NSG 124: EAQ Ortho Soft Tissue

Describe a meniscus injury

A meniscus injury refers to injury to the fibrocartilage of the knee that is characterized by popping, clicking, and tearing sensations with effusion and swelling

A patient states, "I twisted my ankle while walking." Which assessment finding makes the nurse suspect that the injury is a third-degree sprain?

A third-degree sprain involves complete tearing of the ligament, and a gap in the muscle may be apparent or be palpated through the skin. The swelling may occur due to the inflammatory responses by the released mediators but is not specific to the degree of sprain. Redness may or may not be present. The patient may feel pain due to the injury irrespective of the degree of the sprain, but the pain becomes severe in a third-degree sprain.

The nurse provides education for a patient that recently underwent acromioplasty about the postoperative plan of care. Which statement made by the patient indicates the need for further teaching?

Acromioplasty is the surgical removal of the acromion, which relieves rotator cuff compression during the movement. Weightlifting is usually restricted until the patient fully recovers. Physical therapy is initiated from the first postoperative day to facilitate recovery without any complications. Pendulum exercises begin on the first postoperative day. The shoulder is immobilized with a sling for a short time.

Which condition does the nurse suspect in a patient with a traumatic ligament tear caused by a combination of excessive deceleration force and limb rotation?

An ACL tear occurs where there is traumatic knee ligament tear caused by a combination of excessive deceleration force and knee rotation. Subluxation injury is a partially dislocated joint resulting from a severe sprain (ligament damage) or strain (muscle or tendon damage) commonly caused by trauma such as a fall. A meniscus injury occurs when there is torn or damaged knee cartilage commonly caused by deep squats and heavy lifting. A rotator cuff is a capsule containing cluster of muscles and tendons that support the arm at the shoulder joint; a rotator cuff tear is commonly caused by aging and/or repetitive stress to the shoulder and occurs when there has been injury to the muscle or in the tendon and ligament structures around the shoulder.

As part of a wellness program, the nurse recommends balance exercises. Which does the nurse explain as the primary benefit of the exercises?

Balance exercises help to prevent falling. Strengthening exercises may help to build bone density and muscle strength.

The nurse provides education for an athlete about how to avoid sprains and strains and includes which suggestions? Select all that apply.

Balance exercises help to prevent falls. Strengthening exercises help to build up muscle strength and bone density. Performing warm-up exercises before any vigorous activity reduces the risk of sprains and strains.

Which primary manifestation is associated with bursitis?

Bursitis is the inflammation in the closed sacs lined with synovial membrane that contain synovial fluid and are located between tendons and bones near the joints. The swelling is the primary manifestation of bursitis. Bursitis is characterized by painful joints and a warm sensation, not a tingling sensation. The manifestation of altered neurovascular status may appear later in acute soft tissue injury.

A coal miner with a history of rheumatoid arthritis reports pain, swelling, and a limited range of motion in the knee joints. Which diagnosis does the nurse suspect?

Bursitis is the inflammation of the bursae located near the joints. Rheumatoid arthritis causes inflammation in the joints, resulting in friction between joint surfaces. The repetitive kneeling involved in occupations such as coal mining may result in bursitis.

Which activities may precipitate bursitis?

Bursitis is the inflammation of the bursae. Common precipitating activities include repetitive kneeling or running in worn-out shoes. Bursitis is also precipitated by sitting with crossed legs for prolonged time periods, not for a short time.

The nurse reviews the medical record of a patient with bursitis and identifies that which history finding is associated with the condition?

Bursitis is the inflammation of the closed sacs lined by the synovial membrane that contain synovial fluid. This inflammation may result from rheumatoid arthritis, which is a chronic disease causing inflammation in the joints.

The nurse provides education for a group of nursing students and provides which description of carpel tunnel syndrome (CTS)?

CTS involves the compression of the median nerve, which enters the hand through the narrow confines of the carpal tunnel.

The nurse provides care for a patient with carpal tunnel syndrome (CTS) and recalls that the condition is caused by which event?

CTS is caused by compression of the median nerve, which enters the hand at the wrist through the narrow carpal tunnel. The carpal tunnel is formed by ligaments and bones. CTS is the most common compression neuropathy in the upper extremity.

A patient is hospitalized with severe injuries to the ligament surrounding the hip joint. The patient can develop which syndrome if the fascia surrounding the muscle has limited ability to stretch?

Compartment syndrome is a condition in which swelling causes increased pressure within a limited space (muscle compartment). Because the fascia surrounding the muscle has limited ability to stretch, continued swelling can cause pressure that compromises the function of blood vessels and nerves in the compartment. Compartment syndrome often involves the leg. Overuse syndrome results from repetitive movements and awkward postures. Impingement syndrome is the entrapment of soft tissue structures under the coracoacromial arch of the shoulder. Carpal tunnel syndrome may be caused by median nerve compression; the median nerve enters the hand through the carpal tunnel's narrow confines.

Which is the most useful initial nursing action for a patient who sustains a knee sprain?

Ice application is the most useful intervention after a sprain. Cold compression produces hypothermia of the affected area, facilitating vasoconstriction and reducing the perception and transmission of nerve pain impulses. An NSAID can be given after the cold compress is applied.

The nurse provides education for a group of nursing students about sports-related injuries and includes which definition of impingement syndrome?

Impingement syndrome is the entrapment of soft tissue structures under the coracoacromial arch of shoulder. The tear within the muscle or tendons or ligament structures around the shoulder is a rotator cuff tear.

A patient experiences tearing of a ligament as a result of shearing applied to a joint. Which diagnosis does the nurse suspect?

Ligament injury is the tearing or stretching of a ligament as a result of inversion, eversion, shearing, or torque applied to a joint.

A patient is found to have a partially dislocated shoulder. How does the nurse document this finding?

Subluxation, also known as dislocation, may be assessed by means of palpation of the space between the head of the bone and the cavity where it is normally located. Subluxation results in partial loss of function and intense pain. A subluxation is not a fracture since there is no break in bone integrity, but a subluxation is treated similarly to a fracture. With subluxation, there is no rupture in the integrity of the bone. Subluxation may be described as a misalignment, but this is not an accurate term.

clinical tests for CTS

The clinical findings indicate CTS. It is associated with hobbies or work that require continuous wrist movement. Tinel's sign is elicited by tapping over the median nerve as it passes through the carpal tunnel in the wrist. Phalen's sign can be elicited by allowing the wrists to fall freely into maximum flexion and maintaining this position for more than 60 seconds. The positive responses for both include a tingling sensation in the median nerve distribution over the hand associated with CTS

The nurse is caring for a patient with a dislocated hip. The nurse recalls that this type of injury is associated most commonly with which event?

The hip is the most common dislocation of the lower extremity and generally is associated with motor vehicle collisions. Falls from a high place generally result in a fracture. Osteoporosis of the hip joint is more likely to result in a fracture and not dislocation. Pathologic fractures secondary to a history of cancer are not associated with hip dislocations.

A patient reports pain of the knee. The nurse flexes the knee by 25 degrees and also pulls the tibia forward while keeping the femur stable. The nurse feels a soft forward motion of the tibia with an indistinct endpoint. The nurse suspects which diagnosis?

The knee with an anterior cruciate ligament tear may produce a positive Lachman's test. This test involves flexing the knee by 15 to 30 degrees and pulling the tibia forward, keeping the femur stable. It is considered positive with forward motion of the tibia with a soft feeling and indistinct endpoint.

The nurse provides education for a patient who has injured the anterior crucial ligament (ACL) and is scheduled for reconstructive surgery. The nurse recognizes that the patient, who is a soccer player, needs more teaching when the patient makes which statement?

When the athlete has ACL reconstructive surgery, the patient does not understand the severity when the patient mentions a plan to play soccer soon. The patient likely will not be able to play soccer for six to eight months. The patient will be able to do range of motion soon after surgery. Immobilization and progressive weight bearing with physical therapy will occur during rehabilitation.