Patients/Residents/Clients with Musculoskeletal Disorders:
Patients/Residents/Clients with Musculoskeletal Disorders:
Remind students to avoid pulling excessively on residents/patients/clients arms because of the risk of dislocation
Arthritis is an inflammation of a joint.
1) Two Types:
i) Osteoarthritis
a) Most common; usually results from aging
b) Symptoms - joint pain, stiffness, aching, and limited movement of a joint
c) Treatment – Rest, no cure, supportive measures; applications of heat and cold,
i. Aspirin, anti-inflammatory meds & injections of steroids
ii. Special exercises
ii) Rheumatoid Arthritis
a) Chronic affects the connective tissues and joints. More common in women
b) Can result in permanent deformity and immobility
c) Treatment – reduce pain, Rest, prescribe exercises, anti-inflammatory meds,
iii) Bursitis – Inflammation of the bursae, small, fluid-filled sacs surrounding the joints.
Frequently affects the shoulder. Elbow and hips
(a) Symptoms – severe pain, limited movement, and fluid accumulation in the joint
(b) Treatments- pain meds, injecting steroids anesthetics, rest, PT to preserve joint movement
iv) Fractures – break in the bone: common in elderly is hip
(a) Prevention can be a key – remind pt to use ambulatory devices, encourage to use hand rails, clean up spills, keep room walk area clear.
(b) Can be stress related due to Osteoarthritis or when bones become brittle, they can break with even “simple” falls and or activities
(c) Post - op care will be necessary if surgery was performed
(d) Observe for skin breakdown and the development of decubitus. Report any redness
(e) Avoid adduction, internal rotation, and severe hip flexion
v) Loss of a Limb-Amputation is surgical removal of all or part of an arm or leg
(a) Can be a result of, severe injury, severe infections, circulatorydisorders, gangrene
(b) Death of tissue occurs in gangrene and if untreated can spread to whole body causing death
(c) Person may have a prosthesis, person may feel phantom limb pain or sensation after limb removed.
(d) Carefully follow stump care orders and if the person has a prosthesis monitor skin and give good skin care to stump.
(e) report redness, swelling, problems moving the stump, increased pain
v) Key Points to remember when aligning a resident/patient/client
(a)A resident/patient/client confined to bed will require turning at least every 2 hours. Provide exercise for the muscles, stimulates circulation, prevents pressure ulcers (decubitus). Correct technique is necessary to prevent injury to self and resident/patient/client
(b) keep body in correct alignment with the spine
(c) use pillows and or rolled blankets or towels for support.
(d) Use logrolling technique if back problems present
vi) Range of Motion Exercise – used to prevent contractures of joints, do not push joint past pain, exercise each joint at least 3 times, can be performed during bath, have patient assist whenever possible
Review under restorative care
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