Musculoskeletal Disorders

what characterizes osteoporosis

low bone mass

what are sx of osteoporosis?

loss of height, posture change, back pain, fractures

what sites are most susceptible to fractures with osteoporosis

hip, spine, wrist

what is the gold standard for identifying osteoporosis

dual energy x-ray absorptiometry (DXA)

what is the T score for osteoporosis

-2.5 or lower

what is the t score of osteopenia

-1 to -2.5

Risk factors of osteoporosis

gender, age, sedentary lifestyle, smoking

what are oral medications used for osteoporosis

alendronate

what are IV meds for osteoporosis

Zoledronic acid

Where is osteoarthritis most common?

hands, knees, hips, spine

is osteoarthritis systemic or non-systemic

non-systemic

what are risk factors of osteoarthritis?

age, genes, obesity, trauma, overuse

Sx of osteoarthritis

localized chronic joint pain, worsening pain with activity, contractures, loss of function

medical interventions of osteoarthritis

• Acetaminophen

• NSAIDS

what are non-pharm interventions for osteoarthritis

weight reduction, aerobic exercise, heat & cold therapy, balance rest and activity

surgical management of osteoarthritis

total joint replacement

what is an open reduction of a fracture

surgical realignment of bone

what is an internal fixation of a fracture

mix of screws, plates, pins, ect to hold bone in alignment

what is an external fixation

external frame with pins through bone enables increased movement

what are interventions for fractures

CMS checks, 6Ps

what are the 6Ps?

pain, pulselessness, pallor, paresthesia, pressure, paralysis

what is the most common complication from fractures

DVT

what are interventions for a DVT

early ambulation, turning in bed, compression devices

when does a PE usually occur

3 days post injury

what is the most important sign of fat embolism

altered LOC

what are sx of a fat embolism

petechiae over upper body, altered LOC, chest pain

what causes fat embolisms

large bone fractures

what is compartment syndrome

increased pressure causes decreased blood flow

what are sx of compartment syndrome

pain, pallor, numbness

what is the treatment of rhabdomyolysis

large amounts of IV fluids and electrolytes

what are sx of hip fractures

cannot move leg, shortened & externally rotated leg

what is an intracapsular fracture

bone broken inside joint

what is an extracapsular fracture

located in the intertrochanteric and trochanteric areas

what are intertrochanteric fractures

comminuted usually more severe than intracapsular breaks and often to fixate

why is bucks traction used

keep the leg straight and hip immobile to provide immobilization, decrease muscle spasms, and prevent contracture

what is a total hip arthroplasty

replacement of both the acetabulum and head of the femur

what is a hemiarthroplasty

replacement of the head of the femur

what are post op nursing interventions with a total hip

keep operative leg abducted and externally rotated, do not elevate HOB more than 45 degrees

when should you start ambulating post total hip

immediately

what teachings you should give a pt after a total hip

• no dangling

• avoid positions with greater than a 90 degree flexion

• use a toilet seat elevator

• no bending over

what are some home care teachings for pts after a total hip

• do not adduct legs

• do not sit for long periods of time

• weight bearing as tolerated for 2-3 months

• check hone for fall risks

what are complications of a total hip?

DVT, PE, dislocation, infection

what are predisposing factors of low back pain

age, osteoarthritis, poor body mechanics, heavy lifting, prolonged sitting, trauma, infection, obesity

sx of lumbosacral back pain

muscle spasms, sciatica, paresthesia, acute or persistent pain

how to diagnose lumbosacral back pain

MRI/CT