The Musculoskeletal System RACHEL S. Natividad, RN, MSN.
-
Upload
joseph-brian-park -
Category
Documents
-
view
212 -
download
0
Transcript of The Musculoskeletal System RACHEL S. Natividad, RN, MSN.
The Musculoskeletal System
RACHEL S. Natividad, RN, MSN
Subjective and Objective Data
Obtaining a health history
Assessment Inspection/Palpation
Range of Motion passive and active
Muscular strength
Inspection/Palpation Inspect swelling, mass or deformities, stiffness
or instability of joints, limbs and body regions
Palpate for temperature, tenderness surrounding joint
ROM’s
Have the pt perform active ROM
If unable to, use passive ROM
Palpate for unusual joint movement during ROM
Measuring Range of Motion
Assessing Muscles Assess muscle
tone and strength
Strength against gravity/full resistance
note as 0/5-5/5
“5/5” = normal
Rheumatoid arthritis Chronic, systemic,
inflammatory disease that attacks the joints, and surrounding tissues, hand, knees, hips, and feet
Deformitiesof RA
Swan neck deformity
Boutinniere Deformity
Ulnar Shift
Osteoarthritis A chronic
degeneration of joint cartilage caused by aging or trauma
Pain, stiffness, swelling
Osteoarthritis: Cont.
Heberdens Nodes
Bouchards Nodes
Hard, nontender nodes
Osteoporosis A
decrease in bone mass, porous, brittle, and prone to fracture
Contractures
Assessment Guide: Activity & Rest
Objective Data Activity Level and Tolerance:
ambulates with walker independently/ with minimal assistance; bedrest; up in wheelchair
Assessment Guide: Activity & Rest Muscles and joints
Description: fair muscle tone, no atrophy; atrophy to RLE. No stiffness or contractures; R wrist contracted
Movement: limited ROM to RUE; FROM all extremities
Strength: strong UE, LE; weak RUE & RLE
Coordination: able to perform most ADLs; can comb hair and reach for water glass
Assessment Guide: Activity & Rest
Posture/Gait
Slumped, kyphosis, erect; gait unsteady, shuffling, ataxia
Assessment Guide: Activity & Rest
Circulation, Sensation, and Movement Describe:
CSM intact; no sensation to R big toe and second toe;
numbness and tingling to LEs; Decreased ROM to LUE due to contractures
Assessment Guide: Activity & Rest
Rest/Sleep Patterns
Sleeps most of the day Takes midday naps
Assessment Guide: Activity & Rest
Interventions in use: Assistive device, equipment
Cast, trapeze, foot cradle, Special beds
Air bed, eggcrate mattress Med List:
Glucosamine, Allopurinol, NSAIDS, etc.