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ASSESSMENT OF ASSESSMENT OF MUSCULOSKELETAL MUSCULOSKELETAL
FUNCTIONFUNCTION
CONNIE K. CUPPLES, MS, CONNIE K. CUPPLES, MS, MSN, RNMSN, RN
STRUCTURE OF LONG BONESTRUCTURE OF LONG BONE
NURSING HISTORYNURSING HISTORYPAIN PAIN
Bone - dull, deep ache Bone - dull, deep ache Muscle – cramping, sore, achingMuscle – cramping, sore, aching
ALTERED SENSATIONSALTERED SENSATIONSParesthesias – burning, Paresthesias – burning,
numbness, tinglingnumbness, tingling
PHYSICAL ASSESSMENTPHYSICAL ASSESSMENT
POSTURE – kyphosis, lordosis, POSTURE – kyphosis, lordosis, scoliosisscoliosis
PHYSICAL ASSESSMENTPHYSICAL ASSESSMENTGaitGaitBone IntegrityBone IntegrityJoint Function (ROM, symmetry, Joint Function (ROM, symmetry, position, edema, crepitus,nodules)position, edema, crepitus,nodules)Muscle Strength & Size (clonus & Muscle Strength & Size (clonus & fasciculations, girth)fasciculations, girth)Skin (edema, color, temp, intactness)Skin (edema, color, temp, intactness)Neurovascular StatusNeurovascular Status
DIAGNOSTIC EVALUATIONDIAGNOSTIC EVALUATION
RadiographicRadiographic ArthrocentesisArthrocentesis
CT ScanCT Scan EMGEMG
MRIMRI BiopsyBiopsy
ArthrographyArthrography LabLab
Bone DensitometryBone Densitometry CBCCBC
Bone scanBone scan ChemistryChemistry
ArthroscopyArthroscopy
NURSING IMPLICATIONSNURSING IMPLICATIONS
Patient education before tests to Patient education before tests to allay anxietyallay anxiety
Inquire about allergies to iodine or Inquire about allergies to iodine or seafood before scans, MRI, seafood before scans, MRI, arthrographyarthrography
Remove all metal before MRIRemove all metal before MRI
Signed consent prior to invasive Signed consent prior to invasive proceduresprocedures
NURSING INTERVENTIONS NURSING INTERVENTIONS POST ARTHROSCOPYPOST ARTHROSCOPY
Compression dressing (elastic wrap)Compression dressing (elastic wrap)
Ice packsIce packs
Analgesics as orderedAnalgesics as ordered
Extension & elevation of jointExtension & elevation of joint
Activity & weight-bearing restriction Activity & weight-bearing restriction as orderedas ordered
Teach pt to watch for swelling, Teach pt to watch for swelling, numbness, cool skin, elevated tempnumbness, cool skin, elevated temp