i iii ESSENTIALS of ORTHOPEDIC NURSING 1ST Edition 2009BY: JAMES M. ALO, RN, MAN, MAP, Ph.D A & C Printers 200- A N Domingo St. San Juan City Tel. # 986-33-23/998-2507 E-mail Add: email@example.com
iii ii ESSENTIALS of ORTHOPEDIC NURSING Philippine Copyright, 2009 by James M. Alo 1ST 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 distributed By: HanjazZ Publishing Blk 2 Lt 13-C Grasshopper St. Saint Mary Village, Las Pinas City Tel #: (02) 846-1450 Mobile #:09187309403 Web site: http://www.james2gloves.com A & C Printers 200- A N Domingo St. San Juan City Tel. # 986-33-23/998-2507 E-mail Add: firstname.lastname@example.org
iiiPREFACE Fundamental concepts, principles, and methods of orthopedic nursingdesigned to provide the students with basic knowledge on the clinicalprocedures on how to manage and care orthopedic patient. This book will aid the student to demonstrate the knowledge and skillsrelated to the management of care to patients with fracture and musculoskeletaldisorders. This book consists of four parts. The first part deals with the history oforthopedic nursing, today’s’ orthopedic nurse, orthopedic nursing in thePhilippines, perspectives on orthopedic nurses, the environment of care, thehealth care team, nurses key role in promoting environment of care and using amodel for orthopedic nursing. The second part deals with the anatomy and physiology of themusculoskeletal system. The third part is on basic care and comfort; principles ofbasic body mechanics, transfer techniques, ambulation and it’s assistive devices,joint movement, therapeutic exercises, complication of immobility and specifictherapeutic positions. The fourth part deals with the musculoskeletal disorderswith 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 studentswho will be exposing in orthopedic nursing and is guide of them. Care has beentaken to confirm the accuracy of the information presented and to describegenerally accepted nursing practices. Thus, it is hard to ensure that all theinformation presented is entirely exact for all circumstances. The author makeno warranty, express or implied, with respect to this work, and disclaim anyliability, loss or damage as a result, directly or indirectly of the application of anyof the contents of this endeavor. The author also acknowledges his owe of gratitude to all those who, inone way or another, helped in the publication of this book. James M. Alo
iii iv To my wife, jazzy and hannah who are my joy and 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 enhancedmy skills in orthopedic nursing. in Philippines Orthopedic Center under DOH. To Dr. Teodoro R. Castro- POC Director, Agnes G. Sarabia- ChiefNurse, 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.
iii vTABLE OF CONTENTS PagePreface iiiAcknowledgment ivPART 1 Introduction 1 History of Orthopedic Nursing 2 Today’s Orthopedic Nurse 2 Orthopedic Nursing in the Philippines 3 Perspectives on Orthopedic Nurses 6 Perspectives on Orthopedic Nursing 7 The Environment of Care 8 The Health Care Team 9 Nurses Key Role in Promoting Environment of 10 Care Using a Model for Orthopedic Nursing 11PART 2 Musculoskeletal System 12 List of Major Human Organ System 12 Structures in Humans 14 1.1. Skeletal 14 1.2. Muscular 39 1.3. Joints 43 1.4. Tendons 44 1.5. Ligaments 45 1.6. bursa 46PART 3 Basic Care and Comfort 47 Basic Body Mechanics 47 Principles of Body Mechanics 48 Transfer Techniques 48 Ambulation and it’s Assistive Devices 49 Joint Movements 51 Therapeutic Exercises 51 Complications of immobility 52
iii Specific Therapeutic Positions 54PART 4 vi Musculoskeletal Disorders 55 Osteoporosis 56 Paget’s Disease 61 Bone Tumors 63 Osteoarthritis 67 Disorders of Joints and Connective Tissues 71 a. Rheumatoid Arthritis 73 b. Psoriatic Arthritis 80 c. Discoid Lupus Erythematosus 82 d. Systemic Lupus Erythematosus 83 e. Scleroderma 87 f. Sjogren’s Syndrome 90 g. Mixed Connective Tissue Disease 92 h. Polymyositis and Dermatomyositis 94 i. Relapsing Polychonditis 97 j. Vasculitis 98 k. Polyarteritis Nodosa 99 l. Temporal Arteritis 100 m. Wegener’s Granulomatosis 102 n. Reiter’s Syndrome 103 o. Behcet’s Syndrome 105 p. Ankylosing Spondylitis 107 q. Gout and Pseudogout 108 Bone and Joint Infections 113 a. Osteomyelitis 114 b. Infection Arthritis 117 c. Charcot’s Joints 119 Disorders of Muscles, Bones and Tendons 120 a. Spasmodic Torticollis 121 b. Fibromyalgia Syndrome 122 c. Bursitis 124 d. Tendinitis and Synovitis 126 Fracture 129 Spinal Cord Injury 136 Osteomyelitis 142 Herniated Nucleus Pulposus 145
iiiOsteosarcoma 149Pott’s Disease 153 viiBuerger’s Disease 155Gouty Arthritis 160Scoliosis 165Osteomalacia 171Clubfoot 172Spina Bifida 173Congenital Hip Dysplasia 176Coxa Plana 177Hydrocephalus 178Foot Problems 180 a. Ankle Sprain 180 b. Foot Fracture 182 c. Heel Spurs 184 d. Sever’s Disease 185 e. Posterior Achilles Tendon Bursitis 186 f. Anterior Achilles Tendon Bursitis 187 g. Posterior Tibial Neuralgia 187 h. Pain in the Ball of the Foot 188 i. Ingron Toenail 190 j. Onychomycosis 190 k. Nail Discoloration 191Sports injuries 192 a. Stress Fracture of the Foot 197 b. Shin Splints 198 c. Popliteus Tendinitis 200 d. Achilles Tendinitis 201 e. Runner’s Knee 202 f. Hamstring Injury 204 g. Weight Lifter’s Back 205 h. Backhand Tennis Elbow 207 i. Forehand Tennis Elbow 208 j. Rotator Cuff Tendinitis 210Exercise and Fitness 212 a. Starting an Exercise Program 212 b. Preventing Injuries 214 c. Choosing the Right Exercise 217
iiiPreventing Infection and Promoting Healing 220Balance Skeletal Traction Application 221 viiiHow to Tie a Knot 230Casting 231BST Equipments 237The Gadgets 238Tractions 247Hardware 253 a. Screws and Plates 253 b. Implants 256Braces 258Common Abbreviations in Surgery 260Surgeries 261Anesthesia Abbreviation 261Exercises 263Review Questions Related to Musculoskletal 267DisordersNursing Care Plan 280BIBLIOGRAPHY 286