Professional Documents
Culture Documents
SYSTEM
4.
Assess the effectiveness of pain
measures
Nursing Management
IMPAIRED PHYSICAL MOBILITY
1. Instruct patient to perform range of motion
exercises, either passive or active
2. Provide support in ambulation with
assistive devices
3. Turn and change position every 2 hours
4. Encourage mobility for a short period and
provide positive reinforcements for small
accomplishments
Nursing Management
SELF-CARE DEFICITS
1. Assess functional levels of the patient
2. Provide support for feeding problems
Place patient in Fowler’s position
Provide assistive device and supervise
mealtime
Offer finger foods that can be handled by
patient
Keep suction equipment ready
Nursing Management
SELF-CARE DEFICITS
3. Assist patient with difficulty bathing
and hygiene
Assist with bath only when patient has
difficulty
Provide ample time for patient to finish
activity
Musculoskeletal Modalities
Traction
Cast
Nursing Management
Traction
A method of fracture immobilization by
applying equipments to align bone
fragments
Used for immobilization, bone alignment
and relief of muscle spasm
Traction
Skin traction
Skeletal traction
Traction
Pulling
force exerted on bones to
reduce or immobilize fractures,
reduce muscle spasm, correct or
prevent deformities
Nursing Management
Traction: General principles
1. ALWAYS ensure that the weights hang
freely and do not touch the floor
2. NEVER remove the weights
3. Maintain proper body alignment
4. Ensure that the pulleys and ropes are
properly functioning and fastened by tying
square knot
Nursing Management
Traction: General principles
5. Observe and prevent foot drop
Provide foot plate
6. Observe for DVT, skin irritation and
breakdown
7. Provide pin care for clients in skeletal
traction- use of hydrogen peroxide
Nursing Management
CAST
Immobilizing tool made of plaster of
Paris or fiberglass
Provides immobilization of the fracture
Nursing Management
CAST: types
1. Long arm
2. Short arm
3. Spica
Casting Materials
Plaster of Paris
Drying takes 1-3 days
If dry, it is SHINY, WHITE, hard and
resistant
Fiberglass
Lightweight and dries in 20-30 minutes
Water resistant
Nursing Management
CAST: General Nursing Care
1. Allow the cast to dry (usually 24-72
hours)
2. Handle a wet cast with the
PALMS not the fingertips
3. Keep the casted extremity
ELEVATED using a pillow
4. Turn the extremity for equal
drying. DO NOT USE DRYER for
plaster cast
Nursing Management
CAST: General Nursing Care
5. Petal the edges of the cast to
prevent crumbling of the edges
6. Examine the skin for
pressure areas and Regularly
check the pulses and skin
Nursing Management
CAST: General Nursing Care
7. Instruct the patient not to
place sticks or small objects
inside the cast
8. Monitor for the following: pain,
swelling, discoloration, coolness,
tingling or lack of sensation and
diminished pulses
Common Musculoskeletal
conditions
Nursing management
METABOLIC BONE
DISORDERS
Osteoporosis
A disease of the bone characterized by
a decrease in the bone mass and
density with a change in bone structure
METABOLIC BONE
DISORDERS
Osteoporosis: Pathophysiology
Normal homeostatic bone turnover is
altered rate of bone RESORPTION is
greater than bone FORMATION
reduction in total bone mass
reduction in bone mineral density
prone to FRACTURE
METABOLIC BONE
DISORDERS
Osteoporosis: TYPES
1. Primary Osteoporosis- advanced
age, post-menopausal
2. Secondary osteoporosis- Steroid
overuse, Renal failure
METABOLIC BONE
DISORDERS
RISK factors for the development of
Osteoporosis
1. Sedentary lifestyle
2. Age
3. Diet- caffeine, alcohol, low Ca and Vit D
4. Post-menopausal
5. Genetics- caucasian and asian
6. Immobility
METABOLIC DISORDER
ASSESSMENT FINDINGS
1. Low stature
2. Fracture
Femur
3. Bone pain
METABOLIC DISORDER
LABORATORY FINDINGS
1. DEXA-scan
Provides information about bone mineral
density
T-score is at least 2.5 SD below the young
adult mean value
2. X-ray studies
METABOLIC DISORDER
Medical management of Osteoporosis
1. Diet therapy with calcium and Vitamin D
2. Hormone replacement therapy
3. Biphosphonates- Alendronate, risedronate
produce increased bone mass by inhibiting
the OSTEOCLAST
4. Moderate weight bearing exercises
5. Management of fractures
METABOLIC DISORDER
Osteoporosis Nursing Interventions
1. Promote understanding of osteoporosis and
the treatment regimen
Provide adequate dietary supplement of
calcium and vitamin D
Instruct to employ a regular program of
moderate exercises and physical activity
Manage the constipating side-effect of
calcium supplements
METABOLIC DISORDER
Osteoporosis Nursing Interventions
Take calcium supplements with meals
Take alendronate with an EMPTY
stomach with water
Instruct on intake of Hormonal
replacement
METABOLIC DISORDER
Osteoporosis Nursing Interventions
2. Relieve the pain
Instruct the patient to rest on a firm
mattress
Suggest that knee flexion will cause
relaxation of back muscles
Heat application may provide comfort
Encourage good posture and body
mechanics
Instruct to avoid twisting and heavy lifting
METABOLIC DISORDER
Osteoporosis Nursing Interventions
3. Improve bowel elimination
Constipation is a problem of calcium
supplements and immobility
Advise intake of HIGH fiber diet and
increased fluids
METABOLIC DISORDER
Osteoporosis Nursing Interventions
4. Prevent injury
Instruct to use isometric exercise to
strengthen the trunk muscles
AVOID sudden jarring, bending and
strenuous lifting
Provide a safe environment
Juvenile rheumatoid Arthritis
Definition:
AUTO-IMMUNE inflammatory joint disorder
of UNKNOWN cause
SYSTEMIC chronic disorder of connective
tissue
Topical analgesics