NUR443 EXAM NOTES GRADED A+ LATEST
UPDATE
• Ch. 40- Musculoskeletal Care Modalities
o Key Terms
▪ Abduction
• Movement away from center or median line of body
▪ Adduction
• Movement toward the center or median line of body
▪ Avascular necrosis
• Death of tissue due to insufficient blood supply
▪ Brace
• Externally applied device to support the body or body part,
control movement, and prevent injury
▪ Cast
• Rigid external immobilizing device molded to contours of body part
▪ Cast syndrome
• Psychological or physiologic response to confinement in body cast
▪ External fixator
• External metal frame attached to bone fragments to stabilize them
▪ Fracture
• Break in the continuity of bone
▪ Heterotopic ossification
• Misplaced formation of bone
▪ Neurovascular status
• Neurologic and circulatory functioning of a body part
▪ Osteolysis
• Lysis of bone from inflammatory reaction against
polyethylene particulate debris
▪ Osteomyelitis
• Infection of bone
,NUR443 EXAM NOTES GRADED A+ LATEST
UPDATE
▪ Osteotomy
• Surgical cutting of bone
▪ Paresthesia
• Abnormal sensation of tingling or numbness or burning
▪ Sling
• Bandage used to support an arm
▪ Splint
• Device designed specifically to support and immobilize body part
in desired position
▪ Traction
• Application of a pulling force to part of body
▪ Trapeze
• Overhead assistive device to promote patient mobility in bed
o Connective Tissue Disorders
▪ Sprain
• Etiology and pathophysiology
o Partial or complete tearing of the ligaments that hold
various bones together to form a joint
o Occurs during trauma when a joint is forced or twisted pasts
its normal ROM
o Ankle, knee and wrist are most commonly sprained
• Signs and symptoms and diagnosis
o Grade I (mild)- tenderness, minimal swelling and loss of function
o Grade II (moderate)- more severe pain; swelling and
bleeding into joint; some loss of function
o Grade III (severe, complete tearing of fibers)- pain may be
less severe, but swelling, loss of function, and bleeding into
joints are more marked
o Physical and radiographic examination to rule out a fracture
or other pathology
• Treatment and Nursing Management
,NUR443 EXAM NOTES GRADED A+ LATEST
UPDATE
o RICE- rest, ice, compression and elevation
o Apply ice immediately after injury and for the next 24 hours
o Apply ice bag to 10 to 20 minutes every 1 to 2 hours during
the day
o Wrap injured part snugly with elastic bandage, being careful
not to cut off circulation and elevate
o Protect ligament until it heals by scarring
o Ligaments do not “grow” back together
o Air casts, braces or supports are used only until a joint has
been strengthened
o Muscle atrophy can occur if joint is immobilized too long
and muscles not exercised
o Surgical repair may be necessary
o Grade III sprains often require a cast
o Crutches needed for grade II or III
o NSAIDs around the clock for first couple of days to
decrease swelling
o The Patient in a Cast, Splint, or Brace
▪ Cast
• Rigid, external immobilizing device
• Uses
o Immobilize reduced fracture
o Correct a deformity
o Apply uniform pressure to soft tissue
o Support and stabilize weakened joints
• Materials- Non plaster (fiberglass), plaster of Paris
▪ Splints and Braces
• Contoured splints of plaster or pliable thermoplastic materials may
be used for
o Conditions that do not require rigid immobilization
, NUR443 EXAM NOTES GRADED A+ LATEST
UPDATE
o For those in which swelling may be anticipated
o And for those who require special skin care
• Braces are custom fitted to various parts of the body and are used to:
o Provide support
o Control movement
o Prevent additional injury
▪ Nursing Management of a Patient in a Cast, Splint, or Brace
• Assessment
o Before application
▪ General health assessment
▪ Emotional status
▪ Presenting signs and symptoms and condition of area
o Monitoring of neurovascular status and for
potential complications, swelling, bruising, and
abrasions
o Volkman contractures- inability to straighten fingers due
to blood flow obstruction
o Treat lacerations and abrasions before cast, brace, splint
o Provide information about the purpose of treatment
o Prepare patient for application by explaining procedure
o Assessing neurovascular changes using 6 Ps
▪ Pain
▪ Poikilothermic
▪ Pallor
▪ Pulselessness
▪ Paresthesia paralysis
o Monitor and treatment pain
▪ Describe exact site, character, and intensity of pain
▪ Treat with elevation, ice packs and analgesics
• Collaborative problems and potential complications
UPDATE
• Ch. 40- Musculoskeletal Care Modalities
o Key Terms
▪ Abduction
• Movement away from center or median line of body
▪ Adduction
• Movement toward the center or median line of body
▪ Avascular necrosis
• Death of tissue due to insufficient blood supply
▪ Brace
• Externally applied device to support the body or body part,
control movement, and prevent injury
▪ Cast
• Rigid external immobilizing device molded to contours of body part
▪ Cast syndrome
• Psychological or physiologic response to confinement in body cast
▪ External fixator
• External metal frame attached to bone fragments to stabilize them
▪ Fracture
• Break in the continuity of bone
▪ Heterotopic ossification
• Misplaced formation of bone
▪ Neurovascular status
• Neurologic and circulatory functioning of a body part
▪ Osteolysis
• Lysis of bone from inflammatory reaction against
polyethylene particulate debris
▪ Osteomyelitis
• Infection of bone
,NUR443 EXAM NOTES GRADED A+ LATEST
UPDATE
▪ Osteotomy
• Surgical cutting of bone
▪ Paresthesia
• Abnormal sensation of tingling or numbness or burning
▪ Sling
• Bandage used to support an arm
▪ Splint
• Device designed specifically to support and immobilize body part
in desired position
▪ Traction
• Application of a pulling force to part of body
▪ Trapeze
• Overhead assistive device to promote patient mobility in bed
o Connective Tissue Disorders
▪ Sprain
• Etiology and pathophysiology
o Partial or complete tearing of the ligaments that hold
various bones together to form a joint
o Occurs during trauma when a joint is forced or twisted pasts
its normal ROM
o Ankle, knee and wrist are most commonly sprained
• Signs and symptoms and diagnosis
o Grade I (mild)- tenderness, minimal swelling and loss of function
o Grade II (moderate)- more severe pain; swelling and
bleeding into joint; some loss of function
o Grade III (severe, complete tearing of fibers)- pain may be
less severe, but swelling, loss of function, and bleeding into
joints are more marked
o Physical and radiographic examination to rule out a fracture
or other pathology
• Treatment and Nursing Management
,NUR443 EXAM NOTES GRADED A+ LATEST
UPDATE
o RICE- rest, ice, compression and elevation
o Apply ice immediately after injury and for the next 24 hours
o Apply ice bag to 10 to 20 minutes every 1 to 2 hours during
the day
o Wrap injured part snugly with elastic bandage, being careful
not to cut off circulation and elevate
o Protect ligament until it heals by scarring
o Ligaments do not “grow” back together
o Air casts, braces or supports are used only until a joint has
been strengthened
o Muscle atrophy can occur if joint is immobilized too long
and muscles not exercised
o Surgical repair may be necessary
o Grade III sprains often require a cast
o Crutches needed for grade II or III
o NSAIDs around the clock for first couple of days to
decrease swelling
o The Patient in a Cast, Splint, or Brace
▪ Cast
• Rigid, external immobilizing device
• Uses
o Immobilize reduced fracture
o Correct a deformity
o Apply uniform pressure to soft tissue
o Support and stabilize weakened joints
• Materials- Non plaster (fiberglass), plaster of Paris
▪ Splints and Braces
• Contoured splints of plaster or pliable thermoplastic materials may
be used for
o Conditions that do not require rigid immobilization
, NUR443 EXAM NOTES GRADED A+ LATEST
UPDATE
o For those in which swelling may be anticipated
o And for those who require special skin care
• Braces are custom fitted to various parts of the body and are used to:
o Provide support
o Control movement
o Prevent additional injury
▪ Nursing Management of a Patient in a Cast, Splint, or Brace
• Assessment
o Before application
▪ General health assessment
▪ Emotional status
▪ Presenting signs and symptoms and condition of area
o Monitoring of neurovascular status and for
potential complications, swelling, bruising, and
abrasions
o Volkman contractures- inability to straighten fingers due
to blood flow obstruction
o Treat lacerations and abrasions before cast, brace, splint
o Provide information about the purpose of treatment
o Prepare patient for application by explaining procedure
o Assessing neurovascular changes using 6 Ps
▪ Pain
▪ Poikilothermic
▪ Pallor
▪ Pulselessness
▪ Paresthesia paralysis
o Monitor and treatment pain
▪ Describe exact site, character, and intensity of pain
▪ Treat with elevation, ice packs and analgesics
• Collaborative problems and potential complications
