MUSCULOSKELETAL WORKSHEET (NU 170/171)
Condition Presentation (notes) Interventions:
Assess, Monitor, Medicate, Educate
JUVENILLE IDIOPATHIC Joint pain/swelling/morning stiffness NSAIDs, DMARDs, Corticosteroids
ARTHRITIS (JIA) ↑ESR/CRP/ANA/RF PT & splinting, Cold vs Heat
DUCHENNE MUSCULAR Weakness, falls, calf hypertrophy Gower’s maneuver
DYSTROPHY (MD) PROGRESSIVE worsening PT/ST/RT – assistance w/ADLs
SCOLIOSIS Lateral curvature (mild, mod, severe) Posture, exercises, brace (teen concerns)
Unequal shoulder/hip height Surgery – logroll, tortoise shell brace; transfusion
Explainable injury vs suspect abuse Assessment:
Note: bones more porous; bend vs break 5Ps (Pain, pulselessness, pallor, paresthesia, pressure)
F Ossify ~ 20 y/o; Rapid bone growth = bone pain Neurovascular/CMS checks
Complications: compartment syndrome, hemathrosis
R Presentation: Pain, guarding, bruising, petechiae = R.I.C.E.
A Interventions: ↑ protein diet, pain meds, I&O, autonomy/play
Types
C Spiral: toddlers fx – not always abuse Immobilization for Functional alignment
T Greenstick: common under 10 y/o Closed (external): bandage, cast, splint, traction, fixators
U Incomplete: Buckle & Torus fractures ORIF (internal): metal implants (immobilizer)
Crutch training – TDNWB
R Don’t manipulate traction unless trained; reason to cut rope?
E SKIN traction
S Russells: sling under knee to ankle
Bucks: (boot device) – femoral & hip fractures
Bryants: adhesive bandage - 90o suspended w/hips off bed- femur fx/hip dislocation
SKELETAL traction: uses pins – PIN CARE (qshift – qd; sterile)
90/90
CAST CARE: Nothing under cast, cool air ok for itching
Fiberglass/Synthetic: more durable, lightweight; dries quickly
Plaster: molded, dries 24-48H; not water resistant; petaling (protect rough edges)
Condition Presentation (notes) Interventions:
Assess, Monitor, Medicate, Educate
JUVENILLE IDIOPATHIC Joint pain/swelling/morning stiffness NSAIDs, DMARDs, Corticosteroids
ARTHRITIS (JIA) ↑ESR/CRP/ANA/RF PT & splinting, Cold vs Heat
DUCHENNE MUSCULAR Weakness, falls, calf hypertrophy Gower’s maneuver
DYSTROPHY (MD) PROGRESSIVE worsening PT/ST/RT – assistance w/ADLs
SCOLIOSIS Lateral curvature (mild, mod, severe) Posture, exercises, brace (teen concerns)
Unequal shoulder/hip height Surgery – logroll, tortoise shell brace; transfusion
Explainable injury vs suspect abuse Assessment:
Note: bones more porous; bend vs break 5Ps (Pain, pulselessness, pallor, paresthesia, pressure)
F Ossify ~ 20 y/o; Rapid bone growth = bone pain Neurovascular/CMS checks
Complications: compartment syndrome, hemathrosis
R Presentation: Pain, guarding, bruising, petechiae = R.I.C.E.
A Interventions: ↑ protein diet, pain meds, I&O, autonomy/play
Types
C Spiral: toddlers fx – not always abuse Immobilization for Functional alignment
T Greenstick: common under 10 y/o Closed (external): bandage, cast, splint, traction, fixators
U Incomplete: Buckle & Torus fractures ORIF (internal): metal implants (immobilizer)
Crutch training – TDNWB
R Don’t manipulate traction unless trained; reason to cut rope?
E SKIN traction
S Russells: sling under knee to ankle
Bucks: (boot device) – femoral & hip fractures
Bryants: adhesive bandage - 90o suspended w/hips off bed- femur fx/hip dislocation
SKELETAL traction: uses pins – PIN CARE (qshift – qd; sterile)
90/90
CAST CARE: Nothing under cast, cool air ok for itching
Fiberglass/Synthetic: more durable, lightweight; dries quickly
Plaster: molded, dries 24-48H; not water resistant; petaling (protect rough edges)
