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NURS3230 Week 14 Nursing Management of Musculoskeletal Disorders

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John Marsh
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University of North Carolina at Charlotte Illness & Disease Management (NURS 3230) Week 14 Nursing Management of Musculoskeletal Disorders
musculoskeletal disorder management

Nursing Management of Musculoskeletal Disorders
Diagnostic Procedures
– Arthroscopy
– Nuclear scans
o Gallium/thallium scans
– Dual x-ray absorptiometry scans (DXA)
– Electromyography (EMG) and nerve conduction studies
The Patient with a Cast
– Rigid, external mobilizing device
– Various types
o Short or long arm
o Short or long leg
o Walking
o Body
o Shoulder or hip spica
Cast Specifics
– Synthetic fiberglass
– Must be minimal swelling
– Window can be placed for wound inspection
– Tubular cotton under cast
Nursing Interventions for the Patient with a Cast
– Explaining the treatment regimen
– Relieving pain
– Improving mobility
– Maintaining adequate neuromuscular function
– Elevating the extremity
– Monitoring for potential problems
o Compartment syndrome
o Pressure ulcers
Care of Extremity Following Cast Removal
– Skin care
– Gradual resumption of activities
– Management of swelling
The Patient in Traction
– Principle of traction
o Must be continuous
o Ensure good body alignment
o Ropes must be unobstructed
o Weights must hang freely

Traction
– Classification
o Straight or running: countertraction provided by client’s body
o Balanced suspension: countertraction produced by roped and weights
– Types
o Manual
o Skin (Buck’s)
o Skeletal
o Halo
Skin Traction – Buck’s Extension Traction
– Applied to the lower leg
– Potential complications
o Skin breakdown
o Nerve pressure
o Circulatory impairment
– Nursing interventions
o Monitoring traction device
o Monitoring for complications
Skeletal Traction
– Applied directly to the bone
– Surgical procedure
– Nursing interventions
o Maintain effective traction/positioning
o Prevent skin breakdown
o Monitor neurovascular status
o Providing pin care
o Promoting exercise
The Patient with an External Fixator
– Used for complicated fractures
– Nursing interventions
o Proper positioning
o Monitoring neurovascular status
 Compartment syndrome
o Pin care to avoid infection
o Avoid post-op complications
 Incentive spirometer
 Active ROM’s while in bed
Home Care Checklist – External Fixator Patient
– Pin site care
– S/s infection or complications
– Reporting increase in pain

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NURS3230 Week 14 Nursing Management of Musculoskeletal Disorders

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