Chapter 41 Musculoskeletal Care Modalities Copyright 2014 Wolters

  • Slides: 19
Download presentation
Chapter 41 Musculoskeletal Care Modalities Copyright © 2014 Wolters Kluwer Health | Lippincott Williams

Chapter 41 Musculoskeletal Care Modalities Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Splints and Braces • Contoured splints of plaster or pliable thermoplastic materials may be

Splints and Braces • Contoured splints of plaster or pliable thermoplastic materials may be used for conditions that do not require rigid immobilization, for those in which swelling may be anticipated, and for those who require special skin care. • Braces (i. e. , orthoses) are used to provide support, control movement, and prevent additional injury. They are custom fitted to various parts of the body. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Answer B. Rigid external immobilizing device molded to contours of body part A sling

Answer B. Rigid external immobilizing device molded to contours of body part A sling is a bandage used to support a body part. A cast is a rigid external immobilizing device molded to contours of a body part. A splint is a device designed specifically to support and immobilize a body part in a desired position. A brace is an externally applied device to support the body or a body part, control movement, and prevent injury. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question Is the following statement true or false? A patient’s unrelieved pain should be

Question Is the following statement true or false? A patient’s unrelieved pain should be reported to the physician 30 minutes after administered pain medication. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Answer False A patient’s unrelieved pain must be immediately reported to the physician to

Answer False A patient’s unrelieved pain must be immediately reported to the physician to avoid possible paralysis and necrosis. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Joint Replacements • Used to treat severe joint pain and disability and for repair

Joint Replacements • Used to treat severe joint pain and disability and for repair and management of joint fractures or joint necrosis • Frequently replaced joints include the hip, knee, and fingers • Joints including the shoulder, elbow, wrist, and ankle may also be replaced Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Needs of Patients With Hip or Knee Replacement Surgery • Mobility and ambulation –

Needs of Patients With Hip or Knee Replacement Surgery • Mobility and ambulation – Patients usually begin ambulation within 1 day after surgery using walker or crutches. – Weight bearing as prescribed by the physician • Drain use postoperatively – Assess for bleeding and fluid accumulation • Prevention of infection – Infection may occur in the immediate postoperative period (within 3 months), as a delayed infection (4– 24 months), or because of spread from another site (more than 2 years) • Prevention of DVT • Patient education and rehabilitation Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Hip Prosthesis • Positioning of the leg in abduction to prevent dislocation of the

Hip Prosthesis • Positioning of the leg in abduction to prevent dislocation of the prostheses • Do not flex hip more than 90 degrees • Avoid internal rotation • Protective positioning • Hip precautions Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Use of an Abduction Pillow to Prevent Hip Dislocation After Total Hip Replacement Copyright

Use of an Abduction Pillow to Prevent Hip Dislocation After Total Hip Replacement Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Knee Prostheses • Encourage active flexion exercises • Use of continuous passive motion (CPM)

Knee Prostheses • Encourage active flexion exercises • Use of continuous passive motion (CPM) device Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

CPM Device Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

CPM Device Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Nursing Process: The Care of the Patient Undergoing Orthopedic Surgery— Assessment, Preoperative • Routine

Nursing Process: The Care of the Patient Undergoing Orthopedic Surgery— Assessment, Preoperative • Routine preoperative assessment • Hydration status • Medication history • Possible infection – Ask specifically about colds, dental problems, urinary tract infections, infections within 2 weeks • Knowledge • Support and coping Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Nursing Process: The Care of the Patient Undergoing Orthopedic Surgery— Assessment, Postoperative • Pain

Nursing Process: The Care of the Patient Undergoing Orthopedic Surgery— Assessment, Postoperative • Pain • Vital signs, including respirations and breath sounds • LOC • Neurovascular status and tissue perfusion • Signs and symptoms of bleeding: wound drainage • Mobility and understanding of mobility restrictions • Bowel sounds and bowel elimination • Urinary output • Signs and symptoms of complications: DVT or infection Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Nursing Process: The Care of the Patient Undergoing Orthopedic Surgery— Diagnoses • Acute pain

Nursing Process: The Care of the Patient Undergoing Orthopedic Surgery— Diagnoses • Acute pain • Risk for peripheral neurovascular dysfunction • Risk for ineffective therapeutic regimen management • Impaired physical mobility • Risk for situational low self-esteem and disturbed body image Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Collaborative Problems and Potential Complications—Postoperative • Hypovolemic shock • Atelectasis • Pneumonia • Urinary

Collaborative Problems and Potential Complications—Postoperative • Hypovolemic shock • Atelectasis • Pneumonia • Urinary retention • Infection • Thromboembolism: DVT or PE • Constipation or fecal impaction Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Nursing Process: The Care of the Patient Undergoing Orthopedic Surgery—Planning • Major goals before

Nursing Process: The Care of the Patient Undergoing Orthopedic Surgery—Planning • Major goals before and after surgery may include the relief of pain, adequate neurovascular function, health promotion, improved mobility, and positive self-esteem. • Postoperative goals include the absence of complications. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Relief of Pain • Administration of medications – Patient-controlled analgesia (PCA) – Other medications

Relief of Pain • Administration of medications – Patient-controlled analgesia (PCA) – Other medications – Medicate before planned activity and ambulation • Use alternative methods of pain relief – Repositioning, distraction, guided imagery • Specific individualized strategies to control pain – Use of ice or cold – Elevation – Immobilization Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Nursing Process: The Care of the Patient Undergoing Orthopedic Surgery— Interventions • Muscle setting;

Nursing Process: The Care of the Patient Undergoing Orthopedic Surgery— Interventions • Muscle setting; ankle and calf-pumping exercises • Measures to ensure adequate nutrition and hydration Note: Large amounts of milk should not be given to orthopedic patients on bed rest • Skin care measures, including frequent turning and positioning • Follow physical therapy and rehabilitation programs • Encourage the patient to set realistic goals and perform self-care within limits of therapeutic regimen Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Nursing Process: The Care of the Patient in Traction—Interventions • Preventing atelectasis and pneumonia

Nursing Process: The Care of the Patient in Traction—Interventions • Preventing atelectasis and pneumonia – Encourage coughing and deep breathing exercises – Use of incentive spirometry • Constipation – Monitoring of bowel function – Hydration – Early mobilization – Stool softeners • Patient education Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Chapter 67 Musculoskeletal Care Modalities Copyright 2010 WoltersChapter 67 Musculoskeletal Care Modalities Copyright 2010 Wolters
Chapter 21 Musculoskeletal System Musculoskeletal System The musculoskeletalChapter 21 Musculoskeletal System Musculoskeletal System The musculoskeletal
Musculoskeletal System Overview of musculoskeletal system Musculoskeletal ofMusculoskeletal System Overview of musculoskeletal system Musculoskeletal of
Chapter 12 Therapeutic Modalities Copyright 2013 Wolters KluwerChapter 12 Therapeutic Modalities Copyright 2013 Wolters Kluwer
Chapter 29 Musculoskeletal Care 29 Musculoskeletal Care ObjectivesChapter 29 Musculoskeletal Care 29 Musculoskeletal Care Objectives
Chapter 67 Musculoskeletal Care Modalities 1 Cast AChapter 67 Musculoskeletal Care Modalities 1 Cast A
Chapter 12 Therapeutic Physical Modalities Therapeutic Modalities TheseChapter 12 Therapeutic Physical Modalities Therapeutic Modalities These
Chapter 15 Therapeutic Modalities Therapeutic Modalities n InChapter 15 Therapeutic Modalities Therapeutic Modalities n In
Chapter 15 Therapeutic Modalities Therapeutic modalities can beChapter 15 Therapeutic Modalities Therapeutic modalities can be
Chapter 17 Therapeutic Modalities Therapeutic Modalities Various methodsChapter 17 Therapeutic Modalities Therapeutic Modalities Various methods
Chapter 12 Therapeutic Physical Modalities Therapeutic Modalities TheseChapter 12 Therapeutic Physical Modalities Therapeutic Modalities These
Chapter 3 Musculoskeletal System Copyright 2018 Wolters KluwerChapter 3 Musculoskeletal System Copyright 2018 Wolters Kluwer
Mechanical Modalities Therapeutic Modalities in Athletic Rehabilitation MechanicalMechanical Modalities Therapeutic Modalities in Athletic Rehabilitation Mechanical
Athletic Training Modalities 2 Modalities Thermotherapy Types ofAthletic Training Modalities 2 Modalities Thermotherapy Types of
Multimodal Interaction Modalities vs Media Modalities are waysMultimodal Interaction Modalities vs Media Modalities are ways
Introduction 22 Comparison of Modalities Review Modalities XrayIntroduction 22 Comparison of Modalities Review Modalities Xray
Modalities are Fun Sports Med 2 Therapeutic ModalitiesModalities are Fun Sports Med 2 Therapeutic Modalities
Athletic Training Modalities Modalities Objectives Legal ramifications ofAthletic Training Modalities Modalities Objectives Legal ramifications of