Musculoskeletal

Question 1

Manifestations of sprains & strains

Answer 1

Pain, edema, decreased function, and bruising

Question 2

Health promotion

Answer 2

i. Warm up exercises and stretching

ii. Strength, balance, and endurance exercises

Question 3

Acute care of sprains & strains

Answer 3

i. RICE: rest, ice, compression, and elevation
ii. Rest: Stop activity and limit movement
iii. Ice: 24 to 48 hours; 20 to 30 minutes at a time
iv. Compression: elastic bandage; apply distal to proximal
v. Elevate: above the heart
vi. Analgesia

Question 4

Injuries from prolonged force or repetitive movements and awkward postures

Answer 4

Repetitive Strain Injury (RSI)

repetitive trauma disorder, overuse syndrome

Question 5

At risk for RSI & example

Answer 5

those who perform repetitive motions without sufficient muscle rest
dancers, butchers, athletes, keyboard operators

Question 6

S/S of RSI

Answer 6

Inflammation, swelling, and pain in muscles, tendons, and nerves of the neck, spine, shoulder, forearm, and hand

Question 7

RSI treatment

Answer 7

i. Identify precipitating activity
ii. Modify equipment or activity
iii. Pain management
iv. Rest
v. Physical therapy

Question 8

Carpal Tunnel Syndrome often caused by (6 things)

Answer 8

Trauma
Edema
Cancer
RA
Soft tissues masses
hormones

Question 9

CTS is increased incidence with

Answer 9

diabetes, PVD, RA, and women

Question 10

Manifestations with CTS

Answer 10

1. Impaired sensation, pain, numbness, or weakness; clumsiness
2. Tinel’s/Phalen’s sign

Question 11

Late stages of CTS

Answer 11

Atrophy, recurrent pain, and dysfunction of hand

Question 12

CTS Prevention (10 things)

Answer 12

a. Identify risk factors
b. Adaptive devices
c. Ergonomic changes
d. Acute Care—relieve compression
e. Rest/splints @ night
f. PT
g. Corticosteroid injection
h. Change in occupation
i. Surgery
j. Open or endoscopic

Question 13

Cap refill:

Answer 13

Greater than 3 seconds indicates arterial insufficiency

Question 14

Pallor and cool/cold

Answer 14

indicates poor arterial insufficiency

Question 15

Overall goals for musculoskeletal treatment

Answer 15

1. Healing with no associated complications
2. Satisfactory pain relief
3. Maximal rehabilitation potential

Question 16

Surgical goal of amputation

Answer 16

Preserve as much extremity length and function as possible while removing infected, pathologic, or ischemic tissue

Question 17

Nursing assessment of amputation

Answer 17

i. Assess for preexisting illnesses

ii. Assess vascular and neurologic condition

Question 18

Priority problems for amputation

Answer 18

i. Disturbed body image
ii. Impaired tissue integrity
iii. Chronic pain
iv. Impaired mobility

Question 19

Goals for a patient with an amputation will

Answer 19

i. Have adequate relief from underlying health problem
ii. Have satisfactory pain management
iii. Reach maximum rehabilitation potential
iv. Cope with body image change
v. Make satisfying lifestyle adjustments

Question 20

Pt and caregiver education

Answer 20

i. Examine lower extremities daily
ii. Report changes in feet or toes
iii. Review safety precautions related to recreational activities or hazardous work

Question 21

Phantom limb sensation

Answer 21

1. Shooting, burning, or crushing pain and feelings of coldness, heaviness, and cramping
2. May subside or be chronic

Question 22

Pt & caregiver education post op

Answer 22

Residual limb care, ambulation, contracture prevention, recognition of complications, exercise, and follow-up care

Question 23

Specific caregiver education post op

Answer 23

3. Frequent movement: laying on abdomen
4. Vitamin A & C
5. Wash limb @ night & air it out for 20 minutes, put clean sock on
6. No lotion, alcohol, powders, or oils

Question 24

Rehabilitation

Answer 24

i. Success depends on physical and emotional health
ii. Physical and occupational therapy involvement important
iii. Flexion contractures (e.g., hip) delay rehabilitation
iv. Proper bandaging important for prosthesis fitting
v. Should not sit in a chair for more than an hour

Question 25

Amputation expected outcomes

Answer 25

i. Accept changed body and integrate changes into lifestyle
ii. Have no evidence of skin breakdown
iii. Have reduction of absence of pain
iv. Become mobile within limitations imposed by amputation