ASSESSMENT OF ASSESSMENT OF MUSCULOSKELETAL MUSCULOSKELETAL

FUNCTIONFUNCTION

CONNIE K. CUPPLES, MS, CONNIE K. CUPPLES, MS, MSN, RNMSN, RN

STRUCTURE OF LONG BONESTRUCTURE OF LONG BONE

NURSING HISTORYNURSING HISTORYPAIN PAIN

Bone - dull, deep ache Bone - dull, deep ache Muscle – cramping, sore, achingMuscle – cramping, sore, aching

ALTERED SENSATIONSALTERED SENSATIONSParesthesias – burning, Paresthesias – burning,

numbness, tinglingnumbness, tingling

PHYSICAL ASSESSMENTPHYSICAL ASSESSMENT

POSTURE – kyphosis, lordosis, POSTURE – kyphosis, lordosis, scoliosisscoliosis

PHYSICAL ASSESSMENTPHYSICAL ASSESSMENTGaitGaitBone IntegrityBone IntegrityJoint Function (ROM, symmetry, Joint Function (ROM, symmetry, position, edema, crepitus,nodules)position, edema, crepitus,nodules)Muscle Strength & Size (clonus & Muscle Strength & Size (clonus & fasciculations, girth)fasciculations, girth)Skin (edema, color, temp, intactness)Skin (edema, color, temp, intactness)Neurovascular StatusNeurovascular Status

DIAGNOSTIC EVALUATIONDIAGNOSTIC EVALUATION

RadiographicRadiographic ArthrocentesisArthrocentesis

CT ScanCT Scan EMGEMG

MRIMRI BiopsyBiopsy

ArthrographyArthrography LabLab

Bone DensitometryBone Densitometry CBCCBC

Bone scanBone scan ChemistryChemistry

ArthroscopyArthroscopy

NURSING IMPLICATIONSNURSING IMPLICATIONS

Patient education before tests to Patient education before tests to allay anxietyallay anxiety

Inquire about allergies to iodine or Inquire about allergies to iodine or seafood before scans, MRI, seafood before scans, MRI, arthrographyarthrography

Remove all metal before MRIRemove all metal before MRI

Signed consent prior to invasive Signed consent prior to invasive proceduresprocedures

NURSING INTERVENTIONS NURSING INTERVENTIONS POST ARTHROSCOPYPOST ARTHROSCOPY

Compression dressing (elastic wrap)Compression dressing (elastic wrap)

Ice packsIce packs

Analgesics as orderedAnalgesics as ordered

Extension & elevation of jointExtension & elevation of joint

Activity & weight-bearing restriction Activity & weight-bearing restriction as orderedas ordered

Teach pt to watch for swelling, Teach pt to watch for swelling, numbness, cool skin, elevated tempnumbness, cool skin, elevated temp