Musculoskeletal System

  1. Arthography
    used to see acute or chronic tears of the joint capsule or ligaments of the knee, shoulder, ankle, or wrist
  2. Arthography procedure
    • radioplaque injected to joint cavity
    • joint put to ROM to distribute agent
    • x-rays are taken

    *note - contrast agent will leak from joint cavity if tear is present for 1-2 days
  3. rnsg interventions
    • normal to hear clicking/cracking in joint for 1-2 days
    • joint rested for 12 hrs
    • compression elastic bandage applied
    • assess for allergies to contrast agent if used
  4. arthrography contraindications
    • pregnancy
    • claustrophobia
    • inability to tolerate position due to age
    • debility or disability
    • metal implants
  5. Bone densitometry
    used to estimate bone mineral density (BMD)
  6. DXA or DEXA
    used to estimate extent of osteoporosis and monitor pt's response to osteoporosis tx
  7. Bone scan
    to detect metastatic & primary bone tumors, osteomyelitis, fractures, & aseptic necrosis

    *radioisotope injected IV - scan done 2-3 hrs after injection
  8. bone scan interventions
    • possible allergies to radioisotope
    • contraindicated to pregnant women
    • drink lots of fluids to distribute & eliminate the isotope
    • empty bladder bec a full bladder interferes w/ accurate scanning of pelvic bones
  9. Arthroscopy
    • direct visualization of a joint (joint structures, synovium, articular surfaces)
    • used to diagnose joint disorders
  10. Arthroscopy can?
    repair/treat tears, defects, and disease process through arthroscope
  11. arthroscopy complications (rare)
    • infection
    • hemarthrosis
    • neurovascular compromise
    • thrombophlebitis
    • stiffness
    • effusion
    • adhesions
    • delayed wound healing
  12. arthroscopy interventions
    • joint wrapped w/ compression dressing to control swelling
    • ice to control edema & promote comfort
    • joint extended/elevated to reduce swelling
    • adm analgesics
  13. arthroscopy s/s of complications
    • swelling
    • numbness
    • cool skin
  14. Arthrocentesis
    joint aspiration to obtain synovial fld for examination or relieve pain d/t effusion
  15. arthrocentesis helpful to diagnose what?
    • (synovial fluid)
    • septic arthritis
    • inflammatory arthopathies
    • bleeding
    • pain from effusion
  16. Synovial fld
    • clear
    • pale
    • straw colored
    • scanty in volume
  17. arthrocentesis rnsg
    • sterile dressing applied
    • risk for infection
  18. Casts
    • used to
    • immobilize reduced fracture
    • correct deformity
    • apply uniform pressure on soft tissue
    • support and stabilize weakend joints
  19. Fiberglass cast
    • let pt know to expect increasing warmth
    • don't put on hard/sharp edges while drying
  20. Plaster cast
    • less costly
    • better mold than fiberglass
    • will also produce heat
    • crystallization process takes 15-20 mins
    • 24-72 hrs to completely dry
  21. Splints and braces
    may be used after cast
  22. Splints
    • do not require rigid immobilization
    • used when swelling is anticipated or require special skin care
  23. Braces
    • used to provide support, control movement, prevent addtl injury
    • for longer use than splints
  24. General nrsg mngt for cast, splint, brace
    • assess neurovascular status
    • consider swelling, bruising, skin abrasions
    • let pt know what to expect with procedure
    • assess pain (character & intensity)
    • most pain can be relieved by elevation, cold packs, analgesics
Card Set
Musculoskeletal System
Exam III