Chapter 63: Med Surg Flashcards Preview

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Flashcards in Chapter 63: Med Surg Deck (84)
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injury to a ligamentous structure surrounding a joint, usually caused by wrenching or twisting motion


first degree sprain

mild; involves tears in only a few fibers resulting in mild tenderness and minimal swelling, self-limiting with full fx returning within 3-6 weeks


second degree sprain

moderate; involves partial disruption of the involved tissue with more swelling and tenderness


third degree sprain

complete tearing of a ligament in association with moderate to severe swelling, a gap in the muscle may be apparent, may require surgical repair if it involves the fascia or tendons



excessive stretching of a muscle and its fascial sheath usually involving the tendon, mostly occur in large muscle groups


why does edema develop in an injured area?

tiny hemorrhages within the disrupted tissues occur along with the local inflammatory response


acute intervention of strains and sprains

stopping the activity and limiting movement, applying ice, compressing, elevating, and providing analgesia



limits swelling, wrapped starting distally and progressing proximally to encourage fluid return, bandage left in place for 30 minutes and removed for 15 minutes



severe injury of the ligamentous structures that surround joint evidence by obvious deformity and local pain, tenderness, loss of fx of injured part, and swelling


tx for dislocation

prompt attention! must be realigned and immobilized, nurses need to reduce pain and protect injury



partial or incomplete displacement of the joint surface, less severe than dislocation, may require less healing time


repetitive strain injury

cumulative traumatic disorder resulting from repetitive movements, awkward postures, or sustained force causing tiny tears that become inflammed


s/s of repetitive strain injury

pain, weakness, numbness, impairment of motor fx


tx of repetitive strain injury

precipitating activity, modification of activity, pain management with heat/cold, rest, to type: keep the hips and knees flexed to 90 degrees and feet flat with the wrists kept straight


carpal tunnel syndrome

caused by compression of the median nerve caused by pressure from trauma or edema caused by inflammation of tendon


s/s of carpal tunnel

weakness especially in thumb, burning pain, tingling, numbness, and + phalen's test


predisposed to carpal tunnel

diabetes, hypothyroidism, women


tinel's sign

tapping over the median nerve as it passes through the carpal tunnel in the wrist and positive response is sensation of tingling


phalen's sign

allow wrists to fall freely into maximum flexion and maintain position for longer than 60 seconds, positive sign is sense of tingling over median nerve


tx of carpal tunnel

in acute cases, stop the aggravating motion and let wrist rest with wrist splint, injection of corticosteroid directly into carpal tunnel may relieve, avoid extreme temps, carpal tunnel release


release surgery

indicated if symptoms persistent for more than 6 months, open release enlarges carpal tunnel and endoscopic is faster and causes less pain


rotator cuff injury

occurs gradually from aging, repetitive stress, or injury from falling, can tear as sudden force of adduction occurs when limb is in abduction, confirmed with MRI


s/s rotator cuff injury

shoulder weakness, severe pain when the arm is abducted 60-120 degrees, decreased ROM, drop arm test


drop arm test

arm falls suddenly after is has been abducted 90 degrees is a sign of rotator cuff injury


tx rotator cuff injury

rest, ice, heat, NSAIDs, corticosteroid injections to joint, physical therapy, surgery indicated when complete tear or no improvement with conservative therapy (arthroscope surgery)


meniscus injury

associated with ligament sprains that commonly occur in athletes (basketball, football, rugby, soccer, hockey) exhibited by rotational stress when the knee is in varying degrees of flexion and foot is planted; MRI diagnose


s/s of meniscus injury

pain with flexion, internal rotation, and knee extension, no significant edema, localized tenderness, knee clicks or pops, quadricep atrophy is injury has not been tx


tx meniscus injury

ice, immobilization, weight bearing as tolerated, knee brace, physical therapy, surgery may be indicated and done with arthroscopy


anterior cruciate ligament (ACL) injury

usually occurs from noncontact when the athlete pivots, lands from a jump, or slows down when running, x rays and MRI diagnostic


lachman's test

flex the knee 15-30 degrees and pull tibia forward while femur is stabilized, considered positive for ACL injury if there is forward motion of the tibia with the feeling of a soft or indistinct endpoint