2004 6:04:53 PM Document presentation format: On-screen Show Other titles – PowerPoint PPT presentation

Number of Views:330
Avg rating:3.0/5.0
Slides: 36
Provided by: weeblyCom
Category:

less

Transcript and Presenter's Notes

Title: Musculoskeletal System


1
Musculoskeletal System
2
Inflammatory Disorders
  • Presentations
  • Rheumatoid Arthritis
  • Ankylosing spondylitis
  • Osteomyelitis
  • Bursitis

3
Degenerative Disorders
  • Osteoporosis
  • Osteoarthritis DJD/Degenerative Joint Disease
  • Total Joint Arthroplasty

4
Osteoporosis
  • Increased porosity in the bone
  • Common disorder of bone metabolism
  • Decreased mineral and protein matrix
  • Bone brittle, fragile
  • Prone to fractures

5
Osteoporosis
  • 10 million people in United States have
    Osteoporosis
  • Another 34 million have low bone density, which
    puts them at risk for Osteoporosis
  • 80 of affected are women
  • 1.5 million fractures occur each year related to
    Osteoporosis

6
Osteoporosis
  • Silent disease
  • No symptoms of bone loss
  • May have 50 loss prior to diagnosis
  • Multiple fractures may cause decrease in height
  • Only diagnosed by BMD
  • Bone Mineral Density
  • Painless
  • Non-invasive
  • safe

7
Osteoporosis
  • Risk Factors
  • Small bones
  • Advanced age
  • Family history
  • Post-menopause with out estrogen replacement
  • Eating disorders
  • Low calcium diet
  • Inactive activity
  • Smoking
  • Increased alcohol consumption
  • Use of corticosteroids or anticonvulsant
    medications

8
Medical-Surgical Management
  • Pharmacological four medications
  • Estrogen
  • Fosamax
  • Miacalcin
  • Testosterone
  • No cure
  • Prevention

9
Osteoporsis
  • Diet
  • Activity

10
Nursing Process
  • Assessment
  • Subjective Data

11
  • Objective Data

12
Dowagers Hump
13
Degenerative Joint Disease/DJDOsteoarthritis
  • NOT inflammatory
  • Wear and tear disease
  • Slow, steady, progressive destruction of the
    joint
  • Etiology unknown
  • Most common form of arthritis

14
Osteoarthritis or DJD
  • Symptoms
  • Early morning stiffness
  • Pain after physical activity
  • Joint enlargement
  • Bouchards nodes
  • Heberdens nodes
  • Hypertrophic spurs
  • Distal interphalanges
  • Hard, painless

15
Heberdens Nodes
16
Heberdens Nodes
Heberdens nodes.
17
Bouchards Nodes
18
Osteoarthritis
  • Diagnostic tests
  • Radiographic studies
  • Arthroscopy
  • Synovial fluid examination
  • Bone scans

19
Osteoarthritis
  • Medical management/nursing interventions
  • Surgery

20
Total Joint Arthroplasty
  • Joint replacement
  • Replacement of both articular surfaces with in a
    joint capsule
  • Hip, knee, shoulder and fingers are most common
    sites
  • Replacement consist of metal and polyethylene

21
Total Joint Arthroplasty
  • Older method of cemented in prepared bone is not
    used as often
  • New technology uses porous coated cement-less
    artificial joint component. This allows bone to
    grow into the joint and less prosthesis failure
    noted.

22
Total Hip Replacement
  • Replacement of severely damaged hip with an
    artificial joint
  • Usually people over 60 years
  • Severe pain, irreversible damage to hip joints

23
Hip Replacement
  • Potential problems
  • Dislocation of prosthesis
  • Excessive wound drainage
  • Infection

24
Following Hip Replacement
  • Clients hip and leg to be kept in position of
    adduction and extension
  • Knees are apart by abductor pillow or by using
    foam wedges
  • Entire leg to be supported when turning side to
    side
  • AVOID ACUTE FLEXION OF THE HIP

25
Following Hip Replacement
  • Fracture bed pan should be used
  • Raised toilet seat in bathroom
  • Vital signs, circulation, movement and sensation
    checks (CMS) to be done frequently
  • Inspect dressing frequently
  • Monitor drainage from portable suction device (JP
    Drainage) can be as high as 200 -500 cc. With in
    48 hours should be less than 30 cc and suction
    devices can be removed.

26
Client Goals after Hip Replacement
  • Ambulate independently
  • Out of bed the night of the surgery or the next
    day
  • Gait training begins so that client can use
    crutches or cane
  • FLEXION OF KNEE TO BE AVOIDED
  • No more than 90 degrees
  • No stair climbing for three months

27
Total Knee Replacement
  • Severe pain and functional disability related to
    joint destruction
  • Following knee replacement clients may use CPM
    continuous passive motion machine which helps
    increase circulation to operative area and
    promotes flexibility with in he knee joint.

28
Knee Replacement
  • Following surgery.
  • Knee to be imoblized
  • Firm compression dressing
  • Adjustable soft knee immobilizer
  • Transfer to chair ok, but NO WEIGHT BEARING is
    allowed on knee until ordered my MD

29
Total knee replacement
  • SCD Sequential Compression Device may be used
    or
  • TED hose Anti embolism stocking worn to
    minimize the development of thrombophlebitis
  • Rehabilitation starts second day
  • When patient is sitting knee should be elevated
  • Weight bearing should start with in 1- 2 days

30
Nursing Management
  • Cough and deep breathe
  • Use trapeze to raise hips off bed for bedpan use

31
NursingAssessment
  • Nursing Assessment should include
  • Neurovascular assessment of affected extremity
  • Incision assessment
  • Vital signs
  • Lung sounds
  • Pedal pulses
  • Intake and output

32
Nursing Assessment
  • Irritablity
  • Restlessness
  • Orientation
  • Neurovascular assessment for pain, numbness,
    tingling and paresthesia

33
Objective Assessment
  • Incision assessment for
  • Approximation
  • Redness
  • Drainage
  • Skin color

34
Assessment
  • Other assessments
  • Tachypnea
  • Dyspnea
  • Hypoxia
  • Crackles and wheezes ( s/s of fat embolism)
  • Position of affected part

35
Care Plans
  • Divide in to groups and create care plans
Write a Comment
User Comments (0)
About PowerShow.com