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short-term relief; endoscopic surgical decompression of the nerve with symptoms > 6 mo. Nursing Management: management of pain; education and preventionRotator Cuff InjuryCauses: aging, repetitive stress (overhead motions), or fall injury. Sports: swimming, racquet sports, baseballClinical manifestations: shoulder weakness and pain and decreased ROM pain when abducted between 60-120 degrees; four muscle involvementDiagnostics: X-ray and MRI (to confirm)Collaborative care and mgmt: oConservative: Rest, ice and heat, NSAIDS, corticosteroids injections; oSurgery- acromioplasty; immobilization by sling for short term; PT first day postop to prevent frozen shoulder Meniscus InjuryEtiology: Rotational injuries to the knee; occupations that require kneeling or squatting
Clinical manifestations: localized tenderness, pain and effusionDiagnostics: MRI; athrogram or athroscopy; assessment may reveal a positive McMurray’s test; patient reporting clicking, popping, and locking.Collaborative care and Nsg Mgmt oPrevention: warm-up and stretching before activity; mainly sports injury relatedoTreatment: Ice, immobilize, and partial weight bearing with crutches. A knee brace or immobilizeris also used. Often surgery with a meniscectomy is required via an arthroscopy procedure. This can often be done on an outpatient basis. Pain relief with NSAIDs or other analgesics. Rehab withstretching and ROM.Anterior Cruciate Ligament (ACL) injury Knee injuries account for over 50% of all sports injuries. ACL is most commonAssess/Diag: Lachman’s test (knee flex 15-30 degree while pulling tibia forward) positive for ACL; X-ray and MRICollaborative care: rest, ice, NSAIDs, elevate, knee immobilizer or knee brace, ambulate with crutchesReconstructive surgery: if necessary will require removal of torn tissue and placement of autologous or allograph tissue; rehab is necessaryRecovery: may be 6 to 8 monthsBursitisCauses: repeated trauma, gout, rheumatoid arthritis, or infection at the joint site. Most commonly a problem at the hand, knee, greater trochanter of hip, shoulder and elbow. Clinical manifestations: warmth, pain, swelling, and limited ROMDiagnostics: Assessment, history and physicalCollaborative care and nsg mgmt: rest; icing to decrease pain and inflammation; Tx: pressure dressing or splint; NSIADs; aspiration of the bursa and intraarticular injection of a corticosteroid. A bursectomy may benecessary if the bursal wall become so thick that the joint will not move.Bursae of the HIP-Common Site of BursitisFracturesTypes of fractures. oA,Transverse fracture is a fracture in which the line of the fracture extends across the bone shaft at a right angle to the longitudinal axis. oB,Spiral fracture is a fracture in which the line of the fracture extends in a spiral direction along the shaft of the bone.