Med Surg Nursing I Chapter 68

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Med Surg Nursing IChapter 68

• Caring for Clients with Traumatic Musculoskeletal
  Injuries

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Traumatic Injuries

• Strain a stretching or pulling injury to a
  muscle
• Contusion soft tissue injury from trauma
• Sprain a ligament injury
• Avulsion fracture is when a chip of the bone to
  which the ligament is attached detaches

• S/S pain, swelling, ecchymosis
• Treatment apply ice or chemical cold pack for
  1st 24-48 hrs to reduce swelling after 2 days
  may apply heat elevation, rest, NSAIDS

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Dislocations

• When the articular surfaces of a joint are no
  longer in contact with each other
• Occurs most often in the shoulder, hip knee
  caused mostly by trauma
• May lead to compartment syndrome when a tendon or
  nerve is constricted in a confined space
  decreased arterial blood flow causing palsy

• S/S hearing of a popping noise, c/o that the
  joint suddenly gave out, pain, obvious
  malformation of the joint, limited ROM
• Treatment manipulation of the joint back into
  place under local or general anesthesia,
  followed by immobilization
• Nursing care pain management, elevation
  immobilization, neuro checks, cold packs

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TENDONITIS

• Inflammation of a tendon caused by overuse
  related to work/sports activities that injure or
  overuse related tendons
• Epicondylitis (tennis elbow)
• Ganglion cysts develop near tendon sheaths
  joints of the wrists
• Carpal tunnel syndrome a group of symtoms
  located near the wrist where the carpal bones,
  tendons median nerve pass through a narrow,
  inelastic canal
• S/S pain, inflammation, numbness

• Medical/surgical treatment
• applications of cold heat
• antiinflammatory meds NSAIDS
• exercise
• splinting
• surgical repair
• Nursing care
• education re meds
• rest of affected extremity
• perform prescribed exercises

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ROTATOR CUFF TEAR

• Results from traumatic injury or chronic overuse
  of the shoulder joint
• Treatment
• initial use of NSAIDS
• rest
• corticosteriod injections into joint
• surgical intervention

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Fractures

• Types, Box 68-2
• S/S depends on type, but most all have pain
  loss of function deformity false, unusual
  motion, crepitus, edema, spasm
• Medical surgical treatment see chapter 67 for
  care
• Box 68-1 complications of fractures

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Fractured Hip

• Usually occurs as a result of a fall in older
  adults with osteoporosis fig 68-3
• S/S severe pain that increases with movement of
  the leg, shortening external rotation of the
  leg
• Intracapsullar fig 68-3
• Extracapsular fig 68-3

• Medical Surgical treatment
• traction until surgery performed
• ORIF Hemiarthroplasty or partial hip
  replacement
• Nursing mgmt prevention of complications, avoid
  adduction of affected leg use of overhead
  trapeze no flexion of affected hip gt 90 degrees