NSG 326 Adult Health IMusculoskeletal InjuriesOlder Adult & Musculoskeletal InjuryAcute Soft Tissue InjuriesAnkle SpainAcute Soft Tissue InjurySprains & StrainsAcute Treatment for Sprains & StrainsSlide 9Dislocation & SubluxationClinical Manifestations of Dislocation/SubluxationDislocation of HipRepetitive Strain Injury [RSI]Slide 14Slide 15Carpal Tunnel SyndromeRotator Cuff InjuryMeniscus InjuryBursitisHousemaid’s or Clergyman’s KneeMuscle SpasmsFracturesTypes of FracturesSlide 24Slide 25Risk FactorsPreventionClinical Manifestations of FractureDiagnosticsCollaborative CareExternal Fixation of FractureSlide 32Fracture HealingNursing Assessment of Patient with a FractureInterventions in Care of Patient with FractureCastsNursing Management of Patient with a Casted ExtremityInstructions for a Client with a CastInstructions for Client Following Cast RemovalQuestionAnswerDrug Therapy for a Client with a FracturePotential Complications with a FractureAcute Compartment SyndromeSlide 45Rib FractureRib Fracture: Nursing Management/Client EducationSlide 48Hip FractureSlide 50Types of Hip FracturesSlide 52Slide 53Slide 54Signs & Symptoms of Hip FracturesSlide 56Nursing ManagementNursing Management & Teaching Pre-OperativelyNursing Management & Teaching Post-OperativelyComplications of Hip Fracture RepairDischarge of ClientGerontological Considerations with Hip FractureSlide 63Slide 64Slide 65Slide 66AmputationDaily Residual Limb InspectionResidual Limb CarePrevent Flexion ContracturesAmputation: Gerontologic ConsiderationsLower Limb ProsthesisSlide 73Prepared by Dr. K. A. EnnenNSG 326 Adult Health IProblems of Movement & CoordinationMusculoskeletal InjuriesCommon cause is traumaAccidental injuries leading cause of death in children & young adultsOccupational & environmental hazardsHome environmentNurses role is in education of publicOlder Adult & Musculoskeletal InjuryPrevention of falls – environmentTreat pain of osteoarthritisUse ambulation aids with educationPrevent overweight/obesity to decrease stress on joints & musclesRegular/frequent exerciseADLsHobbiesWeight-bearing Shoes – consider safety & supportAcute Soft Tissue InjuriesSprains Tendons/ligaments surrounding jointsCaused by wrenching or twisting motionStrainExcessive stretching of a muscle/tendonEtiologyFalls, direct blows, crushing injury, MVA, sports injuryAnkle SpainAcute Soft Tissue InjuryAssessment FindingsEdemaEcchymosis/contusionPain, tendernessDecreased sensation, pulse, movementPallorInability to bear weightMuscle spasmsSprains & StrainsPreventionPre-conditioningStretching & warm-up prior to exercisingEndurance steady progressUse of elastic support bandages or adhesive tape wrappingAcute Intervention for InjuryStopping the activity & limit movementApplying ice compresses to injured areaCompressing involved extremityElevating extremityProviding analgesia as necessaryAcute Treatment for Sprains & StrainsAcute treatment is first 24-48 hoursRICE – decrease local inflammationRestIce – 20-30 min/app, warm-up 10-15minDecrease transmission & perception of nerve pain impulsesCompression – limits swelling; on 30min., off 15 min.ElevationAfter 24-48 hours warm, moist heat to decrease swelling and increase comfort; on 20-30 min. with a cool down.Dislocation & SubluxationComplete versus partial/incompleteSevere ligament injury around jointResults in displacement/separation of articular joint surfacesCommon in thumb, elbow shoulder, hip, patella, & traumaClinical Manifestations of Dislocation/SubluxationDeformitySwelling of soft tissuesLocal pain & tendernessLoss of joint functionDislocation is an orthopedic emergency – closed reduction or surgery [ORIF]Avascular necrosisCompartment syndromeDislocation of HipRepetitive Strain Injury [RSI]Cumulative traumatic disorder resulting from prolonged, forceful, or awkward movementsOveruse syndrome [RSI]“nintendinitis”, carpal tunnel syndrome, rotator cuff injury, meniscus injury, bursitistennis, dancing, swimming, baseball, weight-liftingRepeated movements strain tendons, ligaments, muscles, causing tiny tears that become inflamedOther factors: poor posture & positioning; poor work space ergonomics, repetitive lifting of heavy workloads without sufficient muscle restResults in inflammation, swelling, weakness, numbness, impaired motor function, & painCarpal Tunnel SyndromeCaused by compression of the medial nerve which enters the hand through the narrow confines of the carpal tunnelMost common compression neuropathy in upper extremityClinical manifestations: weakness (thumb), burning pain, numbness, impaired sensation, & clumsiness in performing fine hand movementsPainters, musicians, bowlers, knitters, seamstresses, computer usersRotator Cuff InjuryA rotator cuff injury is an injury (tear) to one or more of the four muscles in the shoulder. Acute or chronic/progressiveInjury can range from an inflammation of the muscle without any permanent damage, such as tendinitis, to a complete or partial tear of the muscle that might require surgery to fix it.Meniscus InjuryThe meniscus is a small, "c" shaped piece of cartilage that acts as a cushion in the knee joint. A meniscus tear occurs when these pieces of cartilage tear and are injured usually during movements that forcefully rotate the knee while bearing weight. Causes mild to severe pain, swelling, audible “click & pop” in knee.BursitisBursitis is the inflammation of one or more bursae (small sacs) of synovial fluid in the body.Caused by repetitive movement & excessive pressureMovement difficult & painful; stiffness; burning pain around jointOlecranon bursitisTreated with rest, ice compresses, anti-inflammatory drugs and pain medication.Housemaid’s or Clergyman’s KneeHousemaid's knee is actually one of two types of swelling you can develop at the front of the knee. The other is known as clergyman’s knee. Both are painless, fluid-filled swellings (the size of a squashy tangerine) which develop as a result of a minor injury. The difference between them is simply in their location. If the swelling is in front of the kneecap, it’s called housemaid’s knee. These days, thanks to Hoovers and other modern gadgets few cleaning ladies develop it. However it’s an