Adult Health 1 Study Guide

Musculoskeletal Unit

Chapters 39-42

Remember that assigned textbook readings should be supplemental to reviewing & studying the Powerpoint presentations. Answers to these study guide questions can be obtained from the textbook chapters, powerpoint presentations, as well as class lectures & in-class activities.

Chapter 38:

Know: Osteoarthritis (p. 1104-1106) 

· Risk factors

· Clinical manifestations

· Medical management

· Nursing care

Chapter 39: Assessment of Musculoskeletal Function

· Functions of this system are to support & protect the body, and foster movement of the extremities

· Musculoskeletal disorders and injuries directly affect the quality of life of individuals & are the leading cause of disability in the U.S.

· This chapter is meant as a review of the structures of the musculoskeletal system – know the basic structures and their functions – bones, joints, ligaments, tendons, muscles

· Health history – H&P:

o Address symptoms experienced (pain, altered sensation, limited ROM, etc.)

o Ability to perform ADLs and level of assistance needed

o Diet & exercise patterns

o Weight management

o Occupation

o Family history of disorders

o Posture

o Gait

o Balance

o Muscle size & strength

o Indicators of peripheral vascular dysfunction (Chart 39-3)

· Diagnostic tools: X-ray, CT, MRI, bone densitometry, bone scan, arthroscopy, EMG, biopsy

Chapter 40: Musculoskeletal Care Modalities

Know: External fixator devices, Joint replacements (knee & hip)

1. What is the most important nursing assessment when caring for a patient who is in a cast, splint, or brace?

2. Name 3 teaching points you would include in your education on cast care for your patient. See Chart 40-2.

3. What is compartment syndrome? How is it treated?

4. What are the “5 Ps” we want to monitor patients in casts for in order to prevent compartment syndrome?

5. When are external fixators utilized for patients?

6. Having an external fixator device puts the patient at a higher risk of what?

7. What are the patient goals of using traction for a fracture?

8. Why is proper alignment and freely hanging weights so important to maintain continuous skeletal traction?

9. Identify the proper positioning and movement restrictions needed for the operative extremity following a knee or hip arthroplasty. See Chart 40-7.

10. Name 5 potential complications that can result following a knee or hip arthroplasty.

Chapter 41: Management of Patients with Musculoskeletal Disorders

Know: Osteoporosis. OM

1. What are some risk factors for the development of osteoporosis? See Chart 41-7.

2. Name some health promotion activities to prevent osteoporosis that we should teach to patients. See Chart 41-5.

3. The biggest risk for patients with osteoporosis is that they are more prone to fractures. What are some nursing interventions & strategies we can do to help prevent falls & fractures in patients with this condition?

4. What are some nursing considerations to be mindful of when giving patients prescribed bisphosphonates as treatment for osteoporosis?

5. a. What is osteomyelitis?

b. What is the most prevalent causative agent?

c. What are some of the clinical manifestations of this condition?

d. What is the primary medical treatment that is prescribed to treat this condition?

e. What may be indicated if pharmacological management is not successful in treating this condition?

Chapter 42: Management of Patients with Musculoskeletal Trauma 

Know: Sprains, Fractures 

1. When caring for sprains, we teach nurses to utilize the ‘PRICE’ acronym. What does ‘PRICE’ stand for?

2. What are some of the clinical manifestations that are seen when a fracture is present?

3. What are the top 5 nursing priorities when caring for a patient with a fracture?

4. What is the difference between an open and closed fracture?

5. What are some symptoms of fat embolism? How is a fat embolism different from a DVT or PE?