Definition: Ability to move or be moved freely and easily, essential for daily activities.
Factors Affecting Mobility: Physical conditions such as musculoskeletal injuries, degenerative diseases, aging.
Importance in Nursing: Nurses assess, maintain, and improve patients' mobility, addressing underlying health concerns and quality of life issues.
Differentiate between strains, sprains, & dislocations.
Identify clinical manifestations, treatment modalities, complications, and rehabilitation needs of common fractures.
Describe nursing management and health education for patients with casts, splints, braces, or in traction.
Utilize the nursing process for adult patients with hip fractures or knee injuries.
Recognize sports and occupation-related musculoskeletal disorders, their signs/symptoms, and treatments.
Describe site actions, indications, pharmacokinetics, contraindications, adverse reactions, and drug-drug interactions for:
Anti-inflammatory agents
Bisphosphonates
Muscle Relaxants
Opiates.
Outline nursing considerations and patient teaching needs for each class mentioned.
Management of Care
Safety and Infection Control
Health Promotion and Maintenance
Psychosocial Integrity
Basic Care and Comfort
Pharmacology
Reduction of Risk
Physiological Adaptation
Number of Bones: Adult human skeleton consists of 206 bones for structural support, protection, and mobility.
Joints: Connections between bones allowing a wide range of motion.
Growth & Development: Bone growth primarily occurs during childhood and adolescence, peaking in early adulthood.
Bone Remodeling: Continuous process of bone resorption and formation, ensuring strength and adaptation to stress.
Framework: Supports the body, maintaining its weight-bearing and upright structure.
Support: Maintains the shape/form of the body by supporting surrounding tissues like muscles and organs.
Movement: Assists through muscle attachment and joint formation, enabling motion.
Protection: Shields vital organs like the brain, heart, and lungs from injury.
Bone Remodeling: Process of constant remodeling and adaptation throughout life.
Peak Bone Mass: Achieved during puberty; critical for future bone health.
Bone Loss: Increases with age, heightening fracture risk. Importance of calcium, exercise, and vitamin D for health.
Increased Bone Resorption: Leads to osteoporosis and higher fracture risk.
Decreased Bone Density: Loss of muscle mass/strength affects mobility and balance.
Joint Stiffness and Pain: Due to cartilage degeneration and inflammation.
Reduced Flexibility: Impacting overall movement restrictions.
Fractures (Hip): Common in elderly post-fall; types include comminuted, displaced, and non-displaced.
Joint Replacement (Hip and Knee): Surgical replacements due to arthritis.
Sprains, Strains, and Dislocations: Definitions and differences in injuries to ligaments and muscles.
Fractures: Pain, swelling, bruising, deformity, limited motion, inability to bear weight.
Sprains: Pain, swelling, bruising, joint movement difficulty.
Strains: Pain, spasms, swelling, weakness in muscles or tendons.
Dislocations: Deformity, pain, loss of function.
Trauma from falls, accidents, sports injuries.
Osteoporosis or weakened bone structure.
Overuse/repetitive stress injuries (stress fractures).
Diseases impacting bone integrity (e.g., cancer).
Simple (Closed): Bone breaks without puncturing skin.
Compound (Open): Bone breaks and pierces skin; higher risk of infection.
Comminuted: Bone shatters into multiple pieces.
Displaced: Bone fragments misaligned.
Greenstick: Partial fracture, typically in children.
Transverse: Straight break across bone.
Spiral: Twisting break from rotational forces.
Compound (Open): High infection risk; requires immediate surgical intervention.
Complex (Comminuted): Shattered bone, significant surrounding damage; may require advanced surgery.
Acute pain, loss of function, deformity, shortening of the extremity, crepitus, swelling, and discoloration. Typically diagnosed through symptoms and radiography.
Immobilization: Essential to prevent further injury; immobilize joints above and below the fracture.
Assess Neurovascular Status: Important before and after splinting.
Open Fracture: Cover with sterile dressing.
Do Not Attempt to Reduce: Avoid manipulation of the fracture on site.
Fracture Reduction: Align fractured fragments via manipulation or traction.
Closed Reduction: Internal fixation holds fragments (pins, screws).
Open Reduction: External casting/splinting.
Early Complications: Shock, fat embolism, compartment syndrome, VTE.
Delayed Complications: Delayed union, malunion, nonunion, avascular necrosis, CRPS, heterotopic ossification.
Hemiarthroplasty, meniscectomy, amputation, fasciotomy, open reduction internal fixation (ORIF), joint replacements.
Active infections, rapidly progressing inflammation, osteoporosis, severe medical conditions (heart/lung issues).
Initial Treatment: Immobilization, traction, reduction.
Surgical Interventions: ORIF, hip replacement.
Leg Abduction: Maintained to prevent dislocation.
Pain Management: Key to patient comfort.
Early Mobilization: Encouraged to prevent complications.
Post-Op Education: Focus on precautions and rehabilitation goals.
Focus on positioning, avoid excessive movements, use assistive devices like abduction pillows.
Knee Replacement: Commonly for arthritis/trauma; involves prosthetic knee implant.
Shoulder Replacement: Involves prosthetic implant for various shoulder conditions.
Weight Bearing: Start with partial; avoid bending/twisting.
Pain Management: Medications and wound care essential for recovery.
Preoperative Care: Assessment, education, and prep.
Postoperative Care: Focus on pain management, rehabilitation, and mobility exercises.
Monitor for infection, DVT, dislocation risks; assess mobility, pain levels, ADLs.
Sprains: Injury to ligaments.
Strains: Injury to muscles/tendons.
Dislocations: Bone displacement from joint position.
Monitor for pain/inflammation, provide RICE education, assist with immobilization, and follow-up care.
IMAGERY: MRI, arthrography, electromyography, biopsy, and arthrocentesis.
Pain management, neurovascular assessment, exercise promotion, nutrition, hydration, and improving mobility.
Safe environment, weight management, fall risk assessment, proper warm-up before activities.
Fractures: Educate on cast care, signs of complications, safe mobility techniques.
Joint Replacements: Post-operative care, signs of complications, strength exercises.
Sprains/Strains/Dislocations: R.I.C.E. method for recovery.
Signs to report: persistent pain, changes in sensation, infection signs.
Follow-up care necessary for cast removal and after care.
Pain Relief Medications: Opioids, NSAIDs, acetaminophen.
Antibiotics: Post-surgery for joint replacement patients.
Muscle Relaxants: For strains/sprains.
PTs assess functionality; OTs enhance functional independence; Nurses support rehabilitation.