The surgeon always tries to preserve the __knee_____ and the _elbow_______ ifhe canImmediate Post-op CareoKeep a __tourniquet ____________ at the bedsideoAssess for bleeding and drainage/pooling, monitor for hypovolemia, VSoElevation is controversial – short term elevation only and not on pillow (foot of bed up)
oPrevent contractures by _extension______________. Could have patient lie proneoTreat Phantom pain: seen more with AKAs and usually subsides in 3 mos.1stintervention to decrease phantom pain? __deversional_____________ activityH.Osteoporosis (brittle bones)Causes: Decrease in dietary intake of _calcium______ or decrease in calcium __absorption_________ and estrogen deficiencySecondary causes: steroid use, tobacco and alcohol use, endocrine and liver diseases.Common in __menopausal_______________ womenHave to walk to keep calcium in the boneMain concern: Fragility Fractures (especially hips and vertebrae)Patient TeachingoAdequate calcium and Vitamin _D____oMedications: Biophophomates (Fosamax, Actonel), Salmon calcitonin, and raloxifeneoExercise important to prevent progressionI.Low Back Pain and Herniated Intervertebral discRisk FactorsTrauma/heavy lifting (repetitive)Poor posture, muscle toneExcessive body weightSedentary work, prolonged periods of sittingSmokingPregnancyACUTE if it is (<4 weeks) or CHONIC if it is (>than 3 months)Back pain can be caused by muscle strain or sprain, degenerative joint disease, “bulging discs”, or herniated disc(s), trauma, or congenital defectConservative treatment: Analgesics, muscle relaxants, heat/ice, physical therapy
Surgical procedures – know your patients baseline assessment pre-op for numbness/tingling/motor sensation/painoPost-op care lumbar fusion:-Pain Control-Log rolling / maintain good spinal alignment-NV checks as paresthesia may not be relieved immediately after surgery-Monitor VS, urine output, dressing, any drainsJ.Osteoarthritis – most common type of arthritisProgressive degeneration of articular “joint” cartilage (DJD)Cause: genetics, occupational or sports activity, obesityClassic symptoms: Asymmetrical, morning stiffness, crepitus, decreased range of motion, pain with activityHeberden and Bouchard’s nodes or edema to the phalanges jointsTop Nursing Diagnoses: Acute/Chronic __pain_______(gradual onset) and Impaired Physical _mobility______________, Risk for FallTreatment: NSAIDSs, Steroids, Muscle relaxants, Ice or warm packs/soaks, topicalanalgesics (ex. Bengay, Lidocaine)May need walkers, canes, exercise programs such as walking and swimming, braces, K.Rheumatoid ArthritisChronic, inflammatory, systemic __autoimmune_____ disease. The body mistakes its own tissue as a foreign pathogen, turns on itself and starts destroying tissue. (antigen/antibody reaction)Morning stiffness, fatigue, edema, and possibly ___warmth_______ to the joints.
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- Fall '16
- Denise Cauble
- Nursing, Systemic lupus erythematosus