Disuse Syndrom - Lecture Notes Part 2 Musculoskeletal...

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Lecture Notes Part 2 Musculoskeletal Stressors Musculoskeletal stressors: Trauma : Includes fractures, sprains, strains, overuse injuries, amputations Infection : Includes inflammatory conditions as osteomyelitis, arthritis Altered metabolism : Includes cancer, osteoporosis, osteomalacia, rickets, and Paget's disease For the person with a musculoskeletal condition: List the effects on PERSON: (effects entire person; especially with long term immobilization) P P sychosocial leads to depression, job change, altered body image, etc. E E limination, altered due to restricted body position, pain medications, altered diet, etc. R R est, comfort, regulatory, altered due to pain control, sleep deficits due to pain and altered body position, limited movement due to casts, traction, braces, etc. S S afety impaired due to altered gaits neurologic and sensory impairments. O O xygenation, tissue perfusion deficits due to blood loss, complications of fat emboli, factors that compromise oxygenation N N utrition impaired due to markedly increase metabolic needs. Bone healing requires increased protein, Vitamins C and D. Most frequent nursing diagnosis for musculoskeletal Activity tolerance Disuse syndrome, high risk for Impaired adjustment Impaired skin integrity, high risk for Infection, high risk for Pain (acute) Pain (chronic) **Peripheral neurovascular dysfunction, high risk for (priority) Post-trauma response Trauma, high risk for injury *Alteration in tissue perfusion Knowledge deficit Anxiety Alteration in bowel elimination Fear Powerlessness Self-care deficit * All complications of immobility apply depending upon particular dysfunction Components of Assessment Chief complaint: Identify why care is sought. Acute problem: Identify what was injured; how it happened and what was the mechanism, force and direction of injury; when did it occur and what disability resulted; when did the swelling, redness, discoloration, and temperature change develop? What treatment was done? Any 1 of 7
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Lecture Notes Part 2 Musculoskeletal Stressors associated problems? Chronic problem: Identify when the symptoms began, how long, if continuous or intermittent; how did the symptoms begin if spontaneous or a result of injury; why did the symptoms begin and the individual's perception of “why”; what helps or aggravates the problem; what treatment, home or otherwise? History taking and significance: Includes the biographical data such as age, sex, means of transportation, where he lives. Suggests problems. Pain characteristics: PQRST= P-provoking incident; Q= quantity; R= region and radiation and relief; S= severity Location: Poorly localized pain may be associated with blood vessels, joints, fascia, or the periosteum Quality or character: throbbing is usually related to bone injury. Aches most often reflect muscular involvement. Sharp pain is associated with fractures, bone infection. Radiation of pain, what makes it worse?
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Disuse Syndrom - Lecture Notes Part 2 Musculoskeletal...

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