Med Surge

injury 2 a muscle from excessive stress, overuse, or overstretching.

Path/eti = small blood vessels in the muscle rupture, and the muscle fibers sustain tiny tears

S/S = inflammation, local tenderness, and muscle spasms

Nurse = apply cold packs 2 alleviate local pain, swelling, and bruising.

Soft tissue injury resulting from a blow or blunt trauma.

S/s = bruises (ecchymosis) or hematoma (collection of blood)

Nurse= apply cold packs; contusion usually resolves in 2wks

injuries to the ligaments surrounding a joint. Usually 2 wrist, elbow, knee, ankle. Cervical spine sprain = whiplash injury

Causes= sudden, unusual movement or stretching from falls or accidental injuries.

S/s = pain immediately, swelling, person usually can't put weight on affected part, bruising

Tx = ice, chemical cold pack 2 reduce swelling for first 24 to 48hrs, elevation, compression or RICE, sometimes splint or light cast. After 2days if swelling is down apply heat reduces pain.

Nurse = ice packs, after swelling apply heat, NSAIDS 2 ease discomfort. 4 whiplash cervical collar 2 limit movement.

Occur when the articular sufaces of a joint are no longer in contact. Usually shoulder, hip, knee are dislocated.

Path/eti = trauma, diseases of joint, compartment syndrome,

s/s = popping sound, complaint of something "gave out", pain, affected ext is longer than unaffected ext, ROM limited, swelling, coolness, numbness, tingling, pale dusky color of distal tissues

Tx = Dr. reduces the displaced part until normal, then immobilizes the joint w/ elastic bandage, cast, splint for several wks, some may require surgery

Nurse = give pain meds if prescribed, elevating, immobilizing affected limp, applying cold packs, neurovascular assessment every 30mins for several hrs then @least every 2to4hrs for next 1to2days 2 watch 4 compartment syndrome.

a condition in which a structure such as a tendon or nerve is constricted in a confined space.

result of compartment syndrome but is decreased sensation and movement

if compartment syndrome occurs in a upper ext a clawlike deformity of the hand resulting from obstructed arterial blood flow to the forearm and hand. The client is unable 2 extend his/her fingers and complains of pain when trying 2 stretch the hand.

shoulder, elbow, wrist, knee, and ankle. They are usually acute injuries like stress fx or tendonitis related 2 sports & exercise and workrelated injuries.

• inflammation of a tendon caused by overuse ex:
• Epicondylitis
• Ganglioncyst
• Carpal tunnel syndrome

S/s= pain, inflammation, tennis elbow pain radiating down the dorsal surface of the forearm and a weak grasp.

It's "tennis elbow" its a painful inflammation of the elbow.

Causes = excessive pronation & supination of the forearm like with playing tennis, pitching ball, rowing.

s/s = pain radiating down the dorsal surface of the forearm and a weak grasp

its a cystic mass that develops near tendon sheaths and joints of the wrist.

causes = defects in the tendon sheath or joint capsule and occur more in women younger than 50yrs of age.

s/s = pain and tenderness in the affected area

tx = aspiration of the ganglion, corticosteroid injection, and surgical incision

results from repetitive wrist motion that traumatizes the tendon sheath or ligaments in the carpal canal.

Causes = repetitive hand movements ex: typists, cashiers, musicians, assemblers, peeps on the computer all the time.

S/S= pain or burning in one or both hands that radiate to the forearm and shoulder in severe cases more pain @ night and early in the am.

Tx= Tinel's sign & phalan's sign(flex wrist for 30sec) 2 determing pain or numbness. resting the hands, splinting hand or wrist, NSAIDS, corticosteriod, or surgery.

• Nurse = Tell client take NSAIDS w/ food
• Corticosteriod injections explain what 2 expect and let them know injections might cause more discomfort.
• Show how 2 use adn care 4 splints and ROM exercises or underwater hand exercises causes less pain
• Rest joint
• Support affected arm on pillow while sleeping
• Apply cold 4 24 to 48hrs 2 reduce swelling & pain
• Gradually increase joint movement

it's a traumatic injury or from chronic overuse or irritation of the shoulder joint.

s/s = pain w/ movement and limited mobility of the shoulder and arm, peeps have hard time 2 with activities tht involve stretching their arm above their head, can't sleep on affected side.

• Tx= NSAIDS, modify activities 2 rest joint, corticosteroid injections, progressive passive and active exercises and stretching, or surgical procedures:
• Arthroscopic debridement of devitalized tissue
• Arthroscopic tendon repair
• Open acromioplasty w/ tendon repair
• immobilize shoulder 4 several days 2 wks then physical therapy. Full recovery 6 to 12months.

injuries 2 the knee occur as a result of a traumatic injury. Menisci(cartilages in the knee)

These ligaments provide stability 2 forward & backward movements

causes= twisting of the knee or repeated squating. They say knee gave out and may experience click in knee as they ambulate.

Nurse = immobilize, NSAIDS, rehab w/ gradual weightbearing. RECOVERY win 3to12months depending on injury or surgery if required.

occurs secondary 2 trauma but as the client engages in activity the calf muscle contracts suddenly while the foot is grounded firmly in place. Usually loud "pop".

s/s = severe pain and inability 2 plantar flex the affected foot

tx= requires surgical repair 4 complete healing 2 occur, after surgery client wears a cast or brace for 6 to 8 wks, thn PT

Nurse = teach client about activity restrictions, use of ambulatory aids, and pain management

is a break in the continuity of a bone and may affect tissues or organs near the bones as well. They are classified according 2 type and extent.

Causes= sudden direct force from a blow or fall causes most fx, underlying weakness by bone infections, bone tumors. 10-40mins after bone breaks the muscles surrounding the bone are flacid and spasm.

S/s= swelling from hemorrhage, edema, pain, loss of function, deformity, false motion, crepitus(grating of bone over bone), spasms.

Nurse= assess 4 neurovascular & systemic complications, give pain meds as prescribed, provide comfort measures, assist ADLs, prevent constipation, promote physical mobility, prevent infection, maintain skin integrity, self-care,

• the nurse
• teaches simple and direct explanations about the traction and its purpose
• Point out activities that are allowed or contraindicated

hypovolemic shock related 2 blood loss and loss of extracellular fluid from damaged tissue.

Nurse = administer blood & fluid volume replacements as prescribed 2 prevent further losses.

fat gobules released after fx of pelvis or long bones

s/s= onset is rapid, with client experiencing respiratory distress and cerebral disturbances

Nurse= moniter client 4 symptoms, which occur w/in 48-72hrs. To prevent fatty emboli, provide early respiratory support, ensure rapid immobilization of fx, and observe client closely 4 signs of respiratory and nervous system problems

usually occurs in automobile accidents but may occur in falls from ladders or other high places, or in gunshot wounds, severe trauma.

S/s= severe pain, swelling, ecchymosis may be seen, can't move hip or knee, sometimes and open wound or a protusion of bone may be seen

Nurse= implements measures 2 provent complications of immobility and inactivity. Puts clients in line with the pull exerted by the traction, cleans pin sites w/ prescribed agent 2 prevent infection.

results from a fall and occurs more in elderly w/ osteoporosis.

s/s= severe pain that increases with leg movement, pain frequently radiated 2 the knee, large blood loss may happen cuz subtrochanteric and intertrochanteric fx leading 2 hypovolemic shock. may be extensive bruising and swelling in hip, groin and thigh.

Nurse= Watch older peeps more for complications, prevent skin breakdown, wound infection, pneumonia, constipation, urinary retention, muslce atrophy and contractures. Watch wound drain usually in place for 1 to 2 days after surgery READ PG996