MSK med-surg ch 62 PN 2, BRTC
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