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Musculoskeletal
Types of Fractures
Nondisplaced
Displaced
Incomplete
Complete
Closed
Open
Direction of Fracture Line
2 mins
Hip Fracture
Assessment
External Rotation
Muscle Spasms
Shortened Leg
Pain
Interventions
Buck's Traction
Analgesics
Surgery
Considerations
Avascular Necrosis
1 min
Hip Surgery
Neurovascular Assessment
No 90 Degree Hip Flexion
No Adduction
No Internal Rotation
Avoid Turning on Affected Side
Considerations
Thromboembolism Prevention
2 mins
Neurovascular Assessment 6 P's
Pain
Paresthesia
Pulse
Pallor
Pressure
Paralysis
1 min
Sizing Crutches
3 Finger Widths
6 Inches Lateral From Heel
30 Degree Flexion
Tripod Position
1 min
Total Knee Replacement (TKR)
Indications
Joint Pain (Uncontrolled)
Impaired Mobility
Considerations
Compression Dressing
Frequent Neurovascular Assessments
Continuous Passive Motion (CPM) Devices
Early Ambulation
Venous Thromboembolism (VTE) Prophylaxis
Limit Flexion Positions
Monitor for Infection
2 mins
Herniated Disc (Nucleus Pulposus)
Cause/Mechanism
Spine Trauma
Natural Degeneration
Spinal Stenosis
Assessment
Pain
Weakness
Urinary and Fecal Incontinence
Interventions
Brace
Medications
Outpatient Procedures
Surgery
2 mins
Amputation
Indications
Trauma
Peripheral Vascular Disease
Diabetes Complications
Considerations
Gentle Handling
Surgical Tourniquet at Bedside
Prevent Contractures
Frequent Inspection
Compression Bandages
Phantom Pain
Mirror Therapy
2 mins
NSAIDs
Indications
Anti-inflammatory
Analgesic
Fever
Closure of Patent Ductus Arteriosus
Mechanism of Action
Reversible Inhibition of COX-1 and COX-2
Block Prostaglandin Synthesis
Side Effects
Interstitial Nephritis
Gastric Ulcer
Renal Ischemia
1 min
Aspirin (Acetylsalicylic Acid)
Mechanism
Inhibits Platelet Aggregation
NSAID
Indications
Thrombotic Event Prevention
General Pain
Inflammatory Conditions
Fever
Side Effects
Pancytopenia
GI Ulcers
Bleeding
Considerations
Withhold Before Surgery 7-10 Days
Reye's Syndrome
2 mins
Aspirin Poisoning (Salicylism) Assessment
Early Symptoms
Nausea and Vomiting
Tinnitus
Confusion
Hyperventilation
Respiratory Alkalosis
Late Symptoms
Metabolic Acidosis
Coma
Hyperthermia
1 min
Reye's Syndrome
Cause
Aspirin (Salicylates) to Treat Viral Illness (In Children)
Assessment
Cerebral Edema
Lethargy (Decreased LOC)
Vomiting
Liver Failure
Interventions
Monitor for Increased ICP
Mannitol (Osmitrol)
Considerations
No Aspirin for Children
2 mins
Ibuprofen (Advil, Motrin)
Mechanisms
NSAID
COX Inhibitor
Indications
General Pain
Fever
Inflammatory Conditions
Side Effects
GI Ulcers
Nephrotoxicity
Rash
Considerations
Avoid with Alcohol
Risk of Thrombotic Event
2 mins
Prednisone (Glucocorticoids)
Mechanism
Glucocorticoid
Indications
Inflammatory Conditions
Organ Transplant Rejection
Side Effects
Cataracts and Glaucoma
Cushing's Syndrome
Osteoporosis
Immunosuppression
Hyperglycemia
Ulcers
Considerations
Adrenal Insufficiency
Taper Gradually
2 mins
Acetaminophen
Indications
Fever
Pain
Mechanism of Action
Reversibly Inhibits COX
Acts Primarily in CNS
Side Effect
Hepatic Necrosis
N-acetylcysteine Antidote
51 secs
Acetaminophen Antidote
Antidote
N-Acetylcysteine
33 secs
Celecoxib
Indications
Rheumatoid Arthritis
Osteoarthritis
Pain
Mechanism of Action
NSAID
Selectively Inhibits COX-2
Side Effects
Sulfa Allergy
Increased Risk of Thrombosis
GI Bleed
Contraindication
Pregnancy > 30 Weeks
1 min
R.I.C.E. (Treating Soft Tissue Injury)
Rest
Ice
Compression
Elevation
1 min
Compartment Syndrome Assessment
Mechanism
Trauma
Increased Pressure
Compressed Nerves and Blood Vessels
Assessment
1 or more of 6 P's
Ankle-Brachial Index (ABI)
Considerations
May take Days to develop
Early Detection
Ischemia
Damage often Irreversible
2 mins
Compartment Syndrome Interventions
Interventions
Frequent Neurovascular Assessments
Evaluate Pain
Do Not Elevate Extremity
Remove or Loosen Restrictive Items
Fasciotomy
Amputation
Considerations
Infection
Monitor Urine Output
2 mins
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