musculoskeletal objectives

what does an x-ray do

visualize bone

x-ray precautions

ensure pt isnt pregnant

what does a dexascan do

measures bone mineral density

what is a precaution with a dexascan

avoid calcium supplements the day of

what is a precaution for a CT scan

ensure pt has no shellfish allergy

what are precautions for an MRI

ensure there is no metal on patient, claustrophobia management

what does a bone scan do

find malignancies

what are precautions for a bone scan

give radioisotope, empty bladder, remain supine

what does an arthroscopy show

abnormalities of the meniscus, joint, and ligaments

what does a positive ESR indicate

inflammation

what does a positive rheumatoid factor indicate

connective tissue disease

what dies a decrease of calcium and phosphorus indicate

osteomalacia (bone weakness)

what does increased uric acid indicate

gout

what does a positive C-reactive protein indicate

inflammatory disease, infection

what does an elevated CPK indicate

muscular dystrophy, trauma

what is traction

applies pulling force on extremity to attain realignment

what is a NANDA for traction

risk for infection from the pins

what are nursing interventions for traction

maintain bed in high position and ensure patient is pulled up in bed so the weight is not sitting on the floor

what is compartment syndrome

too much swelling and pressure against a pressure dressing or cast

what is the tell tale sign of compartment syndrome

out of proportion pain

what are the 6 P's of compartment syndrome

paresthesia (numbness and tingling)
pain unrelieved by analgesics
pallor
pressure increase
paralysis
pulselessness

what is the treatment for compartment syndrome

remove cast, needle to remove swelling, fasciotomy

what is osteomyelitis

infection of bone, marrow, and soft tissue

what is the cause of osteomyelitis

staph aureus

what are the signs and symptoms of osteomyelitis

bone pain, fever, N/V, swelling, warmth, sepsis

what are the nursing interventions for osteomyelitis

get cultures and then start antibiotics

what is a closed reduction

non-surgical realignment of the joint

what is an open reduction (ORIF)

surgical fixation with screws, rods, plates, and pins

what is acute back pain associated with

activity

what is the treatment for acute back pain

analgesics, muscle relaxants, rest, heat/cold

how long does back pain have to last for it to be considered chronic

3 months

what is the treatment for chronic back pain

pain relief, antidepressants, surgery

what are the nursing interventions for a post-op patient after surgery for intervertebral disk damage

maintain spine alignment (use log roll), opioids, bed rest, assess for CSF leaks