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ESSENTIALS of ORTHOPEDIC NURSING

James Malce Alo, RN, MAN, MAP, Ph.D

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ESSENTIALS of ORTHOPEDIC NURSING1ST Edition

2009

BY: JAMES M. ALO, RN, MAN, MAP, Ph.D

A & C Printers200- A N Domingo St. San Juan City

Tel. # 986-33-23/998-2507E-mail Add: ac_printer@yahoo.com.ph

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ESSENTIALS of ORTHOPEDIC NURSINGPhilippine Copyright, 2009 by

James M. Alo1ST Edition

ISBN 978-971-94484-0-2

ALL RIGHTS RESERVEDNo part of this book may be reproduced in any form or by any means

without the written permission from the author.

Published and exclusively distributedBy: HanjazZ Publishing

Blk 2 Lt 13-C Grasshopper St. Saint Mary Village, Las Pinas CityTel #: (02) 846-1450

Mobile #:09187309403Web site: http://www.james2gloves.com

A & C Printers200- A N Domingo St. San Juan City

Tel. # 986-33-23/998-2507E-mail Add: ac_printer@yahoo.com.ph

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PREFACE

Fundamental concepts, principles, and methods of orthopedic nursing designed to provide the students with basic knowledge on the clinical procedures on how to manage and care orthopedic patient.

This book will aid the student to demonstrate the knowledge and skills related to the management of care to patients with fracture and musculoskeletal disorders.

This book consists of four parts. The first part deals with the history of orthopedic nursing, today’s’ orthopedic nurse, orthopedic nursing in the Philippines, perspectives on orthopedic nurses, the environment of care, the health care team, nurses key role in promoting environment of care and using a model for orthopedic nursing.

The second part deals with the anatomy and physiology of the musculoskeletal system. The third part is on basic care and comfort; principles of basic body mechanics, transfer techniques, ambulation and it’s assistive devices, joint movement, therapeutic exercises, complication of immobility and specific therapeutic positions. The fourth part deals with the musculoskeletal disorders with it’s definition, causes, signs and symptoms, anatomy and pathophysiology, diagnostic procedures, medical management and nursing management.

This book is especially good to be possessed by teachers and students who will be exposing in orthopedic nursing and is guide of them. Care has been taken to confirm the accuracy of the information presented and to describe generally accepted nursing practices. Thus, it is hard to ensure that all the information presented is entirely exact for all circumstances. The author make no warranty, express or implied, with respect to this work, and disclaim any liability, loss or damage as a result, directly or indirectly of the application of any of the contents of this endeavor.

The author also acknowledges his owe of gratitude to all those who, in one way or another, helped in the publication of this book.

James M. Alo

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To my wife, jazzy and hannah who are my joyand inspiration,

To my family and friends,gives support and strength.

To my students, past and tomorrow,who are the hope for nursing’s future.

To AdU and UPHSD, who give me the opportunity to enhanced my skills in orthopedic nursing. in Philippines

Orthopedic Center under DOH.To Dr. Teodoro R. Castro- POC Director, Agnes G. Sarabia-

Chief Nurse, Dr. Judy C. Franco- Nurse IV, Eva T. Cruza- Nurse III, Sheirna B. Campita- Nurse III, Elizabeth M. Raymundo- Nurse III

and POC Clinical Instructors with the marvelous learning experienced.

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TABLE OF CONTENTSPage

Preface iiiAcknowledgment

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PART 1Introduction 1

History of Orthopedic Nursing 2Today’s Orthopedic Nurse 2Orthopedic Nursing in the Philippines 3Perspectives on Orthopedic Nurses 6Perspectives on Orthopedic Nursing 7The Environment of Care 8The Health Care Team 9Nurses Key Role in Promoting Environment of Care

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Using a Model for Orthopedic Nursing 11PART 2

Musculoskeletal System 12List of Major Human Organ System 12Structures in Humans

1.1. Skeletal1.2. Muscular1.3. Joints1.4. Tendons1.5. Ligaments1.6. bursa

14143943444546

PART 3Basic Care and Comfort 47

Basic Body Mechanics 47Principles of Body Mechanics 48Transfer Techniques 48Ambulation and it’s Assistive Devices 49Joint Movements 51Therapeutic Exercises 51Complications of immobility 52Specific Therapeutic Positions 54

PART 4

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Musculoskeletal Disorders 55Osteoporosis 56Paget’s Disease 61Bone Tumors 63Osteoarthritis 67Disorders of Joints and Connective Tissues

a. Rheumatoid Arthritisb. Psoriatic Arthritisc. Discoid Lupus Erythematosusd. Systemic Lupus Erythematosuse. Sclerodermaf. Sjogren’s Syndromeg. Mixed Connective Tissue Diseaseh. Polymyositis and Dermatomyositisi. Relapsing Polychonditisj. Vasculitisk. Polyarteritis Nodosal. Temporal Arteritism. Wegener’s Granulomatosisn. Reiter’s Syndromeo. Behcet’s Syndromep. Ankylosing Spondylitisq. Gout and Pseudogout

717380828387909294979899

100102103105107108

Bone and Joint Infectionsa. Osteomyelitisb. Infection Arthritisc. Charcot’s Joints

113114117119

Disorders of Muscles, Bones and Tendonsa. Spasmodic Torticollisb. Fibromyalgia Syndromec. Bursitisd. Tendinitis and Synovitis

120121122124126

Fracture 129Spinal Cord Injury 136Osteomyelitis 142Herniated Nucleus Pulposus 145Osteosarcoma 149Pott’s Disease 153

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Buerger’s Disease 155Gouty Arthritis 160Scoliosis 165Osteomalacia 171Clubfoot 172Spina Bifida 173Congenital Hip Dysplasia 176Coxa Plana 177Hydrocephalus 178Foot Problems

a. Ankle Sprainb. Foot Fracturec. Heel Spursd. Sever’s Diseasee. Posterior Achilles Tendon Bursitisf. Anterior Achilles Tendon Bursitisg. Posterior Tibial Neuralgiah. Pain in the Ball of the Footi. Ingron Toenailj. Onychomycosisk. Nail Discoloration

180180182184185186187187188190190191

Sports injuriesa. Stress Fracture of the Footb. Shin Splintsc. Popliteus Tendinitisd. Achilles Tendinitise. Runner’s Kneef. Hamstring Injuryg. Weight Lifter’s Backh. Backhand Tennis Elbowi. Forehand Tennis Elbowj. Rotator Cuff Tendinitis

192197198200201202204205207208210

Exercise and Fitnessa. Starting an Exercise Programb. Preventing Injuriesc. Choosing the Right Exercise

212212214217

Preventing Infection and Promoting Healing 220Balance Skeletal Traction Application 221

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How to Tie a Knot 230Casting 231BST Equipments 237The Gadgets 238Tractions 247Hardware

a. Screws and Platesb. Implants

253253256

Braces 258Common Abbreviations in Surgery 260Surgeries 261Anesthesia Abbreviation 261Exercises 263Review Questions Related to Musculoskletal Disorders

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Nursing Care Plan 280BIBLIOGRAPHY 286

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