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NURS 3525-Musculoskeletal Traumas and Surgeries
Exam With Complete Solutions 2025- 2026
Soft tissue injuries sprains, strains, dislocations, ACL tears, carpal tunnel syndrome, rotator cuff tears, shin splints, bursitis what is the common causes of soft tissue injuries? trauma or sports related injuries sprains injury to ligaments surrounding a joint, usually from wrenching or twisting common sites for sprains ankles or wrists strains excessive stretching of a muscle and its fascial sheath, often involving the tendon common sites for strains lower back, calves, hamstrings symptoms of sprains and strains pain, edema, decreased function, contusion (bruise)
severity of damage 1st degree- over stretched 2nd degree- partial tear 3rd degree- complete tear Tx for soft tissue injuries RICE Rest Ice Compression Elevation interventions temperature application 20 - 30 minutes on, ice for first 24 - 48 hours, don't apply directly to skin goal of soft tissue injury management improve mobility and decrease inflammation Assessment findings for acute soft tissue injuries bruising, โ movement, โ sensation, โ pulse, cap refill, edema, muscle spasms, pain shortening or rotation of injury interventions for soft tissue injuries ABC's, neuromuscular assessment of involved limb, elevation, ice, compression, immobilization, pain meds PRN
Anterior cruciate ligament (ACL) key ligament that stabilizes the knee joint ACL tear usually non-contact (from pivoting, jumping, or stopping running) diagnostics of ACL tear MRI and positive Lachman's test Tx for ACL tear immobiliser to provide support, reconstructive surgery (aloe graft or auto graft) classification of fractures
- open or closed
- complete or incomplete
- displaced or non displaced traverse fracture 90* break firm blow perpendicular to the bone Open/compound fracture skin is pieced by the bone (bone may or may not be visible) Oblique fracture curved or angle break in the bone comminuted fracture bone breaks into several different breaks
segmental fracture Single bone broken in more than one place avulsed fracture this is when a piece of bone tears away with the ligament fracture spiral this is when the break wraps around the bone, usually hairline fractures greenstick fracture this usually occurs in children, the bone bends clinical manifestations of fractures these are pain, muscle spasm, inability to bear weight, edema, ecchymosis, decreased or no function, deformation stages of fracture healing
- fracture hematoma
- granulation tissue
- callus formation
- ossification
- consolidation
- remodeling at what stage of fracture healing is clinical union? this is ossification, the cast can be removed
what is skeletal traction? Traction applied directly to the bone with the use of pins and wires. nursing management for traction
- weights must not be on floor, weights must hang free
- must have contestation
- skin and pressure points are monitored q 2 - 4 hrs position changes are encouraged if possible
- traction must be continuous closed reduction Manual movement of the bone, allows for maintenance of alignment what is closed reduction used? Used to decrease tension and stress on ligaments open reduction, internal fixation ORIF, surgical alignment of fractured bones using screws, pins, wires, or nails to maintain bone alignment. risks for ORIF infection, anestesia complications what do you immobilize an ORIF with? splint, not a cast due to swelling benefit of ORIF
early mobilization external fixation the fixation of a fractured bone from the outside what are external fixation biggest risk? infection! pt teaching for external fixation pin care with chlorehexedine cast care dry, cool hairdryer if wet, ADLs, ice above cast or splint, elevate for first 48 hours to reduce swelling nursing management for fractures cast care, ambulation, psychosocial concerns direct complications of fractures malunion, angulation, delayed union, disunion, pseudoarthritis, mysoitis ossificans, refracture pseudo arthritis type of non-union, a false joint forms at the fracture myositis ossificans calcium deposits that result from repeated trauma
48 hours interpersonal care for compartment syndrome receive the source of pressure dont elevate or apply cold compress surgical fasiotomy may be required problems associated with musculoskeletal injuries muscle atrophy, foot drop, contractures clinical manifestation of hip fracture external rotation, muscle spasm, shortening of affected extremity, pain interpersonal care of hip fracture immediate surgery, buck reaction before surgery nursing management of hip fracture
- vitals
- pain meds
- dressings/incision
- neurovasc assessment
- positioning/mobility
- dont sit in a chair without arm rests
- no greater than 90 degrees for legs X dont cross legs X wait 8 wks to put on own shoes X elevated toilet seats for 6 - 8 wks
discharge planning for hip fractures home or rehab social support educate pt and family about post-op complication risk home assessment pain management exercise for strength avoid high impact sports arthroplasty reconstruction or replacement of a joint use of arthroplasty receives pain, improved ROM, correct deformity what joints of arthroplasty available for? elbows, shoulders, phalangeal joints in fingers, wrist, hips, knees, ankles, feet post-op considerations for arthroplasty neuromuscular assessment pain management PT- ROM, CPM, ambulation
- prevent complications when should PACU do a neuromuscular assessment for an arthroplasty? every 15 minutes
