Galen College of Nursing - Fundamentals of Nursing

Galen College of Nursing - Fundamentals of Nursing Notes

Overview of the Musculoskeletal System

  • Bones: Form the framework of the body.

  • Joints: Unions of two or more bones allowing for movement.

  • Skeletal Muscle: Striated muscles encased by connective tissue.

  • Tendons: Fibrous tissues connecting muscles to bones.

  • Ligaments: Connect bones or cartilage.

  • Cartilage: Fibrous connective tissue that cushions joints.

Changes Occurring with Aging

  • Bone Changes:

    • Loss of bone mass and density.

  • Muscle Changes:

    • Decrease in muscle cells and elasticity of muscle fibers.

  • Joint Mobility:

    • Decrease in range of motion in joints.

Principles of Body Movement for Nurses

  • Common injury in healthcare workers: Lower back strain.

  • Proper alignment and body mechanics are crucial to prevent injury.

Correct Body Alignment for Standing

  • Neck straight, head up, eyes straight ahead.

  • Back straight, arms relaxed at sides.

  • Chest out, abdominal muscles tucked in.

  • Knees slightly flexed and feet straight, toes forward.

Correct Body Alignment for Sitting

  • Ensure back support and feet flat on the floor.

  • Avoid slouching, maintain proper hip and knee positions.

Moving and Handling Patients

  • General Principles:

    • Obtain assistance whenever possible.

    • Use leg muscles for lifting to prevent back strain.

    • Keep loads close to the center of gravity.

    • Utilize smooth, coordinated movements.

    • Employ pulling and pivoting techniques.

Hazards of Improper Alignment

  • Interference with circulation leading to:

    • Pressure injuries.

    • Muscle cramps and potential contractures.

    • Muscle atrophy, and fluid collection in lungs.

Pressure Injuries

  • Also known as pressure ulcers, decubitus ulcers, and bedsores.

  • Caused by sustained pressure on skin leading to tissue necrosis.

  • Often found between bony prominences and external surfaces.

Objectives of Positioning

  1. Provides comfort.

  2. Relieves pressure on bony prominences.

  3. Prevents contractures and deformities.

  4. Improves circulation.

Common Patient Positions and Variations

  • Supine: Lying on back.

  • Fowler's Position: Semi-Fowler and Full Fowler positions for patient comfort and rehabilitation.

  • Side-Lying/Lateral Position: Patient lying on their side.

  • Sims' Position: Side-lying position used commonly for enemas and certain examinations.

  • Prone Position: Lying face down.

Common Positioning Devices

  • Trapeze Bars: Aid in patient mobility.

  • Foot Drop: Condition preventing proper foot positioning.

  • Trochanter Rolls: Prevent external rotation of legs.

  • Hand Rolls: Maintain hand positioning and prevent contractures.

Moving the Patient in Bed

  • Using a Lift Sheet:

    1. Requires at least two caregivers.

    2. Stand on opposite sides, use the sheet to lift, avoid dragging the patient.

Logrolling

  • Turning the patient as a single unit while maintaining body alignment.

  • Require three caregivers for patients who cannot turn themselves.

  • Use a pillow under the head during the process.

Transfer Techniques

  • Using Transfer Devices:

    • Slide boards, roller boards, and mechanical lifts.

    • Transfer and gait belts can aid in patient mobility.

Transferring a Patient to a Wheelchair

  1. Assess the patient’s size and ability to assist.

  2. Explain the procedure to the patient.

  3. Place the wheelchair parallel to the bed and lock it.

  4. Assist from the patient’s stronger side for safety.

In-Class Activity Scenarios

  • Various positions discussed for different patient scenarios, such as spinal cord injury management and aiding in procedures like cardiac catheterization and enemas.

  • Importance of alleviating pressure from bony prominences and providing positioning for comfort and assistance.