INTRODUCTION
• The musculoskeletal system allows humans to interact with the surrounding environment through the movement or motion.
• It is based on four elements:
• Bones
• • Joints Muscles Nerves
• The locomotor system is not independent or autonomous, is an integrated with various systems, for example, with the nervous system for the generation and modulation of motor commands. This system consists of the structures responsible for supporting and lead the movements of the body and are two systems.
A) System Bone is the passive element is formed by the bones, cartilage and ligaments.
B) Muscular System: Formed by the muscles to be united by bone to shrink causing the movement of the body. System
Bone
Bone is a strong body, hard and tough which is part of the skeleton of vertebrates. Is mainly composed of bone tissue, a specialized type of connective tissue consisting of cells, and calcified extracellular components.
The adult human body consists of approximately 206 bones, which are rigid and serve to protect the soft organs of our body. Bones are made mostly by calcium, and in turn help to balance it (homeostasis). A joint
in anatomy is the contact point between two bones of the body. It is important to classify the different types of joints according to the tissue that connects in fibrous, cartilaginous, synovial or diartrodias. The human body has different types of joints such as synarthrosis (not mobile), symphysis (single-axis motion) and synovial (greater breadth and complexity of motion).
skeletal features:
• Hold the body allowing this to remain upright.
• Helps movements, along with the muscles and joints. • Da projection
internal organs and tissues
• Bone mineral reserves remain.
• Participate in hematopoiesis or blood cell formation in bone marrow.
muscular system
• Muscle is becoming one of the contractile organs of the human body and other animals, made up of muscle tissue. The muscles are intimately connected well with the skeletal-muscle skeletal-or part of the structure of various organs and systems-visceral muscles.
• The structural and functional unit of muscle is the muscle fiber.
The muscles are divided into:
• striated muscle: striated in nature and voluntary control. Form the skeletal muscles of the body or voluntary muscles.
• striated muscle: striated in nature and voluntary control. Form the skeletal muscles of the body or voluntary muscles.
• Smooth muscle: contains no streaks and is controlled involuntarily. Muscles form the walls of the digestive, urinary, blood vessels and uterus: involuntary or visceral muscles.
• cardiac muscle: striated in nature and control involuntary. Present only in the heart.
The human body consists of approximately 40% of skeletal muscle and 10% of heart muscle and visceral.
• Ligaments are structures to hold the bones together with each other and stabilize the joints.
• They are long strips of dense connective tissue and fibrous, tough, composed mainly of collagen type I.
• Nerves are extensions of the central nervous system.
• Skeletal muscles are primarily governed by the spinal nerves.
LOCOMOTOR SYSTEM ASSESSMENT:
• musculoskeletal assessment can focus on a specific part of the body or can be made as part of a general physical examination.
• The most common symptoms that we find can be pain, weakness, deformity, stiffness and limited movement, crepitus of the joint. • Background morbid
previous.
• Medications you are using. Previous surgeries
•
Supplementary examinations:
• muscle strength tests
• X-Ray • MRI
• Arthroscopy
• arthrocentesis and synovial fluid analysis.
• muscle enzymes. Serological studies
• MAJOR CHANGES
LOCOMOTOR
Sprains:
• A sprain is an injury to the ligaments around a joint. Ligaments are strong, flexible fibers that hold bones together when they are stretched too far or tears, the painful and inflamed joint. Causes
• Discoloration of the skin, especially bruising
• Joint stiffness
First Aid.
ü Apply ice immediately to help reduce swelling, wrap the ice in a cloth and avoid applying it directly on the skin. Ü
DO NOT try to move the area. To help do this, place a firm but not tight bandage over the affected area. The bandages work well for this purpose. If necessary, use a splint.
ü Keep the swollen joint elevated above heart level, including the time at night when going to sleep. Ü
Rest the affected joint for several days. Ü
Aspirin, ibuprofen and other pain medications may help, but DO NOT give aspirin to children.
ü Do not apply pressure to the affected area until the pain subsides (usually 7 to 10 days for mild sprains and 3 to 5 weeks for severe sprains) and the person may require the use of crutches to walk. Rehabilitation to regain motion and strength of the joint should begin within a week.
Keep in mind that attention is required when:
• You suspect a broken bone
• The joint appears deformed
• You have a severe injury or severe pain
• Presents an audible popping sound and immediate difficulty using the joint
• Inflammation is not reduced in two days.
• You have signs of infection: the area becomes redder, hot, it hurts more or fever above 100 degrees F (37.7 º C).
• The pain does not disappear after several weeks. Prevention
• Wear protective footwear for activities that place stress on the ankle and other joints.
• Make sure that shoes fit your feet properly.
• Avoid high-heeled shoes.
• Always warm up and stretch before exercising or playing sports.
• Avoid sports and activities for which you are not well trained.
Minor injuries like sprains may treated at home if there are suspected bone fractures. The acronym RICE is helpful in remembering how to treat minor injuries: rest, ice, compression and elevation (RICE, for its acronym in English). Pain and swelling should decrease within 48 hours and gentle movement may be beneficial, but pressure should not be applied in a sprained joint until pain is completely gone (one to several weeks).
The ankle joint connects the foot with the leg and allows the foot to move up and down and in a move inward and outward. Muscles, tendons and ligaments that surround the ankle providing the stability the ankle joint needs for walking and running.
The most common way the ankle can be injured is by a sprain, and when this occurs, the ankle ligaments are stretched or torn partially or completely. The most common type of sprain is an inversion injury, where the foot is rotated inward. Ankle sprains can range from mild to moderate and severe.
The Type I ankle sprain is mild and occurs when you have had at least a stretch or tear the ligaments.
The Type II ankle sprain is a moderate level occurs when some the fibers of the ligaments are torn completely
ankle sprain type III is the most severe and occurs when the entire ligament is torn and shows great instability in the ankle joint.
The Type II ankle sprain is a moderate level occurs when some the fibers of the ligaments are torn completely
ankle sprain type III is the most severe and occurs when the entire ligament is torn and shows great instability in the ankle joint.
Fractures:
• Applying more pressure on a bone than it can stand, it will split or break. A break of any size is called a fracture and if the broken bone punctures the skin, called an open fracture (compound fracture).
• The overload stress fracture is a hairline crack in the bone that develops because of prolonged or repetitive force on it. General considerations
• Applying more pressure on a bone than it can stand, it will split or break. A break of any size is called a fracture and if the broken bone punctures the skin, called an open fracture (compound fracture).
• The overload stress fracture is a hairline crack in the bone that develops because of prolonged or repetitive force on it. General considerations
• It is hard to tell a dislocated bone from a broken, but both are emergency situations and basic first aid measures are the same. Causes
• The following are common causes of broken bones:
• Fall from a height
• Car accidents • Direct blow
• Child abuse • Repetitive forces, such as those that occur when a person running, can cause stress fractures in the feet, ankles, tibia or hip symptoms
§ Tip or joint visibly out of place or deformed
• Limited movement or inability to move a limb
• Swelling, bruising or bleeding, severe pain
• • Numbness and tingling
• Broken skin with bone protruding
First Aid:
should examine the airways and breathing of the victim.
should keep the person still and calm.
• It needs to carefully watch the victim to detect other injury.
• In most cases, if medical help responds quickly, allow medical personnel take the necessary measures.
• If the skin is broken, it must be treated immediately to prevent infection. Do not breathe on the wound or probe it, if possible, lightly rinse to remove visible dirt or other pollutants, taking care not to rub too hard or flush. Be covered with sterile dressings.
• If necessary, the injury must be splinted or sling. Among the possible elements of splints include a rolled up newspaper or strips of wood. Immobilize the area both above and below the injured bone.
• You can apply ice packs to reduce pain and swelling.
• You should try to prevent shock. Lay the person flat, elevate the feet about 12 inches (30 centimeters) and covered with a coat or blanket, but DO NOT move if you suspect a head injury, back or legs.
CHECK BLOOD CIRCULATION:
• You must verify the person's blood circulation and press hard on the skin that lies beyond the fracture site. For example, if the fracture presented in a leg, press on the foot, the skin should first blanch white and then "pink up" in about two seconds. Other signs that circulation is inadequate include pale or blue skin, numbness and tingling and loss of pulse. If circulation is poor and there are no trained personnel quickly, try to realign the limb into a normal resting position. This will reduce swelling, pain or tissue damage due to lack of blood.
TREAT BLEEDING
• It is recommended to cover the wound with a clean cloth and dry.
• If of continued bleeding, apply direct pressure to the site. DO NOT apply a tourniquet to the extremity to stop the bleeding unless it is a life-threatening situation.
• DO NOT move the person unless the broken bone is stable.
• DO NOT move a person with an injured hip, pelvis or upper leg unless it is absolutely necessary. If you must move the victim, you must drag them to safety by his clothes (for the shoulders of the shirt, belt or pants).
• DO NOT move a person who has a possible spine injury.
• NO Attempt to straighten a misshapen bone or joint or to change its position unless blood circulation appears hampered.
• DO NOT try to reposition a suspected spine injury.
• DO NOT test a bone's ability to move.
a situation is considered serious if:
• There is a suspected broken bone in the head, neck or back.
• There is a suspected broken bone in the hip, pelvis or upper leg.
• A bleeding
• The area below the injured joint is pale, cold, clammy or bluish.
• You can not immobilize the injury completely into the scene without assistance from another person.
• There is a bone through the skin.
• Although it is possible that other fractures are not emergencies, they still deserve medical attention, therefore, call your doctor to find out where and when.
• If a child refuses to put weight on an arm or leg after an accident, not moving the arm or leg, or deformity can be seen clearly, assume that the child has a broken bone and Get medical help.
Prevention
• The should wear protective gear while skiing, cycling, skating and participating in contact sports. This includes helmet, elbow pads, knee pads and shin guards.
• You must create a safe environment for young children, such as placing gates on stairways and keep windows closed.
• Teaching safety measures and help children learn how to care for themselves.
• Supervise children closely. No matter how safe it may seem, the environment or situation, there is no substitute for supervision.
• Avoid falls by not standing on chairs, desks or other unstable objects and remove small rugs and electrical cords from floor surfaces. Use handrails on staircases and non-skid mats in bathtubs. These measures are especially important for older people.
Types of fractures:
Among the various types of bone fracture include:
Oblique - a fracture of the shaft angle
Comminuted - a fracture of many relatively small fragments
Spiral - a fracture of the bone around the shaft or open
Compound - a fracture that breaks the skin
Among the types of bone fracture, there are:
En tallo verde - fractura incompleta en la que el hueso se dobla
Transversa - fractura que atraviesa el axis del hueso
Simple - fractura que no perfora la piel
•Se puede utilizar un dispositivo de fijación externa para mantener huesos fracturados fijos y alineados. Dicho aparato puede ajustarse externamente para asegurar que los huesos permanezcan en posición óptima durante el proceso de consolidación. El dispositivo de este tipo por lo general se utiliza en niños y cuando la piel sobre la fractura ha sufrido daños.
•Se puede utilizar un dispositivo de fijación interna para mantener los huesos fracturados estabilizados y alineados. Este aparato se inserta quirúrgicamente para asegurar The bones remain in an optimal position during and after consolidation.
• Arthritis is an inflammation of one or more joints that causes pain, swelling and limited movement.
Causes and risk factors
Arthritis involves the breakdown of cartilage, which normally protects the joint, allowing for smooth movement. Cartilage also absorbs shock when pressure is exerted on the joint, like when you walk. Without the usual amount of cartilage, bones rub together, causing pain, swelling (inflammation) and stiffness.
joint inflammation can occur for various reasons, including:
- Bone fracture
- Infection (usually caused by bacteria or viruses)
- An autoimmune disease that occurs when the body attacks itself because the immune system believes a body part is foreign.
- "wear and tear" on joints.
Often, the inflammation goes away after the injury has healed, the disease has been treated or after the infection has been eliminated.
With some injuries and diseases inflammation does not go away or destruction results in long-term pain and deformity, which is considered chronic arthritis. Osteoarthritis is the most common and is likely to occur more frequently as people age. You can feel in any joint but most commonly occurs in the hips, knees and fingers.
Risk factors for osteoarthritis include:
- Being overweight
- Previously injuring the affected joint
- Using the affected joint in a repetitive action that puts stress on it (the baseball players ballet dancers and construction workers are all at risk)
- Arthritis can occur in men and women of all ages.
Osteoarthritis is a chronic disease of the cartilage and bone of joints and is thought to be the result of wear and tear on them, although there are other causes such as congenital defects, trauma and metabolic disorders. Joints appear larger, are stiff and pain that increases as they are used during the day.
Other types or causes of arthritis include:
• rheumatoid arthritis (adults)
• Arthritis JRA (children)
• Lupus erythematosus (SLE) Gout
• • •
Scleroderma Psoriatic arthritis Ankylosing spondylitis
• • Reiter syndrome (reactive arthritis)
• Adult Still's disease Viral arthritis
• • gonococcal arthritis
• Other bacterial infections (non-gonococcal bacterial arthritis)
• Tertiary Lyme disease (the late stage) Tuberculous arthritis
• • Fungal infections such as blastomycosis symptoms
The
arthritis patients may experience the following symptoms:
• Joint pain Joint swelling
• • Stiffness, especially in the morning
• Warmth around a joint
• Redness of the skin around a joint
• Decreased ability to move
joint • Osteoarthritis is associated with the aging process and can affect any joint. The affected joint cartilage gradually wears away and the bone ends to rub against bone. Bony spurs develop on the unprotected bones causing pain and inflammation.
• The effects of rheumatoid arthritis can progress to the point of being disabling. Deformities distinctive to late-stage disease, such as ulnar deviation (ulnar) of the bones of the hands, or swan-neck deviation, due to which bones are not aligned because the muscles and tendons on one side joint dominate the other side.
Signs and tests
• You develop a detailed medical history to see if arthritis or another musculoskeletal problem is the likely cause of symptoms.
• After a thorough physical examination may show an accumulation of fluid around the joint (called a "stroke"). The joint may be tender when gently pressed, and can be warm and red, which is more typical in infectious arthritis and autoimmune arthritis. It may be painful or difficult to rotate the joints in some directions, which is known as "limited range of motion."
• In some autoimmune forms of arthritis, the joints may become deformed if the disease is not treated, these deformities are the hallmarks of severe rheumatoid arthritis that has not been addressed.
• The tests vary according to the suspected cause, and often include blood tests and radiographs of joints. To check for infection and other causes of arthritis (like gout caused by crystals), fluid is removed from the joint with a needle and examined under a microscope. For more information, see specific types of arthritis. Treatment
• Treatment of arthritis depends on the particular cause, the severity of the disease, the affected joints and how the condition affects daily activities. In addition, age and occupation are also taken into account when the doctor works together with the patient to develop a treatment plan.
• If possible, treatment can focus on eliminating the underlying cause of arthritis. However, usually the cause is not necessarily curable, as with osteoarthritis and rheumatoid arthritis, therefore, treatment is aimed at reducing pain and discomfort and preventing further disability.
• You can dramatically improve symptoms of osteoarthritis and other types of arthritis without the use of drugs. In fact, making changes in lifestyle without the use of medications is preferable for osteoarthritis and other forms of joint inflammation. If needed, medications should be used in addition to changes in lifestyle.
• The Exercise for arthritis is necessary to maintain healthy joints, relieve stiffness, reduce pain and fatigue, and improve muscle and bone strength. The exercise program must be designed individually for each person and is recommended to work with a physical therapist to design an individualized program, which should include:
• Range of motion exercises for flexibility
• Strength training for
muscle tone • low-impact aerobic activity (also called resistance training)
• A physical therapist can apply heat and cold treatments to the extent necessary and prepare the person for splints or orthotic (straightening) devices to support and align joints, which may be particularly necessary for rheumatoid arthritis. The physical therapist may also consider water therapy, ice massage or transcutaneous nerve stimulation (TENS, for its acronym in English).
• Rest is as important as exercise. In fact, sleep for 8 to 10 hours each night and taking naps during the day can help people recover more quickly from a flare-up and may even help prevent the worsening of it.
Also, you must:
• Avoid positions or movements that place extra stress on joints affected.
• Avoid holding one position for too long.
• Reduce stress can worsen symptoms. You can try meditation or guided imagery. You may also talk to the therapist about yoga or tai chi.
• Make home modifications to facilitate the activities, for example, where rods have taken in the bathroom, tub or near the toilet.
Other steps you can try are:
• Taking glucosamine and chondroitin, as they are the building blocks of cartilage, the substance that lines the joints. These supplements are available in health food stores or supermarkets. Preliminary studies indicate that these compounds are safe and may improve symptoms of arthritis. Are currently conducting further investigations.
• Eat a diet rich in vitamins and minerals (especially antioxidants like vitamin E) found in fruits and vegetables. The sources of selenium include brewer's yeast, wheat germ, garlic, whole grains, sunflower seeds and Brazil nuts, while the omega-3 fatty acids obtained from cold water fish (salmon, mackerel and herring) flaxseed, rapeseed (canola), soybeans, soybean oil, pumpkin seed and walnuts.
• Apply capsaicin cream (derived from chili peppers) on the surface of the skin over painful joints. The improvement can be felt after applying the cream for 3 to 7 days.
• For treatment of arthritis using different drugs within these include:
• Acetaminophen (Tylenol) recommended by the American College of Rheumatology (American College of Rheumatology) and the American Geriatrics Society (American Geriatrics Society) as the first line of treatment for osteoarthritis. It Take up to 4 grams per day (2 extra-strength Tylenol every 6 hours), which can provide significant relief of arthritis pain without many of the side effects of prescription drugs. However, DO NOT exceed the recommended doses of acetaminophen or take the drug in combination with large amounts of alcohol, which can damage liver.
• Aspirin, ibuprofen or naproxen: noesteroides these anti-inflammatory drugs (NSAIDs) are often effective in combating arthritis pain. However, they have potential risks, especially if used for an extended period, so that should not be taken in any amount without consulting doctor. Potential side effects include heart attack, stroke, stomach ulcers, digestive tract bleeding and kidney damage. In April 2005, the FDA asked manufacturers of NSAIDs to include a warning label on their product that alerts users of an increased risk of heart attack, stroke and gastrointestinal bleeding. Patients with kidney or liver disease or a history of gastrointestinal bleeding should not take these medicines unless your doctor specifically recommends them.
• Prescription drugs include:
• inhibitors of cyclo-oxygenase 2 (COX-2): These drugs block an inflammation-promoting enzyme called COX-2. Initially it was believed that these drugs work as well as traditional NSAIDs, but with fewer stomach problems. However, numerous reports of heart attacks and stroke have prompted the FDA to reevaluate the risks and benefits of COX-2. Rofecoxib (Vioxx) and valdecoxib (Bextra) were withdrawn from the U.S. market after reports of heart attacks in patients taking the drugs. Celecoxib (Celebrex) is still available, but labeled with strong warnings and a recommendation that it be prescribed at the lowest dose for the shortest time possible. You should discuss with your doctor about the advisability of using individual COX-2.
• Corticosteroids ("steroids"): these are medications that suppress the immune system and symptoms of inflammation. Usually used in severe cases of osteoarthritis and can be administered orally or by injection. Steroids are used to treat autoimmune forms of arthritis but should be avoided in infectious arthritis. Steroids have multiple side effects include stomach upset and gastrointestinal bleeding, hypertension, bone thinning, cataracts, and increased infections. These risks are most pronounced when steroids are taken for long periods of time or higher doses, which is essential for the strict supervision of a physician.
• modifying antirheumatic drugs disease: these drugs have been used traditionally to treat rheumatoid arthritis and other autoimmune causes of arthritis include gold salts, penicillamine, sulfasalazine and hidroxcloroquina. More recently, methotrexate has been shown to slow the progression of rheumatoid arthritis and improves quality of life of patients. Methotrexate itself can be highly toxic and requires tests Frequent blood for patients who are on medication.
• antibiological: this is the latest advancement in the treatment of rheumatoid arthritis. Such drugs, including etanercept (Enbrel), infliximab (Remicade) and adalimumab (Humira), are administered by injection and can dramatically improve the quality of life of patients.
• Immunosuppressants these drugs such as azathioprine or cyclophosphamide, are used for severe cases of rheumatoid arthritis when other drugs have failed.
SURGERY AND OTHER APPROACHES
• In some cases, surgery to rebuild the joint (arthroplasty) or replacement (such as total joint replacement of the knee) can help maintain a normal lifestyle. The decision to perform joint replacement surgery is normally made when other alternatives such as changes in lifestyle and medications are no longer effective.
• Normal joints contain a lubricant called "synovial fluid" and in those with arthritis, this fluid is not produced in adequate amounts. A relatively new method of treatment is to inject arthritic joints with a manmade version of the liquid as articular hylan GF 20 (Synvisc) or other hyaluronic acid preparations. The synthetic fluid may postpone the need for surgery at least temporarily and improve the quality of life of patients with arthritis. Many studies are evaluating the effectiveness of this therapy.
Call your doctor if:
• Joint pain persists beyond 3 days.
• present a severe unexplained joint pain.
• The affected joint is significantly swollen.
• The person has difficulty moving the joint.
• The skin around the joint is red or hot to the touch.
• You have fever or unintentional weight loss. Prevention
• If arthritis is diagnosed and treated early, can prevent joint damage. You should find out if there is family history of arthritis and share this information with your doctor, even if the person has no symptoms in the joints.
• Osteoarthritis may be more likely to develop if you abuse your joints (injure them many times or the overloaded while injured). Must be careful not to overwork to a damaged or sore joint and also to avoid repetitive movements.
• Being overweight also increases the risk of developing osteoarthritis in the knees and possibly in the hips and hands. See the article on body mass index to know whether a person's weight is healthy.
osteomyelitis
• An acute or chronic bone infection, usually caused by bacteria.
Causes and risk factors
• Often, the infection that causes osteomyelitis often is in another part of the body and spreads to bone through the blood. The bone may have been predisposed to infection because of recent trauma.
• In children, generally, are usually affecting the long bones, while adults are most commonly affected vertebrae and pelvis. Bone infection can be caused by bacteria or fungi. When the bone is infected, pus is produced within it, which can cause an abscess, and abscess then deprives the bone of its blood supply.
• Chronic osteomyelitis results when bone tissue dies from loss of blood supply. Chronic infection can persist intermittently for years. Risk factors are recent trauma, diabetes, hemodialysis, and intravenous drug abuse. People who have had their spleen removed are also at high risk for this disease, whose incidence is 2 cases per 10,000 people
Symptoms
• bone pain • Swelling
local redness and warmth
• Fever • Nausea
• General discomfort, uneasiness, or ill feeling (malaise)
• Drainage of pus through the skin (in chronic osteomyelitis)
• Other symptoms that may be associated with this disease:
• Excessive sweating • chills
• Lumbago • Swelling of ankles, feet and legs
Signs and tests
A physical examination shows bone tenderness and possibly swelling and redness.
• Examinations may be:
• bone scan
• Blood cultures • MRI (MRI Maget)
• Needle aspiration of the area around the affected bones
• Bone lesion biopsy
• This disease may alter the results of the following tests: • X-
joints • Hand x-ray
• Extremity x-ray • X-ray bone
• ALP isoenzyme (ALP) alkaline phosphatase
Treatment
• The goal of treatment is to eliminate infection and prevent its deterioration.
• Supplied antibiotics to kill bacteria that are causing the infection.
• For infections that do not disappear, it may need surgery to remove the dead bone tissue and the space left by the removed bone tissue may be filled or filled with bone graft material to stimulate new bone growth. Antibiotics are continued for at least 6 weeks after surgery.
• Infection of an orthopedic prosthesis may require surgical removal of the prosthesis and infected tissue around the area. In the same operation, you can implant a new prosthesis or delayed until the infection has disappeared.
Expectations (prognosis)
• The forecast Acute osteomyelitis is usually good if treated.
• The prognosis is worse for chronic osteomyelitis, even if carried out surgery. It may require an amputation, especially in diabetics or other patients with poor blood circulation. The prognosis is guarded in those who are infected with a prosthesis.
Nursing Care in Patients with musculoskeletal disorders.
Rating:
or previous clinical diseases such as diabetes, tuberculosis, poliomyelitis, hemophilia, etc.
or drugs used.
or physical activities performed.
or body mass index
or pain (joints, limbs, frequency) or Type Diet
In patients with traumatic injuries (fractures, sprains), you should inquire about:
-Mechanism of injury-related circumstances
injury-diagnostic rating
Physical: observation, palpation, movement and muscle assessment. Palpation of
realiza en cuello, hombros, codos, muñecas, manos, espalda, cadera, rodillas, tobillos, pies. Esto permite valorar la temperatura de la piel, dolor a la palpación local, inflamación y crepitación.
or drugs used.
or physical activities performed.
or body mass index
or pain (joints, limbs, frequency) or Type Diet
In patients with traumatic injuries (fractures, sprains), you should inquire about:
-Mechanism of injury-related circumstances
injury-diagnostic rating
Physical: observation, palpation, movement and muscle assessment. Palpation of
realiza en cuello, hombros, codos, muñecas, manos, espalda, cadera, rodillas, tobillos, pies. Esto permite valorar la temperatura de la piel, dolor a la palpación local, inflamación y crepitación.
Se debe valorar el grado de movilidad tanto activa como pasiva. El rango de movilidad activa significa que el paciente es capaz de hacer todos los movimientos sin ayuda. El rango de movilidad pasiva se produce cuando otra persona mueve las articulaciones del paciente sin su participación.
- Valorar exámenes imagenológicos y de laboratorio
Diagnósticos de enfermería
- Impaired mobility R / C with skeletal muscle involvement m / p
stay in bed - Pain R / C skeletal muscle injury m / p
- Impaired mobility R / C with skeletal muscle involvement m / p
stay in bed - Pain R / C skeletal muscle injury m / p
EVA 7 - Anxiety r / c immobility m / p facie case of trouble and concern
- Risk for impaired skin integrity R / C immobility or immobilizer
- Risk of stroke: thrombotic fat or R / C broken bones or prolonged immobility therapy. Objectives
- Recover physical mobility gradually with the help of multidisciplinary treatment.
- Reduce the pain to tolerable levels.
- Risk for impaired skin integrity R / C immobility or immobilizer
- Risk of stroke: thrombotic fat or R / C broken bones or prolonged immobility therapy. Objectives
- Recover physical mobility gradually with the help of multidisciplinary treatment.
- Reduce the pain to tolerable levels.
- Reduce patient anxiety while maintaining your emotional state
- Maintaining the patency of avoiding skin injury or pressure ulcers.
- Preventing stroke risk through preventive measures.
- Maintaining the patency of avoiding skin injury or pressure ulcers.
- Preventing stroke risk through preventive measures.
Plan and implementing activities
Control vital signs ü ü
Administration of physical modalities for pain. Ü
Administration of antibiotics by medical indication (fractures)
ü Coordinate with passive exercise kinesiologist scheme in immobilized patients. Ü
Perform preventive treatment of stroke signs
ü Evaluate embolism and thrombosis care
ü Make cast: indemnity
-Rate-Rate
skin distal pulse
prevent erosion
-foot-Keeping
-Avoid high-
soak the patient and family education
ü Make changes position
common areas of support Protect ü ü Keep
surgical wounds clean and dry. Ü Constantly evaluate
cleats (external tutors, splints, traction skeletal)
ü adequate mobilization (block in a patient with fractures of the pelvis, to avoid abduction in hip fractures)
ü Monitor bleeding and drainage as appropriate pattern
ü Conduct daily exercise in patients with chronic diseases. Ü
Helping the patient to his expression of fear and fear in chronic disease. Ü
facilitate the use of props to ambulation (walking sticks, burritos)
ü Collaboration arthrocentesis
Control vital signs ü ü
Administration of physical modalities for pain. Ü
Administration of antibiotics by medical indication (fractures)
ü Coordinate with passive exercise kinesiologist scheme in immobilized patients. Ü
Perform preventive treatment of stroke signs
ü Evaluate embolism and thrombosis care
ü Make cast: indemnity
-Rate-Rate
skin distal pulse
prevent erosion
-foot-Keeping
-Avoid high-
soak the patient and family education
ü Make changes position
common areas of support Protect ü ü Keep
surgical wounds clean and dry. Ü Constantly evaluate
cleats (external tutors, splints, traction skeletal)
ü adequate mobilization (block in a patient with fractures of the pelvis, to avoid abduction in hip fractures)
ü Monitor bleeding and drainage as appropriate pattern
ü Conduct daily exercise in patients with chronic diseases. Ü
Helping the patient to his expression of fear and fear in chronic disease. Ü
facilitate the use of props to ambulation (walking sticks, burritos)
ü Collaboration arthrocentesis
Assessment
ü The patient improves mobility without showing progressively account deficit.
ü The patient is in pain VAS less than 3. Ü
patient decreased their anxiety, staying calm
ü The patient remains intact skin without injury or pressure ulcer.
ü The patient shows no signs of a stroke during their hospital stay.
ü The patient remains intact skin without injury or pressure ulcer.
ü The patient shows no signs of a stroke during their hospital stay.
RULES OF PREPARATION OF THE SKIN OF PATIENTS ACIRUGÍA Trauma:
Objectives:
- preventing wound infections in patients undergoing orthopedic surgery by microorganisms from the patient's skin.
Preconditions:
- The material used in the procedure must be sterile and clean to use.
"The operator must be protected gloved procedures, according to the area to prepare.
Preparedness hospital room:
1. Should be performed preoperative shower or bed bath the day before and the day with ordinary soap.
2. You should wash the area thoroughly with soap operative afternoon the day before surgery. The nurse clearly indicate the area to prepare.
3. Should be repeated washing with soap operative site or as close to surgery (30 minutes before taking the flag).
4. Avoid shaving. If necessary to remove hair must be cut this with sterile clipper (clipper).
5. Change the bed sheets and put a clean shirt after preparing the patient.
6. Remind the patient to leave the area prepared and strictly avoid further physical examination procedures.
7. It should record the clinical records preparation (date - time - procedure and operator).
8. Transfer the patient to the flag with sheets and clean shirt. Preparation
Hall:
1. Repeat washing zone operations with povidone foaming and remove with sterile dressings.
2. Brush the area with antiseptic widely operative demarcated by the surgeon (povidone-iodine - iodized alcohol - alcohol 70 ° allergic to iodine).
3. Wait while the antiseptic action (90 seconds) in case of povidone or evaporation in case of alcohol.
Drive transesquelética
is the use of the tension (or force) to move a body part from a problematic position to an optimal functional position. View lateral stability.
Information:
- Traction is used to place tension on a displaced bone or joint (such as a dislocated hip), with weights and pulleys to realign the bone and immobilize it. Traction is also used to place tension on a muscle group (such as lower spinal muscles) so as to reduce muscle spasms, stretching the muscles and keeping them in a state of stretch.
- For treatment of traction are important amount of tension to take a body part to another position, the time during which voltage is applied and the means used to maintain tension.
INFECTION PREVENTION STANDARD INSTALLATION DECREASE IN SKELETAL:
Objective:
- Reducing infection at the site of installation of traction.
Directions of Use:
- a procedure that is performed subject to freeze and control pain in trauma patients.
Procedures:
1 .- Using aseptic technique:
üLavado hands with antiseptic. ÜUso
sterile apron.
ü Use of sterile gloves. ÜUso
mask and hat.
üLimpieza and disinfect the skin before the procedure. Ü
Using sterile field. Ü
Using sterile - Kirschner - Stirrup - Motor or high level disinfection. ÜManejo
biological waste and sharps material.
2 .- Technique:
local anesthesia: skin - subcutaneous and periosteum with lidocaine 2% 5 to 10cc.
skin incision with a scalpel in place of entry and exit of K-wire. Using
Kirschner wires between 2.5 and 3.5 mm. thickness. Use of motor
low-speed (manual)
Kirschner wire tension, healing site of entry and exit.
Protection of the wound with sterile gauze.
• Target:
avoid or reduce the risk of infection in patients with skeletal traction.
1. The residence time of skeletal traction should be the minimum necessary to prevent colonization by hospital germs.
2. Daily review of the traction system by treating physician.
3. Daily Healing sterile technique as sites of entry and exit of K-wire by the nurse.
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