Musculoskeletal System Disorders

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This slide was presented to us in class by Ms. Dinah Hernandez.

Text of Musculoskeletal System Disorders

  • 1.Dinah Hernandez MSN, PHN, RN

2.

  • Common Medical Treatments for MS
    • Application of hot and cold
    • Hot, cold compress or paraffin
    • Physical Therapy Tx (PROM, AROM)
    • External Immobilization
      • Braces, corsets, splints, casts, traction
    • Surgical Treatment
      • Joint- replacement surgery/ arthroplasty
      • Amputation

3.

  • Data Collection
    • Skeletal deformity
      • posture, coordination, body build
      • assymetry, deformity
    • Muscle mass, swelling, deformity, tenderness
    • Assess musculoskeletal function
      • muscle strength, balance, gait
    • Assessment of immobilization device
      • pressure, infection, hemorrhage
      • Complications: neurovascular compromise

4.

  • Complications of pressure
    • Wound infection
    • Infection to the bone
    • Hemorrhage
      • Diminished color
      • Tachycardia
      • Hypotension
      • Rapid respiration
      • Anxiety/panic/confusion
      • Diaphoresis
      • Oliguria

5.

  • Planning and implementation
    • Preventing disorders of immobility
      • Skin breakdown
      • Contractures
      • Constipation
      • Thromboembolism
    • Providing comfortable positioning
    • Providing skin care
    • Adequate nutrition
    • Exercise
  • Evaluation

6.

  • Musculoskeletal Disorders
    • Amputation the absence or removal of all part or limb/ body organ w/c can be congenital or as a result from an injury/ surgery
    • Reasons for surgical treatment:
      • Malignancy
      • Trauma
      • Gangrene
      • Amputation of any extremety is performed at the most distal part to preserve joint and maximize limb length; prosthesis fitting is easier.
      • Amputation is classified
      • According to the affected limb
      • According to the level of amputation

7.

  • Levels of Amputation
    • Below elbow amputation
    • Above elbow amputation
    • Below knee amputation
    • Above knee amputation
    • Phantom limb pain is an after effect of amputation. It refers to the sensation of pressure, itching that occurs to the areas of amputation, and the feeling as if the absent body part is still present. The sensation is common and results from damage to the nerves in the stump

8.

  • Prosthesis artificial device that replaces part or all necessary extremity.
    • Clients are fitted w/ prosthesis asap after surgery
    • Nursing consideration:
      • Wound dressing twice daily
      • Preventing complication
      • Client teaching
      • Provide emotional support
      • Assisting in exercises
      • Replantation is the re-attachment of a completely severed body part back to the body.

9.

  • Chronic back pain
    • Contributing factors
      • Combination of prolonged muscular and ligament strain, pressure on the lumbosacral vertebrae, aging process
    • Causes:
      • Abnormal spinal column curvatures
      • Poor posture
      • Congenital disease
      • Malignancy
      • Compression fracture
      • Osteoarthritis
      • Rickets
      • Rheumatoid arthritis
      • aging

10.

  • Intervertebral Disk (IVD)results when a small pad or disk or cartilage ( nuclues pulposus) between two vertebrae presses against the spinal nerve that radiate out from the spinal cord .
    • Also known as herniated nucleus pulposus (HNP)
    • Also know as sciatica
    • Diagnostic Tests:
    • MRI
    • CT Scan combine with myelography/
    • Diskography

11.

  • Medical Treatment of IVD
    • Physical therapy
    • Antispasmodic/analgesic
    • Ultrasound/intermittent traction. TENS therapy
    • Surgical Treatment
  • Surgical Treatment
    • Lumbosacral decompression
    • Laminectomy
    • Diskectomy
    • Microdiskectomy
    • Spinal fusion
    • Interbody fusion

12.

  • Nursing consideration
    • Provide postoperative care
    • Assist with pain management
    • Wound care
    • Watch for s/s of bleeding, drainage
    • Evaluate pt for neurologic function
    • Follow physicians orders
    • Lumbar Decompression
    • Observe for clients sensation/mobility
    • Observe for complications of spinal nerve damage/cord
    • Immediately report complaints of tingling, numbness or difficulty moving legs
    • Check for edema due to trauma
    • Encourage pt to move to prevent respiratory complication

13.

  • Postlumbar decompression concerns
    • Nerve damage
    • Edema
    • Changes in level of consciousness
    • Muscle spasm
    • Thrombophlebitis
    • Additional injury
    • Infection
  • Cervical decompression
    • Difficulty/changes in sensation in arms
    • Difficulty in moving arms
    • Difficulty in breathing

14.

  • Nursing consideration
    • Log roll
    • Pain medicine (PCA)
    • Use of thoracic-lumbar-sacral orthosis (TLSO)
    • Use of fracture bed; advice pt not to reach/stretch for articles
    • Application of antiembolism stocking & pneumatic compression devices
    • Use of cervical collar ( cervical diskectomy)
    • Teach pt to keep his neck in neutral posn & aligned posn
    • Teach pt for cervical collar care
    • Assist pt with sitting by supporting pts neck & shoulder

15.

  • Temporomandibular Joint (TMJ) painful, aching disorder involving facial