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LMU NURS 241 - Alterations in Musculoskeletal Function

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DRUG LISTMusculoskeletal Study GuideLincoln Memorial UniversityCaylor School of Nursing NURS 241Fall 2008 TITLE: Nursing Strategies: Alterations in Musculoskeletal FunctionDATE: See syllabusTIMES: See syllabusOBJECTIVES: Upon completion of this unit, the student will be able to demonstrate in the clinical/campus laboratory setting, in individual and group conferences, and on written materials, the ability to:1. Define and use the glossary terms as listed in the assigned readings.2. Using the four adaptive modes of Roy’s Adaptation Model (RAM), recognize human adaptive responses to behavior or stimuli that affect musculoskeletal function.3. Describe the pathophysiological, clinical manifestations, management and associated use of the RAM nursing process to provide care for adults with alterations of the musculoskeletal system. 4. Describe the anatomy and physiology of the musculoskeletal system and its relationship to musculoskeletal disorders. 5. Identify the clinical significance and related nursing implications of laboratory and diagnostic tests and procedures used for assessment and evaluation of musculoskeletal function 6. Utilize the RAM nursing process to assess needs and provide care for the adult who is experiencing any of the following common disorders of the musculoskeletal system: a. Musculoskeletal trauma-sprains, strains, contusions, joint dislocationsb. Sports injuries-Rotator cuff tears, epicondylitis, ligament and cartilage injuriesc. Fracturesd. Amputationse. Metabolic bone disorders-osteoporosisf. Infections of bones and joints-osteomyelitis, septic arthritisg. Low back painh. Carpal tunnel syndromei. Degenerative joint disease-osteoarthritisj. Rheumatic disorders -rheumatoid arthritis, systemic lupus erythematosis, fibromyalgia, scleroderma, gout7. Identify different types of fractures and explain the physiology of bone healing.8. Identify and describe the significant changes commonly associated with the normal aging process with regard to the musculoskeletal system. 9. Describe the principles and methods of fracture reduction.110. Describe nursing assessment and interventions for human persons with casts.11. Specify the prevention and management of immediate and delayed complications of fractures.12. Differentiate between the types of traction and external fixator devices regarding their purposes, descriptions, and nursing care needed with each.13. Describe the preoperative and postoperative nursing needs of human persons undergoing orthopedic surgery.14. Discuss passive and active range of motion exercises and isometric exercises usedin the restoration of mobility.15. Describe problems that may occur with immobilization.16. Describe patient teaching for patients who will use crutches, walkers, canes and wheelchairs.17. Describe the psychological implications of amputation and related nursing interventions.18. Identify and explain the process of inflammation and degeneration in the development of rheumatic diseases.19. Discuss the medications on the drug list by generic name, classification, mechanism of action, clinically significant side effects, normal dosage and nursing implications and be able to correctly calculate IV, IM, SQ, and PO dosagesTOPICAL OUTLINE – Alterations in Musculoskeletal FunctionI. Assessment of Musculoskeletal System Function A. Overview of Muscle and Bone Function1. Review of anatomy and function2. Gerontological considerationsB. Health HistoryC. Physical AssessmentD. Diagnostic Evaluation and Nursing Care1. Imaging Proceduresa. Radiographic studiesb. CT Scanc. MRId. Arthography2. Bone densitometry3. Nuclear studies-bone scan4. Endoscopic studies- arthroscopy5. Other studiesa. Arthrocentesisb. Electromyography (EMG)c. Biopsy 6. Laboratory studies2II. Principles and Practices of Rehabilitation (Student to review chapter 11) III. Nursing Care of Adults with Rheumatic Disorders A. Rheumatic Diseases1. Pathophysiology2. Clinical manifestations3. Assessment and diagnostic findings4. Medical Management5. Nursing ProcessB. Diffuse Connective Tissue Diseases 1. Rheumatoid arthritis 2. Systemic lupus erythematosus 3. Scleroderma (systemic sclerosis)C. Degenerative Joint Disease (Osteoarthritis)1. Total hip repair and replacements 2. Total knee replacementD. GoutE. Fibromyalgia IV. Nursing Care of Adults with Common Musculoskeletal Disorders A. Acute low back pain B. Carpal tunnel syndrome C. Metabolic Bone Disorders – Osteoporosis D. Musculoskeletal Infections – Osteomyelitis E. Bone TumorsV. Nursing Care of Adults with Musculoskeletal Trauma A. Contusions/Strains/SprainsB. Joint DislocationsC. Specific MS injuries 1. Rotator cuff tears2. Epicondylitis3. Ligament injury4. Meniscal injury5. Rupture of achilles tendon E. Fractures 1. Physiology of bone healing (student to review) 2. Specific types of fractures (student to review) 3. Management of fractures a. Emergency management b. Reduction c. Immobilization 1. Casts 2. Splints and braces 3. External fixators 4. Traction3d. Complications associated with fractures 1. Early complications a. Shock b. Fat embolism syndrome c. Compartment syndrome 2. Delayed complications a. Delayed union, malunion and nonunion b. Avascular necrosisF. AmputationsREQUIRED READINGS:Smeltzer, S.C., Bare, B.G., Hinkle, J.L., and Cheever, K.H. (2008). Brunner & Suddarth’s Medical surgical nursing. (11th ed.) Philadelphia, PA: Lippincott, Williams, & Wilkins. Chapters 11 (review), 54 pp. 1886-1923, 66 pp. 2336-2353, 67 pp. 2354-2390, 68


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