Disorders of the Musculoskeletal System


CHAPTER 16






Disorders of the Musculoskeletal System


 

 





LEARNING OUTCOMES






 


Upon completion of this chapter, the nurse will:



1.  Summarize the different disorders of the musculoskeletal system


2.  Examine approaches to assess different disorders of the musculoskeletal system


3.  Determine approaches that can be used for more than one musculoskeletal disorder


MUSCULOSKELETAL DISORDERS


Disorders of the musculoskeletal system can range from minor ailments to more severe chronic conditions. The disorders identified are the most common ones appropriate for telephonic care and include:



  Sprain


  Repetitive use injury


  Fracture


  Amputation


  Osteoporosis


  Gout


  Osteoarthritis


  Post-polio syndrome


  Rheumatoid arthritis


  Ankylosing spondylitis


  Spinal stenosis


  Osteomyelitis


  Back pain


  Fibromyalgia


  Spinal deformity


  Foot disorders


ASSESSING DISORDERS OF THE MUSCULOSKELETAL SYSTEM


Remember that the client is already diagnosed with a musculoskeletal problem. When providing telephonic care, you are assessing the client’s current condition, symptoms, and if anything has changed or needs to be referred to the doctor/health care professional.


 







































































































































































































Health Problem


Question


Sprain


When were you told that you had a sprain?


 


Where is the sprain located?


 


When did the sprain occur?


 


What were you told to do to treat the sprain? (RICE)


  Rest?


  Ice?


  Compression?


  Elevation?


 


Are you able to walk with the sprain?


 


What are you doing to treat the pain?


 


For what reasons have you been directed by your doctor or health care provider to seek additional medical care because of the sprain?


Repetitive use injury


When were you told that you have a repetitive use injury?


 


Where is it located?


 


What are your symptoms?


  Pain?


  Numbness?


  Tingling?


 


How long have you had this injury?


 


What are you doing for the injury?


  Avoiding certain activity?


  Using a splint?


  Taking over-the-counter analgesics?


 


Have you been told that you might need surgery?


  If so, when is this going to occur?


 


For what reasons have you been directed by your doctor or health care provider to seek additional medical care because of the injury?


Dislocation


What joint was dislocated?


 


When did it happen?


 


How did it happen?


 


Was the joint “put back into the socket”? (closed reduction)


 


What were you told to do to treat it?


  Pain medication?


  Splinting?


  Mild range of motion exercises?


 


For what reasons have you been directed by your doctor/health care provider to seek additional medical care because of the injury?


Fracture


What bone was broken (fractured)?


 


When did it happen?


 


How did it happen?


 


What has been done to treat it?


  Casting?


  Surgery?


  Splinting?


 


If casted, what have you been directed to do to care for the cast such as:


  Report if the cast feels tight?


  Make sure the cast does not get wet?


  Place nothing down the cast to scratch itchy skin?


 


How long do you need to wear the cast?


 


Have you been told that you will need physical therapy after the cast is removed?


 


(If a lower extremity is casted) What are you using to help you walk?


  Crutches?


  Cane?


  Walker?


 


When do you go back to have the broken bone checked?


 


For what reasons have you been directed by your doctor or health care provider to seek additional medical care because of the broken bone?


Amputation


When did you have your (leg/arm) amputated?


 


Can you tell me why it needed to be amputated?


 


How long ago was that done?


 


Has your stump healed?


 


Have you been fitted for a prosthesis?


  Are you wearing it?


 


(If below knee amputation) Are you doing any exercises to make sure your knee can be bent and straightened?


 


(If above knee amputation) Were you directed to lie on your stomach on the bed for short periods of time every day to make sure your hip joints do not get tight?


 


Are you having any pain in your leg/arm with the amputation? (Might experience phantom limb pain.) If so,


  What are you doing to help with the pain?


  Is it helping? Does it control the pain?


 


When are you supposed to go back and see the surgeon for the amputation?


 


For what reasons have you been directed by your doctor or health care provider to seek additional medical care because of the amputation?


Osteoporosis


Who told you that you have osteoporosis?


 


How was it diagnosed?


 


How long ago were you told?


 


What medicine are you taking for the osteoporosis?


Are you taking the medicine as prescribed such as:


  Taking it in the morning with a full glass of water on an empty stomach?


  Sitting upright for 30 minutes after taking the medication?


 


Are you supposed to take calcium and vitamin D supplements also?


 


Have you been directed to do anything to help with the osteoporosis such as:


  Engaging in weight-bearing exercise (walking)?


  Smoking cessation?


  Avoiding alcohol intake?


 


Have you had any broken bones because of the osteoporosis? If so,


  Which one(s):


      Hip?


      Femur?


      Vertebrae?


 


When are you supposed to see your doctor again for the osteoporosis?


 


For what reasons have you been directed by your doctor/health care provider to seek additional medical care because of the osteoporosis?


Gout


When were you told that you have gout?


 


Where is the gout located?


  Foot?


  Toe?


  Knee?


 


What are/were your symptoms:


  Pain?


  Swelling?


 


What medicine are you taking for the gout?


  Are you taking it as directed?


 


What else are you doing to treat the gout?


  Change in diet? (avoiding foods high in purines)


  Avoiding alcohol?


 


When are you supposed to see your doctor again for the gout?


 


For what reasons have you been directed by your doctor or health care provider to seek additional medical care because of the gout?


Back pain


When did you start to have back pain?


 


How long has it been going on?


 


Were you doing anything in particular when it started? Such as:


  Lifting heavy item?


  Twisting the torso?


 


What have you been doing to treat the back pain, such as:


  Rest?


  Ice/heat?


  Mild exercise?


  Over-the-counter pain medicine?


 


Were you told the reason for the back pain, such as:


  Slipped/herniated disk?


 


Are you having any problems, such as:


  Limb weakness?


  Numbness?


  Tingling?


  Change in bowel or bladder function?


 


Were you told that you need/did you have surgery for the back pain? If so,



  When is this going to be done/when did you have it done?

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Oct 5, 2017 | Posted by in NURSING | Comments Off on Disorders of the Musculoskeletal System
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