Rotator cuff tear
THE PATIENT WILL NOT BE ABLE TO EXTERNALLY ROTATE THE SHOULDER,OR PERFORM ABDUCTION
MANAGEMENT OF ROTATOR CUFF TEAR
REST,SLING IF ORDERED,ANTI INFLAMMATORY THERAPY
ACL INJURY
pop, rapid swelling,instability (give out), limited extension
How do you diagnose acl injury
mri,Arthroscopy is performed at which time the repair may be done.Grafting may be done if there is complete tearing
How do you manage an acl injury?
brace, pain/swelling control, rehabilitation plan
Exercise for Acl injury
Isometric exercises are prescribed in the recovery period including quadriceps bent knee exercises and foot exercises
A long leg brace with fixed knee flexion may be used
meniscal injury
JOint. pain, catching, locking , clickking
Management for meniscal injury
pain swelling control,physical therapy as order Arthroscopy may repair or trim tear
Achilles tendon rupture
sudden, posterior ankle/calf pain; cannot stand on toes
Bursitis
THE SACLIKE STRUCTURES THAT LINE FREELY MOVEABLE JOINTS FROM OVER USE OR PRESSURE
WHEN YOU HAVE BURSITIS WHAT HURTS
LOCALIZED PAIN, SWELLING AND TENDERNESS
MANAGEMENT FOR BURSITIS
REST,ICE, ACTIVITY MODIFICATION,
ANTI INFLAMMATORY THERAPY, INJECTIONS MAY BE CONSIDERED
BUNION THE COMMON FOOT PROBLEM
PAINFUL SWELLING OF THE BURSA THAT OCCURS IN THE GREAT TOE, AT THE METATARSAL JOINT,
WHAT CAN CAUSE PEOPLE TO GET BUNIONS?
HEREDITARY, FOOTWEAR THAT COMPRESSES TOES
HOW DO YOU MANAGE HAVIG BUNIONS
WIDER SHOES, PADDING, PAIN CONTROL
IF BUNION SUPER BADDDDD
YOU WILL GET SURGERY WHEN PAIN AND FUNCTION IMPAIRMENT ARE SIGNIFICANT
CARPAL TUNNEL SYNDROME
COMPRESSION OF THE MEDIAN NERVE AS IT PASSES THROUGH THE CARPAL TUNNEL IN WRIST
WHAT ARE SIGNS OF CARPAL TUNNEL SYNDROME
PAIN TINGLING OFTEN AT NIGHT
HOW DO YOU DIAGNOSE CARPAL TUNNEL SYNDROME
PHYSICAL EXAMINATION, COMPRESSION TEST, ELECTROMYOGRAPHY .
HOW DO YOU MANAGE CARPAL TUNNEL
SPLINT IN NEUTRAL , ACTIVITY MODIFICATION, INJECTION OR SURGER IF IT IS SEVERE
WHAT ARE CAUSES OF FRACTURES
TRAUMA,BONE WEAKNESS, EX OSTEOPOROSIS
WHAT IS A FRACTURE
IT IS A BREAK
WHAT. HAPPENS TO THE BODY WITH A FRACTURE
TISSUE INJURY,BLEEDING,POSSIBLE PERFUSION COMPROMISE
WHat are risk factors to hurting your achilles tendon
Diabetes, inflammatory disease,Medications like (Cipro) SIde effect can cause tendonitis
Management of Achilles tendon Rupture
immobilization, or surgery followed by casting, rehabilitation after (6to8 weeks)
HOW THE YOU FRACTURE WITH INTERNAL FIXATION
PINS, NAILS, OR METAL PLATES TO STABALIZE THE POSITION OF THE TWO BROKEN ENDS, OPEN REDUCTION AND INTERNAL FIXATION,IV ANTIBIOTICS AND RISK FOR INFECTION IS STANDARD
NURSING CARE FOR INTERNAL FIXATION
maintain good alignment of effected leg, prevent complications of immobility
control pain
Fractures with external Fixation
Massive open fractures with extensive soft -tissue damage, infected fractures that do not heal properly
Examples of external fixation fracture examples
MUltiple traumas such as burns,chest injury, or head injury.
footdrop
peroneal nerve damage
unable to dorsiflex foot
What happens in time with osteoarthritis
The joints become thickend and withstand weight poorly causing more damage to the cartilage
What do people with osteoarthritis produce less off
They produce less collagen to strengthin and protect joints
What are risk factors for osteoarthritis
Heredity, aging, female gender, obesity, previous joint injury and recreational occupational usage
What is osteoarthritis etiology
non inflammatory degenerative joint disease that can affect any weight bearing joint
What are causes of footdrop
improper positioning , prolonged immobility pressure
what can prevent footdrop
footboard, proper alignment, rom exerciss
osteoarthritis with pain
Asymmetrical degenerative joint disease cartilage break down in the joints
pain pain worse with use; brief stiffness after inactivity, joint deformity
What is management for osteoarthritis ?
pacing, strengthening, low impact exercise, weight management; heat/cold/ analgesics as ordered
what can you do for pain with osteoarthritis
give them salicylates, asparin, or nsaid ibrophen
What happens with Rheumatoid arthritis
Symmetric joint swelling and warmth, Autoimmune inflammatory joint disease with systemic effect and prolonged morning stiffness and fatigue
What is the nurse goal with rheumatoid arthritis
Reduce inflammation and preserve function
How does the nurse care for a patient with rheumatoid arthritis
balance rest and exercise aimed at pain relief, heat/cold applications; splints during flare ups, monitor medication ordered
what should you teach with rheumatoid arthritis
Teach infection precautions with immunosuppressive therapy
what are the first line of meds for rheumatoid arthritis
IBUPROfen ,salicylaytes,costeroids
long term steroid use with rheumatoid arthritis
Long term effects diminish over time requiring increase of the dose to obtain the same results which leads to increase risk of diabetes mellitus, osteoporosis, hypertension, acne, cataracts and weight gain
diagnostics for osteoporosis
xray, dexascan and reported is the t score
signs and symptoms of lyme disease
flu like
bull eye rash
pain and stiffness in joints and muscles 1-2 weeks
lyme disease
bite of a deer tick, spiroche,
nursing management for osteoporosis
Teach the benefits of a healthy lifestyle, need for calcium supplements, and weight bearing exercise
foods you. should eat with osteoporosis
Diary products are the best source of calcium, cheese, yogurt, sardines anchoives are also sources of calcium
goals for osteoporosis
stop bone density loss, increase formation, prevent fractures, estrogen replacement therapy, adequate dietary and supplemetal calcium and vitamin d
what to monitor with medications and osteoporosis
bisphosphonate take with water; remain upright, report swallowing pain or severe heartburn
t score< -2.5
osteoporosis
t score -1.0 to -2.5
osteopenia
How do you manage osteoporis
exercise vitamin d and fall prevention
WHats osteoporosis
decreased bone density which increases the fracture risk
If an elderly patient has gout
and their creatine clearance should not take allopurinol
if you have gout you should stay away from what ?
High purine foods and increase fluid intake to 2000 to 3000cc
signs and symtoms of gout
Tight redden skin over an inflamed, edematous joint accompanied by elevated temperature and extreme pain the joint
Patient teaching with gout
hydration, diet changes, limit alcohol
gout
sudden sever pain, swelling, redness often the great toe
treatment for lyme disease
oral antibiotics doxycline,ceforime if treated 2 to 12 weeks later can lead to stage 2 carditis meningitis,peripheral neuritis
paget disease and bone tumors
abnormal remodelig (weakbones) pain and fracture risk , bone tuors pain swelling and warmth
diagnostics for pagets disease
xray, usually diagnosed and the time of fracture
24 hour urine presence of hydroxyproline prescence indicates osteoclastic activity
nursing management for paget disease
firm mattress may relieve back pain,light brace or corset, avoid lifting and twisting proper body mechanics
safety focus for total hip replacement
its ok to lay on your operated side for 3 months, you should not cross your legs put a pillow between legs when rolling over or lie on your side you can bend hip but not beyond a 93 angle avoid sittiing in low chairs
treatment pajet end get disease
surgery,radiation,chomotherapy
total hip replacement safety focus
Weight bearing status determined by surgeon may be non weight bearing or 25 and up full weight bearing or 25 percent dependent on prothesis use
joint replacement post opp joint replacement
heparin to prevent dvt,may or maynot be weight bearing
whats the primary reason for joint replacemnt
Is to relieve the chronic pain
Total joint replacement
neurovascular checks and pain control
early mobility per order , (atelectasis)- means fluid in ungs