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Musculoskeletal 3

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juniperk's version from 2018-03-02 21:28

Section

Question Answer
With fractures of the femoral neck, what happens to the leg?the leg is shortened, adducted, and externally rotated.
Hip fracture is confirmed how?Xr or MRI
Intracapsular vs extracapsular fractureImpacted intracapsular femoral neck fractures cause moderate discomfort (even with movement), may allow the patient to bear weight, and may not demonstrate obvious shortening or rotational changes. With extracapsular femoral fractures of the trochanteric or subtrochanteric regions, the extremity is significantly shortened, externally rotated to a greater degree than intracapsular fractures, exhibits muscle spasm that resists positioning of the extremity in a neutral position, and has an associated area of ecchymosis.
What are the nursing mgmt post hip surgery?During the first 24 to 48 hours, relief of pain and prevention of complications are important, and continuous neurovascular assessment is essential. The nurse encourages deep breathing and dorsiflexion and plantar flexion exercises every 1 to 2 hours. Thigh-high anti-embolism stockings or pneumatic compression devices are used, and anticoagulants. The nurse administers prescribed analgesic medications and monitors the patient’s hydration, nutritional status, and urine output
Repositioning post hip surgery-turn the patient is to turn to the uninjured side. The standard method involves placing a pillow between the patient’s legs to keep the affected leg in an abducted position.
2 Signs of post op hip infection-Pt complains of constant hip pain and elevated ESR.
If a pt with osteoporosis had a hip fracture, what is the best way to predict another fracture?dual-energy x-ray absorptiometry (DXA or DEXA) scan testing
Femoral shaft fx- What does the pt usually develop and how can you monitor it?the patient develops shock, because the loss of 1,000 mL of blood into the tissues is common with these fractures. The diameter of the thigh should be closely monitored because expansion may indicate continued bleeding
How can you dx strains? What is 1st 2nd and 3rd degree strain?MRI- XR will not show injuries to soft tissue or muscles, tendons, or ligaments. 1- mild stretching of muscle or tendon. 2- partial tearing of the muscle or tendon 3- severe muscle or tendon stretching with rupture and tearing of the involved tissue
What is a dislocation? SubluxationDislocation- bones that form the joint are not aligned. Subluxation- partial dislocation
What is the treatment of joint dislocations? meds? How often are neurovascular checks?The affected joint needs to be immobilized at the scene and during transport to the hospital. The dislocation is promptly reduced, and displaced parts are placed back in proper anatomic position to preserve joint function. Analgesia, muscle relaxants, and possibly anesthesia are used to facilitate closed reduction. The joint is immobilized by splints, casts, or traction and is maintained in a stable position. Neurovascular status is assessed at a minimum of every 15 minutes until stable.
Injury to what nerve causes foot drop?Peroneal nerve
After an external fiator is applied, the extremity is raised to what level compared to the heart?to the level of the heart to prevent swelling.
What are the goals of traction?decreasing muscle spasms and pain, realignment of bone fractures, and correcting or preventing deformities.
What is a straight/ running traction? Countertraction?Straight or running traction applies the pulling force in a straight line with the body part resting on the bed. The countertraction is provided by the client’s body, and movement of the patient’s body can alter the traction provided.
What is balance suspension traction? Countertraction?supports the affected extremity off the bed and allows for some patient movement without disruption of the line of pull. Countertraction is produced by devices such as slings or splints
Which crutch walking is Non-weight bearing? Touchdown weight bearing? Partial weight bearing? Full weight bearing?Non-weight- swing through gait, touchdown- 3 point, Partial- 4 point and swing to gait, Full- 2 point gait
What kind of padding is in prosthetics?None for pressure reasons.
What is used to treat amputation pain and why?Opioid analgesics may be effective in relieving pain. In addition, beta-blockers may relieve dull, burning discomfort; antiseizure medications control stabbing and cramping pain; and tricyclic antidepressants may not only alleviate phantom pain but may also be prescribed to improve mood and coping ability. When medications are not effective in relieving pain, pulsed radiofrequency therapy (PRF) may be tried.
A pt with a lower limb amputation should avoid which position? 3Abduction, external rotation, and flexion of the lower limb are avoided. Do not put on pillow- may cause flexion contracture of the hip. Encourage side-side or prone.
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