MSK med-surg ch 62 PN 2, BRTC

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whiplash injury

A sprain of the cervical spine

fasciotomy

A surgical incision if fascia & separation of muscles.

epicondylitis (tennis elbow)

A painful inflammation of the elbow.

subluxation

A partial dislocation

A patient has stepped in a hole in the yard, causing an ankle injury. The ankle is edematous and painful to palpation. How long should the nurse inform the patient that the acute inflammatory stage will last?

Between 24 and 48 hours

Meniscecromy

A torn menisci the surgeon removes the damage cartilage

Intracapsular hip fx are prone to nonunion and avascular necrosis from the disrupted ___ supply

Blood

Healing of fractures

Blood seeps to area & clots; changes to granulation tissue Osteoblasts proliferate clot, increasing an enzyme secretion restoring alkaline pH Calcium is deposited & true bone forms

Epicondylitis

AKA "Tennis elbow" Painful inflammation of the elbow Usually caused by a repetitive motion

Rotator cuff Have difficulty with activities that involve stretching their hands _____ their heads

Above

Ecchymosis

Bruising.

ecchymosis

Brusing

Rx fractured hip

Buck's traction until cleared for surgery ORIF(open reduction internal fixation) with nail or intramedullary rod Austin-Moore or Thompson prosthesis- hemiarthroplasty; the bone heals around the prosthesis

Healing mass

Callus

Fat embolism

Can go to heart, brain, or lungs Signs: SOB, chest pain, LOC change, anxious

Term for a group of symptoms located in the carpal tunnel of the wrist, a narrow, inelastic canal through which the carpal tendons and median nerve pass

Carpal tunnel

What type of occupation gets carpal tunnel syndrome

Cashiers, typists, musicians, assemblers, and all who spend many hours using a computer keyboard and mouse

Surgical repair of ruptured Achilles' tendon

Cast or brace Physical therapy

Clients experience what type of symptoms with a rotator cuff

Clients experience pain with movement and limited mobility of the shoulder and arm. They especially have difficulty with activities that involve stretching their arms above their heads. Many clients find that pain is worse at night and that they are unable to sleep on the affected side. The diagnosis is based on physical examination—

Which type of fracture produces several bone fragments?

Comminuted

Condition in which a structure such as a tendon or nerve is constricted in a confined space

Compartment syndrome

Nursing care of dislocations

Immobilize

Assessment of strains, contusions & sprains

Limping, swelling, ecchymosis, pain

Assessmentfindings of fractures

Loss of function Deformity False motion Crepitus Edema Spasm Tissue Nerve damage

Signs and symptoms of ruptured Achilles' tendon

Loud pop Sever pain Inability to plantar flex

What type of medication can ease discomfort ?

NSAIDs (non steroidal anti inflammatory drugs)

Tx of Ruptures Achilles tendon

NSAIDs, rest , steroid injection, surgery

Common side effects of NSAIDs

Nasusea, vomiting, diarrhea, constipation, & GI bleeding

NSAID

NonSteroidsal Anti-Inflammatory Drugs

Which term refers to the failure of fragments of a fractured bone to heal together?

Nonunion

Medical and surgical management of sprains, strains, contusions

RICES, heat (when edema unlikely), medications progressive physical therapy

Medical and surgical management of fractures

Re establish functional continuity of the bone Traction (closed or open reduction), internal or external fixation, cast application

Tendonitis causes

Recurrent injuries Epicondylitis Ganglions Carpal tunnel syndrome

A 19-year-old patient presents to the emergency room with an injury to her left ankle that occurred during a high school basketball game. She complains of limited motion and pain on walking, which increased over the last 2 hours. The nurse knows that her diagnosis is most likely which of the following?

Second-degree sprain

Fracture hip signs and symptoms

Sever pain; shortening, external rotation of leg; blood loss; extensive bruising; edema; contained bleeding

Ruptures Achilles tendon

Severe pain, can't plantar flex Will feel a "pop"

Rotator Cuff tear

Shoulder overuse or trauma

Frequent sites of injury and pain in the extreme notices include:

Shoulder, elbow, wrist, knee, and ankle

Contusions

Soft tissue injury Ecchymosis or hematoma

Contusion

Soft tissue injury resulting from a blow or blunt trauma.

Contusion

Soft tissue resulting from a blow or blunt trauma

Ligament and meniscus injuries causes

Traumatic injury

Rotator cuff injuries can occur as a result of a

Traumatic injury or from a chronic overuse or irritation of the shoulder joint

Rotator cuff tear cause

Traumatic injury;chronic overuse of shoulder joint

Fractured hip

Usually affects proximal end of femur Mostly falls, more with elderly Intracapsular-within the hip joint capsule Intertrochanteric/extracapsular- between the trochanters Subtrochanteric/extracapsular- below the trochanters

meniscectomy

excision of the meniscus (performed for a torn cartilage)

A nurse suspects that a client with a recent fracture has compartment syndrome. Assessment findings may include:

inability to perform active movement and pain with passive movement.

A 14-year-old patient is treated in the emergency room for an acute knee sprain sustained during a soccer game. The nurse reviews discharge instructions with the patient's mother. The instructions cover pain management and swelling reduction for the acute inflammatory stage which lasts:

24 to 48 hours.

thromboembolism

A blood clot that has formed within a blood vessel and is floating within the bloodstream.

Fracture

A break in the continuity of a bone.

Surgical procedures for a rotator cuff

Arthroscopic debridement of devitalized tissue Arthroscopic tendon repair Open acromioplasty with tendon repair

For fractures/breaks also

Beware of surrounding organs and tissues

Avulsion fracture

Chip of bone becoming detached

Ganglion

Cyst near tendons and wrist joints Defect

Tennis elbow

Epicondylitis

Cystic mass that develops near tendon sheaths and joints of the wrist

Ganglion cyst

Which term refers to a fracture in which one side of a bone is broken and the other side is bent?

Greenstick

Tendinitis

Inflammation of a tendon by overuse

Contusion

Is a soft tissue injury resulting from a blow or blunt trauma

Rest ice compression elevation

RICE

callus

The healing mass that forms after a bone is fractured, which holds the ends of the bone together but cannot endure strain.

Ruptured Achilles' tendon cause

Trauma

first degree strain

little tissue tearing, mild tenderness, pain with full range of motion, edema

Dislocations

occur when the articular surfaces of a joint are no longer in contact

Epicondylitis

painful inflammation of the elbow. (Tennis elbow)

Arthroscopic tendon repair

reattach the tendon to the bone arthroscopically

A client is brought in by ambulance to the emergency department after being involved in a motorcycle accident. The client has an open fracture on his tibia. The wound is highly contaminated and there is extensive soft- tissue damage. How would this client's fracture likely be graded?

Grade III

Treatment of musculoskeletal trauma involves

Immobilizations of the injured area until it has healed. It also requires prevention of futther injury andncomplications

Rx of Ligament and meniscal injuries

Immobilize, NSAIDs, steroid injection, surgery to repair or remove(meniscectomy)-recovery from surgery is 3-12 months depending on severity

second degree strain

Moderate tearing of musculotendinous fibers Marked loss of strength, swelling, ecchymosis

Made up of four muscles and their tendons that connect the proximal humerus, clavicle, and scapula, which in turn connect with the sternum and ribs

Rotator cuff

sprains

injuries to the ligaments around a joint

Another possible complication during the healing process

involves an insufficient deposit of collagen during the repair stage. The end result is that the ligaments may have reduced tensile strength and future instability leading to recurrent dislocation of the same joint

A fracture is considered pathologic when it

occurs through an area of diseased bone.

PCL

posterior cruciate ligament

epicondylitis

tennis elbow (painful)

Treatment consists of

Applying ice or a chemical cold pack to the area to reduce swelling and relieve pain for the first 24 to 48 hours. Elevation of the part and compression with an elastic bandage also may be recommended.

A patient sustains a fracture of the arm. When does the nurse anticipate pendulum exercise should begin?

As soon as tolerated, after a reasonable period of immobilization

compound fracture

A fracture in which damage also involves the skin or mucous membranes

Olique fracture

A fracture occurring at an angle across the bone (less stable than transverse)

A client is treated in the emergency department for acute muscle strain in the left leg caused by trying a new exercise. During discharge preparation, the nurse should provide which instruction?

"Apply ice packs for the first 24 to 48 hours, then apply heat packs."

depressed fracture

A fracture in which fragments are driven inward (seen frequently in fractures of skull and facial bones)

greenstick fracture

A fracture in which one side of a bone is broken and the other side is bent

Assessing dislocations

"Pop" sound is heard, severe pain, muscle spasm, can see altered shape, swelling, cool, numb, tingling, pale, dusky If an extremity, the arm/leg could be shorter

Dislocation assessment findings

"Popping" sound Sudden instability Pain Altered structural shape Limited ROM

PRICE (acronym) treatment for sprains, contusions, strains

(P)protection(R)rest(I)ice(C)compression(E)elevate

*Volkmann's contracture*

*Clawlike deformity of hand d/t obstructed blood flow to* *forearm and hand*

Carpal tunnel

*Median nerve* entrapped Caused by repetitive motion S/S - pain, burning, decreased sensation

Tinel's test

- Used for Dx of Carpal Tunnel Syndrome - Physician taps over the volar aspect of the pts transverse carpal ligament - Positive test will cause tingling or paresthesia into the thumb, index, middle or lateral half o the ring finger

A client has had surgical repair of a hip injury after joint manipulation was unsuccessful. After surgery, the nurse implements measures to prevent complications. Which complications is the nurse seeking to prevent? Select all that apply.

- skin breakdown - wound infection - pneumonia

How long does it take for the bone to regain its former structural strength after a break?

1 year

fracture

A break in the continuity of a bone. Fractures may affect tissue or organs near the bones as well. Fractures are are classified according to the type and extent.

When providing discharge teaching to a client with a fractured toe, the nurse should include which instruction?

Apply ice to the fracture site.

Rx of ganglion

Aspirate, steroid injection, surgical removal

Treatment of ganglion cysts includes:

Aspiration of the ganglion, corticosteroid injection, and surgical excision

Femur fracture

Assess: pain, muscle spasm, swelling Dx: x-ray Rx: traction, surgery

The ligament is torn or ruptured completely, with possible detachment of a fragment of bone

Avulsion Fx

A client has presented to the emergency department with an injury to the wrist. The client is diagnosed with a third-degree strain. Why would the health care provider prescribe an x-ray of the wrist?

Avulsion fractures are associated with third-degree strains.

Complications of fractures

Compartment syndrome, thromboembolism, day embolism, delayed healing nonunion, malunion, infection, and avascular necrosis

Two days after application of a cast to treat a fractured femur, the patient tells the orthopedic health care provider that he is experiencing severe, deep, and constant pain in his leg. The nurse suspects a diagnosis of:

Compartment syndrome.

Compartment syndrome

Condition in which a structure such as a tendon or nerve is constricted in a confined space.

Which of the following is a term used to describe a soft tissue injury produced by a blunt force?

Contusion

ganglion cyst

Cystic mass that develops near tendon sheaths and joint of the wrist

Diagnostic findings for sprains, strains, and contusions

Physical exam Radiography Arthrography Arthroscopy

Dx of Rotator Cuff tear

Physical exam, x-rays, MRI

meniscectomy

Damaged cartilage For a torn menisci, the surgeon removes the damaged cartilage.

meniscectomy

Damaged cartilage.

avascular necrosis

Death of a bone from insufficient blood supply.

Avascular necrosis

Death of bone from an insufficient blood supply.

Palsy

Decreased sensation and movement

Palsy

Decreased sensation and movement.

ganglion cyst form thrpugh

Defects in the tendon sheath or joints capsule and occur most commonly in women younger than 50 years of age

Treatment for ligaments and meniscal injuries include:

Depends on the extent of the injury. Initial treatment involves immobilizing the joint and limiting weight bearing. The physician may recommend NSAIDs as well as the use of ice during the first 24-48 hours. Gradual introduction of activity assists the client to progress without causing further injury. Surgical procedures include repair or ligaments and tendons involved

Dx of strains, contusions & sprains

Physical exam, x-rays, arthroscopy

A client who suffers an injury in a local high school hockey game presents with left shoulder pain. The client cannot move the left arm, and the left shoulder is lower than the right shoulder. The nurse recognizes the client most likely has a:

Dislocated shoulder

Occur when the articular surfaces of a joint are no longer intact

Dislocation

Rib fracture

Don't do anything for besides pain meds Can not wrap d/t inhibiting deep breathing

Which nursing intervention is appropriate for a client with a closed-reduction extremity fracture?

Encourage participation in ADLs

After a car accident, a client is admitted to an acute care facility with multiple traumatic injuries, including a fractured pelvis. For 24 to 48 hours after the accident, the nurse must monitor the client closely for which potential complication of a fractured pelvis?

Fat embolism

When should a nurse perform neurovascular checks

Every 30 minutes for several hours, then at least every 2 to 4 hours for the next 1-2 days to detect complications such as compartment syndrome

Fractured hip causes

Falls; bone disorder; trauma

A patient sustained an open fracture of the femur 24 hours ago. While assessing the patient, the nurse observes the patient is having difficulty breathing, and oxygen saturation decreases to 88% from a previous 99%. What does the nurse understand is likely occurring with this patient?

Fat emboli

A nurse is performing a shift assessment on an elderly client who is recovering after surgery for a hip fracture. The client reports chest pain, has an increased heart rate, and increased respiratory rate. The nurse further notes that the client is febrile and hypoxic, coughing, and producing large amounts of thick, white sputum. The nurse recognizes that this is a medical emergency and calls for assistance, recognizing that this client is likely demonstrating symptoms of what complication?

Fat embolism syndrome

Multiple injuries often accompany fx of the ____ because they are usually occur with severe trauma

Femur

Healing of a fx begins when blood in the area clots and a ___network forms between the broken bone ends

Fibrin

3 types of muscle strains and sprains

First degree Second degree Third degree

Rx of fractures

Fixation, cast, reduce, traction

For 10-40 minutes after a bone breaks, the muscles surrounding the bone are _____. Then they go into spasms.

Flaccid

Phalen's sign

Flex wrist for 30 seconds to see if pain or numbness occur

Rotator Cuff

Four muscles and their tendons that connect the proximal humerus, clavicle, and scapula, which in turn connect with the sternum and ribs.

Callus

Healing mass

Callus

Healing mass that forms after a bone is fractured, which holds the ends of the bone together but cannot endure strain.

After 2 days a client/nurse may be able to apply

Heat, which reduces pain, and relieves local edema by improving circulation.

RX of shoulder injuries

Heat/cold, NSAIDs, steroid injection, analgesics, rest, surgery

The tissue surrounding the Fx swells from _____ and edema

Hemorrhage

Which factor inhibits fracture healing?

History of diabetes

Medical and surgical management of tendonitis

ICE + HEAT; rest; well-planned exercise; NSAIDs, other medications; splinting; physical therapy; surgery

Rx of strains, contusions & sprains

Ice first 24-48 hours Elevate & wrap with ace bandage Splint or light cast After 2 days can use heat NSAIDs

Signs and symptoms of a traumatic musculoskeletal injury

Immediate pain followed by swelling, ecchymoses, joint instability

Which nursing diagnosis is the most appropriate for a client with a strained ankle?

Impaired physical mobility

A client has come to the orthopedic clinic for a follow-up appointment 6 weeks after fracturing his ankle. Diagnostic imaging reveals that bone union is not taking place. What factor may have contributed to this complication?

Inadequate immobilization

A nurse is caring for a client who has suffered a hip fracture and who will require an extended hospital stay. The nurse should ensure that the client does what action to prevent common complications associated with a hip fracture?

Increase fluid intake and perform prescribed foot exercises.

Shock signs

Increased pulse, decreased BP, anxious, increased but shallow respirations, LOC change

The nurse is caring for a patient who sustained an open fracture of the right femur in an automobile accident. What does the nurse understand is the most serious complication of an open fracture?

Infection

Tendinitis

Inflammation of the tendon caused by overuse.

Sprain

Injuries to ligaments surrounding a joint

Sprains

Injuries to the ligaments surrounding a joint

Sprains

Injuries to the ligaments surrounding a joint.

sprains

Injuries to the ligaments surrounding a joint.

Rotator cuff injuries can occur as a result of a traumatic ____ or from chronic overuse or irritation of the shoulder joint

Injury

Strain

Injury to a muscle when stretched or pulled beyond its capacity

Strain

Injury to a muscle, when it is streched or pulled beyond its capacity.

Sprains

Injury to ligament surrounding a joint Bad sprain can cause an avulsion fracture

Strains

Injury to muscle when its stretched or pulled beyond capacity. Small blood vessels rupture & muscles fibers get tears causing inflammation, tenderness, & muscle spasms

Avascular necrosis

Interruption of the blood supply to the fracture fragments after which the bone tissue dies

Second degree sprain

Involves partial tearing of the ligament with edema, pain with motion, joint instability, and some loss of function

First degree sprain

Involves stretching of the ligament fibers, characterized by mold edema, tenderness, and pain of joint is moved

carpal tunnel syndrome

Is a term for a group of symptoms located in the carpal tunnel of the wrist, a narrow, inelastic canal through which the carpal tendons and median nerve pass

Strain

Is an injury to a muscle when it is stretched or pulled beyond its capacity

A client who has injured a hip in a fall cannot place weight on the leg and is in significant pain. After radiographs indicate intact yet malpositioned bones, what repair would the physician to perform?

Joint manipulation and immobilization

An emergency department nurse is assessing a 17-year-old soccer player who presented with a knee injury. The client's description of the injury indicates that his knee was struck medially while his foot was on the ground. The nurse knows that the client likely has experienced what injury?

Lateral collateral ligament injury

Ligament and meniscal injuries

Lateral or medial collateral knee ligaments: sides of knee Anterior or posterior cruciate ligaments(ACL/PCL): forward/backward movement Meniscus: Cartilage disrupts leg stability

avulsion fracture

Ligament is torn or ruptured completely, with possible detachment of a fragment of bone.

dislocations

Occur when the articular surfaces of a joint are NO longer in contact.

Dislocations

Occur when the articulate surfaces of a joint are no longer in contact.

Dislocation

Occurs when the articular surfaces of a joint are no longer in contact (shoulder, hip, and knee)

Ruptured Achilles Tendon

Often a loud pop, the client experiences severe pain and inability to plantar flex the affected foot

third degree sprain

One or more ligaments are completely torn causing a loss of function, point tenderness, rapid swelling, and pain.

Hip fx occurs more frequently in older adults with ___

Osteoporosis

Tendonitis signs and symptoms

Pain Inflammation Sensation loss

Rotator cuff tear signs and symptoms

Pain Limited mobility

Assess fractured hip

Pain radiating down to knee Fracture & muscle spasm causes shortening and external rotation of that leg

Assessment of fractures

Pain, swelling, decrease sensation, deformity

A nurse is caring for a client with an intracapsular hip fracture. Identify the area where this client's fracture occurred.

Place X on the ball of the bone

The client often heard a " _____ " sound when dislocation occurs

Popping

A client was fitted with an arm cast after fracturing her humerus. Twelve hours after the application of the cast, the client tells the nurse that her arm hurts. Analgesics do not relieve the pain. What would be the most appropriate nursing action?

Prepare the client for opening or bivalving of the cast.

Nursing considerations for fractured hip

Prevent complications Wound drain ABX Trapeze Abductor pillow If prosthesis, no adduction, elevated toilet seat, don't flex >90 degrees

A client who has had an amputation is being cared for by a multidisciplinary rehabilitation team. What is the primary goal of this multidisciplinary team?

Promote the client's highest possible level of function

P.R.I.C.E

Protection (from further injury) Rest Ice Compression & Elevation

A client with a traumatic amputation of the right lower leg is refusing to look at the leg. Which action by the nurse is most appropriate?

Provide feedback on the client's strengths and available resources.

R I C E

Rest Ice Compression Elevation Stabilization

Rx of carpal tunnel

Rest, splints, NSAIDs, steroid injection, surgery

Rx of Rotator Cuff tear

Rest, steroid injection, surgery

Treatment for carpal tunnel syndrome

Resting the hands when possible and splinting the hand and wrist. NSAIDs and periodic injections of a corticosteroid preparation may relieve the inflammation and discomfort. If conservative treatment fails, surgery to release the pressure of the ligament on the median nerve may be performed

Strain

Results from excessive stress, overuse, or over stretching. Small blood vessels in the muscle may rupture, and the muscle fibers sustain tiny tears

Which nursing diagnosis takes highest priority for a client with a compound fracture?

Risk for infection related to effects of trauma

Compartment syndrome

Structure constricted within confined space

Partial dislocation

Subluxation

Causes of fractures

Sudden direct force Bone weakness Bone healing process Complications

Sprains result from

Sudden, unusual movement or stretching around a joint, which is common with falls or other accidental injuries.

Fasciotomy

Surgical incision of fascia and separation of muscles.

Dislocation symptoms

Swelling, coolness, numbness, rom is limited, tingling, & pale or dusky color of the distal tissue

Phalen's sign

TEST FOR CARPAL TUNNEL SYNDROME, press the tops of hands together and hold, (30 sec) pain , numbness, tingling it is positive. (position is reverse of praying position)

Injuries to upper and lower extremities

Tendinitis Epicondylitis Ganglion Carpal tunnel

Common shoulder injuries

Tendinitis, tears/rupture of rotator cuff, bursitis

avulsion fracture

Tendon or ligament pulls bone away at site of attachment.

Inflammation of a tendon caused by overuse

Tendonitis

Epicondylitis

Tennis elbow; painful inflammation of elbow

Carpal Tunnel Syndrome

Term for a group of symptoms located in the carpal tunnel of the wrist, a narrow, inelastic canal through which the carpal tendons and median nerve pass.

palsy

temporary or permanent loss of the ability to control movement

An elite high school football player has been diagnosed with a shoulder dislocation. The client has been treated and is eager to resume his role on his team, stating that he is not experiencing pain. What should the nurse emphasize during health education?

The importance of adhering to the prescribed treatment and rehabilitation regimen

tendinitis (also referred to as tendonitis)

The inflammation of a tendon caused by overuse. Commonly occur as a result of repeated sports &/or work activities.

Third degree sprain

The ligament is torn ruptured completely with possible detachment of a fragment of bone (avulsion fracture) and hematoma formation which contributes to the severe pain, edema, and abnormal joint movement

For 10-40 minutes after a fracture muscles are flaccid

Then they spasm; this can interfere with vascular and lymphatic circulation

Dislocations

When articular surfaces of the joint are no longer in contact

avulsion fracture

When the ligament is torn or ruptured completely with possible DETACHMENT of a fragment of a bone.

Rx for Compartment syndrome

Will need fasciotomy- surgical incision of fascia and separation of muscles to relieve pressure on nerves and vessels

Sprain injuries include

Wrist, elbow, knee, and ankle

Dx dislocations

X-rays

Dx fractured hip

X-rays

Dx of fractures

X-rays, CAT scan, MRI

Dx of upper and lower extremity injuries

X-rays, EMG(carpal tunnel) Tinel's sign or Phalen's sign

fascia

a band or sheet of fibrous connective tissue that covers, supports, and separates muscle

fracture

a break or crack in a bone, may affect tissues or organs near the bone

compartment syndrome

a condition in which a structure such as a tendon or nerve is constricted in a confined space

electromyography

a diagnostic test that measures the electrical activity within muscle fibers in response to nerve stimulation (test for carpal tunnel syndrome)

shock

a failure of the cardiovascular system to keep an adequate supply of blood circulating to the vital organs of the body

Epiphyseal fracture

a fracture through the epiphysis

ganglion cyst

a harmless fluid-filled swelling that occurs most commonly on the outer surface of the wrist

Achilles tendon

a large tendon that runs from the heel to the calf (rupture occurs secondary to trauma)

fasciotomy

a surgical incision through the fascia to relieve tension or pressure

avascular necrosis

an area of bone tissue death caused by insufficient blood flow

ACL

anterior cruciate ligament

avascular necrosis

death of bone from an insufficient blood supply

Palsy

decreased sensation and movement

pulmonary embolism

blockage of the pulmonary artery by foreign matter or by a blood clot (thromboembolism may cause this after a fracture)

contusion

bruise, injury

ecchymosis

bruising

volkmann's contracture

contracture and damage to the muscles of the forearm (clawlike) because of injury to their blood supply (if compartment syndrome occurs in upper extremities can lead to this)

A client is brought to the emergency department after being struck with a baseball bat on the upper arm while diving for a pitched ball. Diagnostic tests reveal that the humerus is not broken but that the client has suffered another type of injury. What type of injury would the physician likely diagnose?

contusion

A school nurse is assessing a student who was kicked in the shin during a soccer game. The area of the injury has become swollen and discolored. The triage nurse should organize care for a

contusion.

Which is not one of the general nursing measures employed when caring for the client with a fracture?

cranial nerve assessment

A client has been diagnosed with a muscle strain. What does the physician mean with the term "strain"?

stretched or pulled beyond its capacity

tendinitis or tendonitis

inflammation of a tendon caused by overuse

Tendinitis

inflammation of tendons caused by excessive or unusual use of a joint

impacted fracture

A fracture in which bone fragment is driven into another bone fragment

Rupture Achilles' tendon, after surgery

Client wears a cats or brace for 6 to 8 weeks. Physical therapy is necessary for the client to regain mobility, strength, and full ROM

Clients with carpal tunnel syndrome report ?

Clients describe pain or burning in one or both hands, which may radiate to the forearm and shoulder in severe cases. The pain tends to be more prominent at night and early in the morning. Shaking the hands may reduce the pain by promoting movement of edematous fluid from the carpal canal. Sensation may be lost or reduced in the thumb, index, and middle, and a portion of the ring finger.

What do clients report with ganglion cysts

Clients experience pain and tenderness in the affected area

What clients do clients report with Epicondylitis

Clients report pain radiating down the dorsal surface of the forearm and a weak gasp

An x-ray demonstrates a fracture in which a bone has splintered into several pieces. Which type of fracture is this?

Comminuted

In a client with a dislocation, the nurse should initially perform neurovascular assessments a minimum of every 15 minutes until stable. Which complication does the assessments help the nurse to monitor in the client?

Compartment syndrome

A nurse is preparing to discharge a client from the emergency department after receiving treatment for an ankle sprain. While providing discharge education, the nurse should encourage what action?

Keep an elastic compression bandage on the ankle.

Rotator cuff tear

Muscles surrounding the shoulder joint a tear in one or more of the tendons that attach to the upper end of the humerus (those tendons form a 'cuff' around the proximal end of the humerus)

Medical and surgical management of ligament and meniscal injuries

NSAIDS ICE Immobilization Limited weight bearing; progressive activity Surgery

Initial treatment of a rotator cuff tear

NSAIDS.. corticosteroids injections into the shoulder joint plus exercises

Medical and surgical management of rotator cuff tear

NSAIDS; rest; immobilization; corticosteroid injections; progressive exercises and stretching; surgery

Decreased sensation and movement

Palsy

Subluxation

Partial dislocation

Which nursing intervention is essential in caring for a client with compartment syndrome?

Removing all external sources of pressure, such as clothing and jewelry

Main symptoms of hip fx

Shortening External rotation

Medical and surgical management of fractured hip

Total hip arthroplasty; hemiarthroplasty

Volkmann's contracture

A claw like deformity of the hand resulting from obstructed arterial blood flow to the forearm and hand. The client is unable to extend his or her fingers and complains of unrelenting pain, particularly if attempting to stretch the hand.

Volkmann's contracture

A claw-like deformity of the hand resulting from obstructed arterial blood flow to the forearm & hand.

Volkmann's contracture

A claw-like deformity of the hand resulting from obstructed arterial blood flow to the forearm and hands.

Carpal tunnel syndrome

A condition caused by compression of the median nerve in the carpal tunnel and characterized especially by weakness, pain, and disturbances of sensation in the hand and fingers

compartment syndrome

A condition in which a structure such as a tendon or nerve is constricted in a confined space.

ganglion cyst

A cystic mass that develops near the tendon sheaths and joints of the wrist.

palsy

A decreased sensation & movement

compression fracture

A fracture in which bone has been compressed (seen in vertebrae fractures)

Comminuted fracture

A fracture in which bone has splintered into several fragments

Transverse fracture

A fracture that is straight across the bone

pathologic fracture

A fracture that occurs through an area of diseased bone (bone cyst, Paget's disease, bony metastasis, tumor); can occur without trauma or a fall

Spiral fracture

A fracture twisting around the shaft of the bone

Simple fracture

A fractures that remains contained; DOES NOT BREAK THE SKIN

crepitus

A grating or grinding sensation caused by fractured bone ends or joints rubbing together; also air bubbles under the skin that produce a crackling sound or crinkly feeling.

callus

A growth of new bone tissue in and around a fractured area, ultimately replaced by mature bone.

avulsion fracture

A pulling away of a fragment of bone by a ligament or tendon and it's attachment

contusion

A soft tissue injury resulting from a blow or blunt trauma.

fat embolism

A syndrome in which fat migrates into the blood stream and combines with pletlets to form emboli; the greatest risk is 36 hours after a fracture; more common in clients with multiple fractures, fractures of the long bones, fractures of the pelvis. Initial symptom is confusion due to hypoxemia; assess for respiratory distress, restlessness, irritability, fever and petechiae; notify physician stat, draw ABGs, administer oxygen, assist with intubation

carpal tunnel syndrome

A term for a group of symptoms located in the carpal tunnel of the wrist, a narrow, inelastic canal through which the carpal tendons and median nerve pass.

strain

An injury to a muscle , when it is stretched or pulled beyond its capacity.

Treatment of tendinitis includes:

Application of cold and heat, exercise, steroidal anti inflammatory medications, local injections of corticosteroids, analgesics, NSAIDS, and rest

strain

to draw or stretch tight beyond the normal limits

Ganglion Cyst

Cystic mass that develops near tendon sheaths and joints of the wrist.

Stages of bone healing

Immediately after a bone fracture, blood seeps into the area and a hematoma (blood clot) forms After 1 week, osteoblasts form as the clot retracts. After about 3 weeks, a procallus forms and stabilizes the fracture. A callus with bone cells forms in 6 to 12 weeks. In 3 to 4 months, osteoblasts begin to remodel the fracture site If the fractured bone has been accurately aligned during healing, remodeling will be complete in about 12 months

After surgery of meniscecromy

Immobilize, NSAIDS, and recommend the application of cold therapy. Physical rehabilitation includes exercises, gradual weight bearing, and the use of any ambulatory devices. Recovery 3 to 12 months

rotator cuff

Made up of four muscles & their tendons that connect the proximal humerus, clavicle, & scapula, which in turn connect with the sternum and ribs.

Rx of dislocations

Manipulate back into place, possibly surgery

Medical and Surgical management of dislocations

Manipulation Immobilization of joint Surgery

First degree strain

Mild stretching of muscle or tendon, causing some edema and muscle spasm, but no real loss of function; pain occurs with full range of motion (ROM)

First degree strain

Mold stretching of muscle or tendon, causing some edema and muscle spasm, but no real loss of function

Assessment findings of ligament and meniscus injuries

Pain; instability; ambulatory difficulty

Subluxation

Partial dislocation.

Second degree strain

Partial tearing of muscle or tendon, leading to inability to bear weight and causing edema, muscle tenderness, muscle spasm, and Ecchymosis (bruising)

Second degree strain

Partial tearing of muscle or tendon, leading to inability to bear weight, limited motion and there is edema, muscle tenderness, muscle spasm, and ecchymosis.

Tinel's sign

Percuss median nerve to elicit pain

Third degree strain

Severe muscle and or tendon tearing causing serve pain, muscle spasm, Ecchymosis, edema, and loss of function

Third degree strain

Severe muscle and/or tendon tearing, causing severe pain, muscle spasm, ecchymosis, edema, and loss of function.

Complications of fractures

Shock Fat embolism Pulmonary embolism Compartment syndrome Delayed bone healing Infection Avascular necrosis

Complications

Shock Embolism Pulmonary embolism INfectoin Delayed bonehealing

Complications of fractures

Shock, fat embolism, pulmonary embolism, compartment syndrome, delayed bone healing, infection, avascular necrosis

Rx of epicondylitis

Splint, heat/cold, NSAIDs, steroid injection, analgesics, rest, surgery

Treatment for epicondylitis

Splinting to test and support the joint structures Corticosteroids may be injected locally

Injuries to the ligaments surrounding a joint

Sprains

Injury to muscle when it is stretched beyond its capacity

Strain

Traumatic injuries

Strains, Contusions, & Sprains

Tests for carpal tunnel syndrome

Tinel's sign - tingling, numbness, and pain Phalen's sign - have the client flex the wrist for 30 seconds to determine if pain or numbness occurs (positive sign ). The examiner percusses the median nerve, located on the inner aspect of the wrist to elicit this response

Fx of the femur usually are treated with some form of _____ to prevent deformities and soft tissue injury

Traction

A client is brought to the emergency department by ambulance after stepping in a hole and falling. While assessing him the nurse notes that his right leg is shorter than his left leg; his right hip is noticeably deformed and he is in acute pain. Imaging does not reveal a fracture. What is the most plausible explanation for this client's signs and symptoms?

Traumatic hip dislocation

Clawlike deformity of the hand resulting from obstructed arterial blood flow to the forearm and hand

Volkmann's contracture

ergonomics

modify work/sport environment an applied science used to promote the safety and well-being of a person by adapting the environment and using techniques to prevent injuries

subluxation

partial dislocation of a joint

RICE

rest, ice, compression, elevation

The type of fracture described as having one side of the bone broken and the other side bent would be:

greenstick.

Compartment syndrome

involves the compression of nerves and blood vessels due to swelling within the enclosed space created by the fascia that separates groups of muscles

menisci

fibrocartilaginous pads in the knee


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