1) define septic arthritis
2) Explain Etiology, Clinical manifestation, pathology, And diagnostic evaluation of Septic arthritis.
3) Explain the management of septic arthritis. (Write management of septic arthritis.)
1) Definition of Septic Arthritis
Infection of the joint occurs in septic arthritis.
Septic arthritis involves inflammation of the joint and is mainly caused by bacterial, fungal, micro bacterial, viral and other pathogens.
This infection mainly travels through the blood stream from another part of the body and creates an infection in the joint.
Septic arthritis occurs when germs from any penetrating injury travel into the joint, creating an infection.
Septic arthritis mainly affects the knee, but septic arthritis also includes the hip, shoulder, and other joints.
Septic arthritis is primarily monoarticular, meaning it primarily involves a single joint such as a hip or knee joint.
explain Etiology Describe the causes
Staphylococcus aureus bacteria (staphylococcus aureus),
If there is any kind of infection or injury in the first joint,
kingella kingae gram negative bacteria
Atheroscopic surgery,
Nigeria gonorrhea (neisseriagonorrhoea),
arthrocentesis,
Streptococcus pneumonie,
joint replacement surgery,
Intravenous drugs abuse,
certain types of medication,
If you have any skin condition like eczema, psoriasis.
Any chronic medical illness,
hemodialysis,
hemophilia,
Immunosuppressive therapy,
corticosteroids drug tacking,
H. IV infection,
joint replacement surgery,
Explain pathophysiology.
Due to any etiological factor and risk factore
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Infection and inflammation occur and due to this synovitis (synovitis := infection of synovial members and
inflamation) and effusion in the joint (jointhe effusion).
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The infecting organism multiplies in the synovial fluid and synovial lining.
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The infecting organism produces virulence factors (adhesion).
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Due to this bacteria penetrates into the joint and infects the joint.
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This leads to the formation of abscesses in the synovial tissues and bones and due to this destruction of the affected joint.
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Septic arthritis.
explain clinical manifestation/ sign and symptoms
Decreased range of motion,
warmth,
joint redness,
Nausea from sticking in the joint,
Excruciating pain in the affected joint especially when trying to move.
The affected joint cannot be moved.
feeling tired
Weakness.
Fever and chills.
pain
Swelling in the joint.
Explain diagnostic evaluation (write diagnostic evolution)
history tacking and physical examination,
evaluation of affected joint,
complete blood count,
white blood count,
erythrocyte sedimentation rate,
ultrasonography,
synovial fluid analysis,
blood culture,
culture of joint fluid,
X Ray,
ct scan,
MRI,
explain the management of septic arthritis (write the management of septic arthritis) medical management
provide antimicrobial therapy,
administration intravenously antibiotics,
antibiotics,
fluid aspiration from affected joints,
if needed surgery should be done,
arthrotomy,
arthroscopy,
provide NSAID (NON STEROIDAL ANTI INFLAMMATORY DRUG),
Nursing management
Anchoring the patient to exercise.
Provide patient education to maintain aseptic technique when changing dressings.
Ask the patient to do frequent hand washing.
Instruct the patient to use the ambulatory aid safely.
Ask the patient to perform range of motion exercises.
Assessing the patient’s pain level and providing appropriate treatment.
Ask the patient to use a pillow.
Asking to elevate the affected joint.
Using a splint to immobilize the joint.
Administer anti-inflammatory medicine to the patient.
Providing analgesic medicine to the patient.
To provide various comfort measures to the patient.
Making hot or cold applications to the patient.
Massaging the affected area and changing its position.
Provide patient for infant support.
Provide a splint to the patient.
Provide relaxation techniques and diversional activities to the patient.
Ask the patient to take complete bed rest.
Ask the patient to rest on the chair if necessary.
Ask the patient to change position frequently.
Ask the patient to move on the bed.
Provide support above and below the affected joint so that jerky moment can be avoided.
1) Explain gonococcal arteritis.
2) Explain Etiology, Clinical manifestation and diagnostic evaluation of gonococcal arteritis.
3) Explain the management of gonococcal arteritis.
1) Define gonococcal arteritis.
Joint inflammation occurs in gonococcal arthritis.
And it is mainly caused by gonorrhea infection.
Gonococcal arthritis is a complication of sexually transmitted infection.
This mainly involves painful inflammation of joints and tissues.
Gonorrhea is mainly spread through sexual contact.
Gonococcal, mainly gonorrhea bacteria, cause joint infection and incubation when spread into the joint through the blood stream.
Gonococcal arthritis is a form of septic arthritis.
2) Explain the Etiology of gonococcal arteritis.
gonorrhea infection,
Nigeria gonorrhea,
Spread from infected mother to child.
Women and teenage girls are more likely to be infected.
multiple sex partners.
unprotected sexual activity.
Explain the clinical manifestation / sign and symptoms. (State the symptoms and signs.)
joint pain,
Fever,
feeling cold,
feel tired,
pain in hands and feet,
gonococcal bacteria migraine to tendon,
Red and swollen joints,
tender and painful joints,
Decreased range of motion,
Fever and chills,
skin lesion,
explain the diagnostic evaluation. Write a diagnostic evaluation.
history tacking and physical examination,
throat culture,
cervical gram stain,
urine and blood tests,
complete blood count tests,
white blood cell count,
blood culture test,
imagine test.
Explain management of gonococcal arteritis. (Write management of gonococcal arthritis.)
In this, drainage of fluid from the joint is done.
Immobilizing the joint by sprinting.
Give the patient antibiotic medicine.
Administering analgesic medicine to the patient.
administration antibiotics.
Provide Azithromycine to the patient.
1) Explain osteomyelitis. Describe osteomyelitis.
2) Explain Etiology, Clinical manifestation, and diagnostic evaluation of osteomyelitis.
3) Explain the management of osteomyelitis.
1) Explain osteomyelitis.
Osteomyelitis is a pyogenic infection of bone and surrounding tissues.
Osteomyelitis is an infection of the bone and mainly involves the cortex and medullary bone.
Osteomyelitis is an acute infection of bone.
It is mainly in acute, subacute and chronic process.
explain Etiology
staphylococcus Aureus ( Staphylococcus aureus ),
E-coli,
pseudomonas (Pseudomonas),
proteus,
salmonella (Salmonella),
rheumatoid arthritis (rheumatoid arthritis),
Persons above 50 years of age.
Sickle cell disease.
Obese or malnourished patient.
patient received hemodialysis.
Whose immune system has been impaired.
Because of the post-operative wound.
Chronic disease means (diabetes, rheumatoid arthritis).
alcoholism,
Intravenous drug use or drug abusers.
Explain clinical manifestation/ sign and symptoms.
bone pain,
fever,
General Dishcompleta.
feeling tired
Swelling and feeling of warmth in the affected area.
Swelling in the local area.
Redness and warmth.
Loss of range of motion.
Feeling cold.
Sweat profusely.
Low back pain.
Swelling of ankle, feet and legs,
Drainage of pus from the skin.
General discomfort.
Nozia.
Sweat profusely.
Swelling in ankle, feet and legs.
Changes in gait.
constant, pulsating pain present.
explain Diagnostic evaluation (Write the diagnostic evaluation.)
history tacking and physical examination,
bone X Ray,
ct scan,
MRI,
blood test,
blood culture,
needle aspiration,
biopsy,
bone scan,
bone biopsy,
bone X Ray,
complete blood count,
c reactive proteins,
erythrocyte sedimentation rate (ESR),
MRI of bone,
needle aspiration,
3) Explain the medical management of osteomyelitis.
administration antibiotic,
cefriaxone,
Ciprofloxacine,
clindamycin,
vancomycin,
lenezolid
administration intravenously antibiotics,
implantation of antibiotic beads or pumps.
provide hyperbaric oxygen.
surgical management
1) Sequestrectomy
In this, dead bone is removed.
2) debridement
This involves removing as much of the dissected bone as possible.
3) drainage
In this, open wound and access are drained by needle aspiration.
4) Provide internal fixation and external supportive devices.
Nursing management If the patient is in pain, provide opioids.
Do an examination of the body area to see if there is any tenderness, warmth and swelling.
Ask the patient to explain his feelings.
Ask the patient to self-care.
Maintain strict aseptic technique when changing dressings and irrigating the wound.
To provide full information about the disease condition to the patient.
Ask the patient to rest.
Ask the patient to adopt relaxation techniques.
Ask the patient to adopt non-pharmacological techniques including relaxation techniques, guided imagery, and deep breathing.
Provide support with pillows to the affected limb.
Elevate the affected area to reduce swelling.
Observe the patient for any pressure ulcers present.
Assess the vascular status of the affected area.
Ask the patient to take complete bed rest.
To check patient’s vital sign.
Ask the patient to take complete bed rest.
Provide the patient with a high protein, vitamin C rich diet and a well balanced diet to bring about proper healing.
Splint should be provided in the affected area to reduce pain and muscle spasm.
Provide the prescribed antibiotic to the patient.
Ask the patient to perform range of motion exercises every four hours.
To provide support to the affected extremity.
1) Define the “potts’s spin” and give the other name of
Pott’s spine.(Define Portus spine and give another name for Portus spine.)
2) Explain the etiology, clinical manifestation and diagnostic evaluation of Potts’ spin. (Write the causes, signs and symptoms and diagnostic evaluation of Potts spine.)
3) Explain the management of pott’s spin.
1) Explain the “potts’s spin.“
Potts spine is also called tuberculosis in spinal cord.
Potts disease is derived from a surgeon named Percival Portsman
Percival Potts’s (who was a surgeon in London).
Potts spine is also called tuberculosis in spinal (intervertebral joints) code.
This is a disease of the spinal cord that occurs when the Mycobacterium tuberculosis reaches the spinal cord and affects the spinal cord.
Another name for Potts spine
Spine tuberculosis,
tuberculosis spondylitis (tuberculous spondylitis),
Potts’s caries,
David disease,
potts’s curvature (potts curvature) . is called
Bone is the main site in Pott’s disease.
It also affects the hip and knee.
These are mainly lower thoracic and upper lumbar vertebrae
2) Etiology of potts’s spin.
The most common cause is Mycobacterium tuberculosis
(mycobacterium tuberculosis).
To persons having poor socio economic condition.
Hiv infection,
drug addiction,
alcoholism,
spread through lymphatic and hematogenous (by blood),
endemic tuberculosis,
Explain the signs and symptoms. (Symptoms and Signs.)
These symptoms have a gradual onset.
Back pain.
Fever.
Avoid night sweats.
Loss of appetite.
Weight loss.
Occurrence of paravertebral swelling.
stiff position.
abscess formation.
Spinal moment restricted.
Weakness.
Spinal deformity causes muscle wasting.
muscles weakness of legs.
compressive myelopathy.
bone necrosis.
osteomyelitis.
Kyphosis (abnormal curvature of spine).
numbness,
paresthesia (feeling of tingling and numbness),
Explain the diagnostic evaluation. (Write the diagnostic evaluation.)
history tacking and physical examination,
Previous exposure to tuberculosis.
spin X Ray.
CSF test := to find out bacteria to.
tuberculin test.
ct scan.
MRI.
radionuclide scanning.
gallium and tuberculosis bone scan.
complete blood count.
Elevated erythrocyte sedimentation rate.
strong positive montoux skin test.
Explain the management of Potts’ spin.
medical management of Potts’ spin.
provide antituberculosis chemotherapy.
(isoniazid and rifampicine and additional drug at least for two months)
Ask the patient to take complete bed rest.
Immobilization of the affected joint.
Ask the patient to take high protein rich food.
drainage of abscess if present.
Physiotherapy to the patient.
surgical management
1) laminectomy,
2) surgical decompression,
3) Anterior radical focal debridement also done.
nursing management
Ask the patient to describe his feelings.
To explain the treatment and its complications to the patient.
To allow the patient’s family members to stay with him.
2) self care deficit.
Provide sponge bath to the patient.
Providing back care to patients.
Providing mouth care to the patent.
Providing eye care to patients.
Changing the patient’s position every two hours.
3) Acute pain related to inflammatory process.
Assess the patient’s pain level.
Provide comfort device to the patient.
Ask the patient to lie down on a hard bed.
Administering the prescribed analgesic medicine to the patient.
Asking the patient to change position frequently.
Provide wet and moist compression to the patient.
4) Impaired physical mobility.
Advice the patient to use assisting device ex:= walker, cans, wheel chair, according to level of mobility of patient.
Asking for early ambulation of the patient.
1) Explain sprain. Describe the spray.
2) Explain Etiology, Clinical manifestation, And diagnostic evaluation of sprain.
3) Explain the management of sprain.
1) Define sprain. (Define sprain.)
A sprain is a condition in which the supporting ligaments of a joint are injured.
A sprain is the stretching or tearing of more than one ligament and supporting muscle fibers surrounding a joint.
Sprain is mainly caused by any sudden injury, hyper extension or twisting motion.
In this the ligament is partially or completely torn.
Sprain mainly occurs in the ankle or knee joint.
A sprain involves injury to the ligaments around the joint.
Normally the ligament maintains the stability of the joint but when a ligament is torn, the stability
Disappears.
Joint ma. Oedema is seen in the joint due to sprain, tenderness is present in the joint and the joint is very painful and swelling and bleeding are also seen.
degree of sprain:=
1) first degree sprain,
2) second degree sprain,
3) Third degree sprain.
1) First degree sprain:=
There is mild amount of stretching of this ligament and no instability of this joint.
2) Second degree sprain:=
In this the ligament ruptures laterally but there is no instability of the joint.
3) Third degree tear:=
In this, complete rupture of the ligament takes place along with instability of the joint is also present.
2) provide Etiology.
Due to twisting of the joint.
Due to fall.
Due to sports injury.
Due to over stretching.
Because of the loud banging.
age.
hight.
weight.
Ankle: due to walking and exercising on uneven surfaces.
knee: During athletic activity.
wrist:= due to weight falling on the arm.
thumb := because of playing games.
Explain clinical manifestation/ sign and symptoms.
Joint pain.
Swelling.
Stiffness in the joint.
Skin discoloration.
Loss of muscle strength.
Having muscle cramps or spasms.
loss of ability to move or use the joints.
Tenderness.
Pain during moments.
Swelling.
brushing.
Discolouration.
Reduced ability to move the affected joint.
Swelling.
pain
explain diagnostic evaluation .(Write diagnostic evaluation.)
history taking and physical examination.
X Ray truly out contusion, sprain, and strain.
MRI.
3) Explain the management of sprain.
medical management:=
RICE
R := REST ,
I:= ICE ,
C:=COMPRESSION ,
E:=ELEVATION .
1)REST:=
Resting can prevent further injury as well as promote healing.
2)ICE:=
Applying ice can stop the build-up as well as relieve ED and discomfort.
Isla is applied wrapped in a clean cloth to reduce swelling.
Do not apply ice directly on the skin.
Apply ice for 10 to 15 minutes.
3) COMPRESSION:=
Provide support through bandages to the injured tissues.
Wrapping the injured area with a bandage.
Elastic compression bandages control swelling and reduce edema and provide support to injured tissues.
4) ELEVATION:=
Swelling is reduced by elevation.
Elevation reduces pain level and improves muscle tone.
Provide support through belt to the affected area
Providing physiotherapy to the patient.
Surgical repair of the affected area.
Immobilization of the affected area with a cast.
Providing hot compression.
Apply electric heating pad.
Do active or passive exercise after two to five days.
A sprain or strain may take a week or even a month to heal.
Assess the neurovascular status of the injured extremity.
If the sprain is severe, immobilization for one to three weeks.
Provide analgesic medication to the patient.
Providing Analgesic medicine to the patient is NSAID (NON STEROIDAL ANTI INFLAMMATORY DRUG) OR COX-2 (CYCLOOXYGENASE).
In case of severe sprain, surgical repair or immobilization by cast.
Applying a splint to prevent further injury.
Nursing management
Providing education to the patient to use crutches, walkers, canes, sleighs in a correct manner.
Provide a comfortable position to the patient.
Palpate the skin for warmth.
Check the neurovascular status of the affected extremity every four hours.
Checking the patient’s capillary refill time.
Checking the patient’s sensation level.
Swelling over the affected extremity does not increase and is seen properly.
To see whether the patient can move the body part properly or not.
Ask the patient to perform range of motion exercises.
Identify the pressure body part and take care not to put pressure on it.
Provide prescribed medicine to relieve pain.
Elevating the affected body part.
Application of splint for mobilization.
Provide cold application for 20 to 30 minutes in that 24 hours.
Ask the patient to take the prescribed analgesic medicine.
Providing education to patients on proper use of crutches.
Initially provide rest to the affected body part but gradually and slowly do the activity.
Provide diversional therapy to the patient.
Provide emotional support to the patient.
Provide a comfortable position to the patient.
To check proper vital signs of the patient.
Ask the patient to move the affected body parts.
teach patient to use (RICE :=REST, ICE, COMPRESSION, ELEVATION) therapy to care for injury.
Ask the patient to follow up properly.
1) explain Dislocation.
2) Explain Etiology, Clinical manifestation and diagnostic evaluation of dislocation.
Write an evaluation.)
3) Explain the management of dislocation.
1) define dislocation.
Dislocation is a condition in which the articular surface separates from the joint.
Joint dislocation occurs when the bone forming the joint dislocates and separates from its anatomical contact.
This is an emergency situation in which the blood and new supply is disrupted.
In subluxation there is partial and complete displacement of the joint surface.
In the displaced bone, blood supply, rupture blood vessels, damage nerve and muscles are ruptured.
1) CONGINATAL DISLOCATION (congenital dislocation).
2) TRAUMATIC DISLOCATION (Traumatic Dislocation).
3) PATHOLOGICAL DISLOCATION.
4) PARALYTIC DISLOCATION
1) CONGENITAL DISLOCATION:=
This dislocation is mainly congenital and it is mainly seen in hip bone and knee bone.
This can be mainly due to any genetic factor or due to improper development of fetus.
2) TRAUMATIC DISLOCATION:=
Traumatic dislocation can be due to fall, any kind of snake bite, trauma and injury and serious violence.
3) Pathological dislocation:=
pathological
Dislocation can be mainly due to any infection, rheumatoid arthritis and neuromuscular disease and other diseases.
4) Paralytic dislocation:=
This may be mainly due to muscle power imbalance.
Ex:= poliomyelitis.
explain Etiology.
due to falling,
Due to hard hitting,
Due to the application of force,
Due to an accident.
age,
sports participation,
hereditary,
sports injury,
downhill skiing,
gymnastics,
volleyball,
due to some disease,
trauma.
explain clinical manifestation
pain,
deformity,
change in length of extremities,
loss of normal movement,
Length of extremity is altered.
Severe pain.
Swelling of the affected extremity.
simply climb.
change in contour of joint.
loss of normal mobility.
Visible deformity is present.
Deformity.
Changes in the length of extremities.
Alteration in normal moments.
explain Diagnostic evaluation Write a diagnostic evaluation.
history tacking and physical examination,
X Ray,
MRI,
Medical management
The doctor immobilizes the part of the joint with a splint for a few weeks.
How long a splint should last depends on the involvement of the joint, nerves, blood vessels, and supporting tissue.
P R I C E treatment
P:= PROTECT
To properly protect the dislocated joint from further injury.
R := RICE
Getting proper rest to promote healing.
I := ICE
To remove the discomtain.
C:=COMPRESSION
To ease the pain.
E := ELEVATION
To reduce swelling. And to remove the discomfort.
Instead of attempting to relocate the dislocated bone, take immediate referral to a physician so that proper treatment can be taken.
REDUCTION:=
In this process the dislocated bone is brought back into re position and this is mainly done by doctor.
In the reduction position, the joint is kept in its stable position using bandage, splint, cast and traction.
Providing analgesic medicine to the patient.
Provide relaxants medicine to the patient.
Ask the patient to perform range of motion exercises.
Assess the patient’s neuromuscular status.
Nursing management.
Assess muscles weakness and severity of weakness.
Provide patient with assistant device like splint, wheel chair which increases mobilization.
Ask the patient to perform range of motion exercises.
Ask the patient to perform exercises that improve muscle strength.
Ask the patient to do as many activities as possible that will allow the patient to be independent.
Assess the patient’s respiratory rate every four hours.
Take measures to prevent skin from breaking down.
Assess the patient’s neurovascular status.
5 by “p”.
P = pain,
P:= pallor,
P:= pulse,
P:= paralysis
P:= parestheaia
Provide immobilization device to the patient.
Providing proper physiotherapy to the patient.
Providing the prescribed medicine to the patient.
Providing a comfort device to the patient to reduce the pain level.
To protect the injured joint.
Refer patients for physical and occupational therapy.
Complication:=
Traumatic arthrotomy,
fracture within the joints,
Avascular necrosis,
arthritis,
Nerve and blood vessel damage.
1) Explain the fracture. Define fracture.
2) Explain Etiology, Classification of fracture Clinical manifestation, And diagnostic evaluation of fracture.
) define fracture. Define fracture.
A fracture means a breakdown in the continuity of a bone is called a fracture.
In a fracture, there is a break down in the structure of the bone.
A fracture also involves the bone, its tissues, bone marrow and periosteum.
Bone fracture is either partial or complete.
2) Explain Etiology.
Due to trauma,
Due to road traffic accident,
due to falling,
Due to injury,
Due to any disease condition,
osteoporosis,
osteomalacia,
Cancer, other bone infections due to long-term use of corticosteroids.
Due to direct injury.
crushing force.
torsion.
Due to excessive muscle contraction.
bending force.
Due to compression force applied.
Due to an accident.
Due to the occurrence of bondiasis.
old age.
occupation.
explain the classification of fracture. (List classification of fracture.)
1) complete fracture:=
In this the bone breaks down in a cross section.
In a complete fracture, the bone is divided into two parts.
2) Incomplete fracture:=
Your bone does not break down completely.
In an incomplete fracture, the bone cracks but does not break down completely.
3) closed fracture:=
A close fracture is also called a simple fracture.
Bone is the background in this.
But it remains inside the skin, i.e. the skin is intact so the wound is not open or visible and the skin is intact on the fracture side.
4) open fracture:=
Open fracture is also called compound fracture.
In this the bone breaks down above the skin and is visible outside.
Fracture site is interrupted skin.
If there is an open fracture, bacteria can enter through the open site and create an infection.
According to grade:=
Grade 1 := In this the wound is clear and smaller than one centimeter.
grade 2:= In this the wound is in moderate amount and one centimeter bigger.
Grade 3 := This wound is highly contaminated with more involvement of soft tissues, nerves and tendons and the wound is larger than 6-8cm.
5) Displaced fracture:=
This fracture is one in which the broken bone separates from each other and is mainly caused by falls.
6)Comminuted fracture:=
This includes bonefragment a crush and break down into many parts.
This is mainly seen due to fall down of elderly people.
Classification by fracture pattern:=
1) linear fracture:=
In this the fracture is parallel to the long axis of the bone.
And this is mainly due to direct force on the bone.
2) Transverse fracture:=
In this the fracture is seen at 90 degrees.
Ex:= paget’s disease,
Osteomalacia.
3)Oblique fracture:=
In this the fracture is seen at an angle of 45° degree.
Fractures are mainly caused by twisting forces.
4) spiral fracture:=
Spiral fracture is called torsion fracture.
This is called bona facture.
This is mainly due to the application of twisting force.
5) Depressed fracture:=
This facture is mainly seen due to depression in the skull bone and facial.
6)longitudinal fracture:=
It is mainly a fracture that occurs in the long axis of the bone.
In this the facture line is longitudinally.
Classification by type of fracture:=
1)Avulsion fracture:=
This is a fracture in which a segment of bone breaks down from a ligament and tendon.
2)Compression fracture:=
A compression fracture is also called a cruciate fracture.
And this is mainly due to any compression being applied to the ebon.
3) Green stick fracture:=
In this, the bone breaks down from the part on one side and the bone bends on the other side.
4) Impacted fracture:=
Continuity of the bone is lost in an impacted fracture.
5) Pathological fracture:=
This fracture occurs mainly when there is backjaw from a deficient bone and the fracture is observed.
6) Stress fracture:=
A stress fracture is often caused by repeated loading on the bone.
Classification by eponym.
1)colles’s fracture:=
Cole’s fracture is also called broken wrist.
The radius bone is fractured about one centimeter from the wrist to the articular surface.
2) Pott’s fracture:=
Potts fractures occur primarily in the medial melleiolus of the tibia and fibula.
Classification by anatomical location:=
1) articular fracture:=
In this fracture there is involvement of the articular surface of the joint.
These fractures mainly damage the articular cartilage and also damage the subchondral bone.
2) Extracapsular fracture:=
This fracture is mainly near the capsule of the joint but there is no involvement of the joint capsule and this type of fracture is mainly in the hip (waist).
3) intracellular fracture:=
These fractures are mainly found within the joint capsule and are mainly found above the neck level and above the head of the femur bone.
4)Epiphysial fracture:=
This structure consists primarily of the epiphysial plate of the long ball.
This fracture is also called Selter fracture.
Explain clinical manifestation/sign and symptoms. (Describe the signs and symptoms of a factor.)
pain,
Tenderness at site of fracture.
Swelling.
Increase in body temperature.
loss of function.
Deformity.
Blood loss.
Deformity.
Swelling.
pain
Impairment in functioning.
simply climb.
Crepitus.
Hypovolemic shock.
shortening of extremities.
discolouration.
Impaired sensation.
abnormal mobility.
shock.
diminished capillary refill.
pallor.
Explain the diagnostic evaluation of fracture.
history taking and physical examination.
Clinical examination.
radiographic examination.
ct scan.
MRI.
management of fracture:=
emergency care of fracture:=
Immobilization of the fractured part immediately upon realization of fracture.
To provide proper support to the factory part.
Taking measures to reduce it if severe trou occurs.
If there is an open fracture, provide immediate sterile dressing.
In this, bleeding is controlled by applying a dressing over the fracture.
Apply pressure if bleeding occurs.
Covering the patient to preserve body heat.
Movement of the extremity at the fracture site, warmth, circulation, color are checked.
Adequate application of splint to the affected joint.
Immobilization of the affected joint.
Make the affected limb move a little bit.
Complete physical assessment to rule out any further injuries.
medical management
1)REDUCTION:=
Reduction restores the fractured part back to its tomical alignment.
1) Closed reduction: =
In closed reduction, the fixed part is properly positioned on its anatomical site and a splint is applied.
2)open reduction:=
In this, internal fixation is used to fix the bone fragment.
In which metal, pin, wire, screen, rod, etc. are used.
2) Immobilization:=
Proper immobilization of bone fragments after fracture.
This immunization is done by external fixator and internal fixator.
External fixator included:=
In this external fixator bandage, cast, spleen are used.
Internal fixation:=
Internal fixator uses metal pin wire screen rod etc.
3) maintaining and restoring function:=
Elevating the affected extremity to reduce swelling.
Provide patient ice application.
Assess the patient’s neurovascular status.
Asking the patient to express his feelings.
Changing the position frequently to reduce the patient’s pain level.
Administering tetanus injection to the patient as a prophylactic.
Provide antibiotic medicine to the patient.
Providing analgesic medicine to the patient.
Provide calcium and iron supplementation to the patient.
Provide cold application on the affected extremity of the patient.
Providing education to the patient for alternative treatments for pain management like relaxation and guided imaginary.
Asking for exercise to reduce muscle wasting.
4) Pharmacological management:=
Providing narcotic medicine to the patient.
Provide analgesic medicine to the patient.
Provide non-steroidal anti-inflammatory medicine (NSAID) to the patient.
Administer antibiotic medicine to the patient.
Administering anticoagulant medicine to the patient.
School softener to the patient.
Nursing management
Elevate the affected extremity to reduce swelling.
Provide a comfortable position to the patient.
Maintain SMT technique while handling the patient.
Assess the patient’s neurovascular status.
To check patient’s vital sign.
Provide prescribed antibiotic, analgesic, calcium supplement.
Maintaining intake output chart of patient.
Provide protein and calcium rich diet to the patient.
Providing reassurance to clients.
Frequently assess the patient for any infection.
Ask the patient to do moderate daily routine activities and exercise.
To check patient’s vital sign.
To check the patient’s pain level using a pain scale.
Elevate the affected lemon slowly.
Ask the client to do deep breathing.
Ask the patient to adopt relaxation techniques.
Checking the patient’s capillary refill time frequently.
Aspirate the limb to see if there is any swelling or swelling.
Keep checking the tightness of the cast.
Keep the affected limb above heart level.
Maintain aseptic technique while dressing the patient.
Ask to do range of motion exercises in the affected extremity.
Ask the patient for early ambulation.
Providing education about patient’s assistive devices like crutches, walker, cans, slings etc.
Change the position of the patient every two hours.
complications
shock,
fat embolism,
compartment syndrome,
volkmans contracture,
deep vein thrombosis,
infection,
delayed union,
avascular necrosis of bone,
reflux sympathetic dystrophy.
1) Explain spinal fracture.
2) Explain Etiology, Clinical manifestation, And diagnostic evaluation of spine fracture.
3) Explain the management of spine fracture.
1) Define spinal fracture. (Define spinal fracture.)
A spinal fracture occurs when the bones of the spine, called vertebrae, break or collapse.
This can mainly happen due to injury or fall down in any train and also due to car accident.
2) Explain Etiology.
Due to abnormal curvature of the spine (Kyphosis,
Scoliosis, Lordosis).
Due to a tumor in the spinal cord.
Due to any injury.
Due to an accident.
due to falling.
due to assault.
Due to sports injury.
Due to any injury in the spinal cord.
explain clinical manifestation/sign and symptoms
Symptoms and signs of a spinal fracture depend on its severity and location.
Severe pain.
simply climb.
tingling and numbness sensation.
Spasm in the muscles.
Weakness.
Bowel and bladder changes.
Decrease of moment.
Paralyze.
explain diagnostic evaluation Write a diagnostic evaluation.
history taking and physical examination.
X Ray.
ct scan.
MRI.
Explain management of fracture of spine.
There are three things to keep in mind in the management of spinal cord.
Maintain alignment of spinal cord.
Immobilization of the spinal cord should be maintained during healing.
Pain should be controlled by restricting movement.
Instrumentation and fusion are surgical procedures used to correct unstable fractures.
plates to join two fractured bones,
Rhodes,
hooks,
Pedicles,
Screws,
And cages are used.
It takes a few months for the bone to fuse with this implant.
Vertebroplasty and kyphoplasty is an invasive procedure. It is done when there is a fracture of the spine.
in vertebroplasty :=
In vertebroplasty, bone cement is inserted into the fractured vertebrae through a hollow needle.
in kyphoplasty:=
In kyphoplasty, a balloon is first inserted and then the balloon is inflated so that the compressed vertebrae can return to their normal position.
Explain the degenerative conditions of joint and spine.
1) Explain Osteoarthritis.
2) Explain Etiology, Clinical manifestation/sign and symptoms and diagnostic evaluation of Osteoarthritis.
3) Explain the management of Osteoarthritis.
1) Explain Osteoarthritis. (Define Osteoarthritis)
Osteoarthritis is a chronic, noninflammatory and slowly progressive disorder that causes deterioration of articular cartilage.
Osteoarthritis mainly affects hip bone and knee bone.
Osteoarthritis is also called degenerative joint diseases.
It is a slowly, progressive, non-inflammatory disorder mainly found in mobile joints and particularly articulation joints.
Osteoarthritis is mainly caused by the breakdown of the cartilage surrounding the joint.
type of Osteoarthritis:=
1) Primary Osteoarthritis:=
Primary Osteoarthritis is mainly seen in elderly people and mainly in women.
Osteoarthritis is mainly seen due to any trauma, hereditary, and due to obesity, age etc.
2) Secondary Osteoarthritis:=
Secondary osteoarthritis occurs at any age.
This is mainly due to any previous injury, repeated strain or sprain, joint dislocation, fracture, inflammation, congenital dislocation of hip,
It is seen due to disorder of nervous system, use of corticosteroids etc.
explain Etiology:=
Due to order age,
more common in women,
Due to genetic factors,
due to excess weight,
Due to obesity,
Due to septic arthritis,
Due to trauma,
Due to strenuous and repetitive exercise,
Due to joint injury,
Due to decreased amount of estrogen.
Due to parathyroid hormone increases.
Due to metabolic diseases like diabetes gout and other hormonal disorders.
explain clinical manifestation/ sign and symptoms
joint pain,
Stiffness in the joint,
Pain increases with activity and pain decreases with rest.
Stiffness in the joint in the morning.
parestheaia (tingling and numbness sensation),
Swelling, muscle weakness, bony deformity,
Swelling in the joint (warmth, effusion, synovial thickening).
Tenderness and soreness in the joint.
Break up.
Decreased flexibility of the joint.
Reduced range of motion in the affected joint.
crapitus (sound caused by friction between two bones).
Swelling in bone.
grating sensation.
explain diagnostic evaluation (write diagnostic evaluation)
history taking and physical examination
X Ray,
ct scan,
MRI,
blood test,
analysis of synovial fluid,
erythrocyte sedimentation rate (ESR Test),
Radionuclide imagine.
explain the management of Osteoarthritis Write the management of Osteoarthritis.
If the patient is in pain, provide analgesic medicine.
Ex:= acetaminophen
Provide medicine to relieve inflammation and pain.
Ex:=NSAID (Non steroidal anti inflammatory drug),
Ibruprofen, Naproxen.
Tramadol.
Cox 2 inhibitor drug.etc.
Proper weight loss to avoid stress on the joint.
Exercising Properly Exercising causes joint moment and muscle tension in the muscles that surround the joint.
Simple exercises like swimming and walking are done on a flat surface because these exercises are less stressful on the joint.
Asking the patient to take proper nutrition, proper sleep and to reduce stress due to which belching improves.
Ask a sick patient to lose weight.
Due to weight loss, the stress on the knee joint, hip joint and spine is reduced and due to this the pain is also relieved.
When the pain level of the patient increases too much, it is also necessary to manage the patient surgically.
Using supportive device like splint, shoe which reduces the pain level.
Using a supportive assistive device which reduces the pressure on the joint and is mainly used to stabilize the ligament and reduce the pain level.
Glucosamine and chondroitin:= These are mainly used to reduce the pain that a person has with osteoarthritis condition.
Providing hot and cold application to the patient.
Providing hot therapy reduces joint stiffness and should be provided mainly two to three times throughout the day.
Cold therapy is mainly used to reduce swelling and cold application should be applied no more than 20 minutes.
Explain the surgical management of Osteoarthritis
1)Osteotomy:=
In osteotomy, the bone is cut from above and below and the weight is reduced due to which the pain level is reduced.
2) joint fusion:=
In joint fusion, the damaged joint is removed and the two bones are fused, and this is mainly done where joint replacement is not effective.
3) Arthroscopy:=
In arthroscopy, mainly the damaged cartilage is cleaned and the tissues are repaired.
4) joint replacement:=
In joint replacement surgery, the damaged joint surface is removed and replaced with a plastic or metal device called a prosthesis.
Explain nursing management.
Assessing the patient’s pain level.
Measuring the location of the patient’s pain and its intensity with a pain scale.
Provide hot or cold application to the patient.
Ask the patient to change position frequently and to assume a comfortable position.
Ask the patient to take complete rest.
Ask the patient to take the prescribed analgesic medicine.
Provide comfortable materials to the patient and ask him to take proper rest.
Ask the patient to perform good body mechanics while walking, sitting, moving, or lifting anything.
Ask the patient to properly use devices like splint, braces, traction, etc.
Ask the patient to take complete rest.
Asking the patient to take the prescribed analgesic medicine.
Ask the patient to adopt stress management techniques.
Provide patient education to minimize activities that increase pain levels.
Providing hot and cold applications to the patient.
To provide education to the patient for correct position and body mechanism.
Ask the patient to roll a towel and then rest at neck level.
Ask the patient to lose weight.
Ask the patient to do as much activity as possible.
To exercise the patient’s proper range of motion.
Provide education to the patient to take adequate rest, sleep and nutrients.
Checking the patient for inflammation at the joint site.
Assess the patient’s range of motion of the affected joint.
Ask the patient to do range of motion exercises.
Providing a safe environment to the patient for example raise the chair, use high grip and tub and toilet, the use of mobility aids/wheelchair rescue.
Provide patient with skills in active and passive exercise.
Telling the patient to do early ambulation by use of assisting device like crutches, walker and canes.
Provide education to the patient to exercise.
Asking the patient to use assistive devices.
Ask the saint to maintain a comfortable position.
Ask the patient to maintain proper posture.
If she is overweight due to tuition, ask her to lose weight.
Ask the patient to take the prescribed medicine.
Asking the patient to make modifications in his life style.
1) define rheumatoid arthritis
2) Explain Etiology, stages Clinical manifestation, and diagnostic evaluation of rheumatoid arthritis.
3) Explain the management of rheumatoid arthritis.
1) Define rheumatoid arthritis. (Define rheumatoid arthritis.)
Rheumatoid arthritis is a chronic, systemic, autoimmune connective tissue disorder that creates inflammation of the synovial membrane surrounding the joints.
And simultaneously destruction and proliferation of synovial members.
And due to this, destruction (Vinas), Ankylosis (Stiffness of joint) and deformity (Physical loss) comes in the joint.
Auto-immune means that the body’s tissue mistakenly identifies itself, affects the body’s own connective tissue and mainly involves the joint, causing joint pain, stiffness,
Immobility ensues.
Rheumatoid arthritis mainly affects other organs of the body as well
Skin, eyes, lungs, and blood vessels are also involved.
2) Explain Etiology of rheumatoid arthritis. (Causes of Rheumatoid Arthritis)
The exact cause of rheumatoid arthritis is unknown.
Due to genetic factors (if a parent has this disease, there is a possibility of it coming to the child),
Due to taking stress.
sex:=women are more likely to develop rheumatoid arthritis.
Due to any infectious agent.
Age mainly between 30 to 60 years of age.
Due to environmental factors.
Being a family history.
Due to hormonal effect.
Due to long term smoking.
Betabolic and
Because of the line in the biochemical Abnor.
Due to any bacterial, fungal, virus infection.
Due to immunological response.
Explain the stages of rheumatoid arthritis. (Describe the stages of rheumatoid arthritis).
1) SINOVITIS (Synovitis),
2) pannus formation
3) Fibrous tissues Ankylosis
4) Bony Ankylosis
1) synovitis:=
In this, when an infection occurs in the body, the infection mainly affects the synovial membrane of the joint and due to this, infection and inflammation occurs in the synovial members and thus synovitis occurs.
And synovial fluid increases.
2) Pannus formation
This synovial fluid becomes inward and becomes quite thick and this fluid increases around the capsule of the joint.
3) Ankylosis of fibrous tissues:=
In this the synovial fluid increases significantly and becomes stiff and gets stuck around the joint forming a hard structure.
4) Bony Ankylosis:=
In this the fibrous tissue creates a very hard structure and bone-like formation and due to this the joint is immobilized and stiffened.
Due to any etiological factor.
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Infection of synovial membrane occurs.
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Inflammation of synovial members occurs.
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Synovial fluid is secreted from synovial members.
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This fluid progresses and accumulates in the bone.
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And the bone becomes very hard and stiff bone which is immobilized bone.
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Rheumatoid arthritis.
explain clinical manifestation/ sign and symptoms
The affected joint becomes red and warm.
Joints become inflamed and stiff and tender.
Pain in the joint.
Morning stiffness occurs in the joint.
Arthritis occurs in more than three bones.
The joint becomes swollen (sponge like).
Arthritis occurs in the hand joint.
firm bumps of tissues under the skin on arms.
Rheumatoid nodules form.
Rh factor positive.
Fluid accumulation occurs in the ankles.
The joint loses its range of motion and becomes deformed.
muscular atrophy around affected joint.
ulnar deviation
In this the finger is deviated towards the ulnar surface.
Swan neck deformity
In this the finger becomes a swan sap.
Bouterine deformity
This finger is bent.
knock knee.
Difficulty in sleep.
numbness and tingling sensation.
burning sensation in hands and feet.
Module formation within the skin.
Burning sensation in the eye.
Itching and discharge.
Dry mouth and eyes.
Chest pain.
Weakness.
Difficulty breathing.
Weakness.
feeling tired
Loss of appetite.
Weight loss.
Getting a low grade fever.
malaise.
Depression.
lymphadenopathy.
Inflammation in the blood vessels.
Having involvement of multiple organs (pericarditis, osteoporosis, anemia, subcutaneous nodules, vasculities, neuropathy, fibrotic lungs disease).
explain the difference evaluation (Write the diagnostic evaluation.)
history taking and physical examination.
Rheumatoid factor test:= RA positive.
antinuclear antibody test.
erythrocyte sedimentation rate (ESR).
c-reactive protein (crp test).
complete blood count test.
Comprehensive metabolic panel (to monitor kidney and liver function).
synovial fluid analysis (synovial fluid changes from transparent to milky, cloudy, and dark yellow fluid).
arthroscopic examination.
X Ray.
joint ultrasound.
MRI.
3) Explain the management of rheumatoid arthritis.
medical management
1)NSAID (NON STEROIDAL ANTI INFLAMMATORY DRUG) (This medicine is used to remove paint and inflammation.)
Ex:= ibuprofen,
Naproxen sodium.
2)DMARDs (disease modifying antirheumatic drugs) :=
This is mainly given in moderate to severe rheumatoid arthritis conditions.
Ex:=imuran,
Antimalarial medication,
Panicillamine and mithotrexate.
3) Antimalarial medication:=
This medicine mainly uses hydroxychloroquine along with methotrexate.
4)Corticosteroids: =
Coticosteroids are primarily used to relieve inflammation.
5) Biological agent:=
Tnf-a antagonist targets B cell, T cell.
actemra in biological agent,
Rituxan,
Remicade,
Enbrel,
Kindred,
Is included.
6) Immunosuppressants :=
This medication mainly weakens the immune system which is out of control in rheumatoid arthritis.
Ex:=azathioprine( imuran, azasan), Cyclosporine.
7)(tumor necrosis factor a):=
This medicine mainly inhibits inflammatory chemicals that inhibit tumor necrosis factor.
explain the surgical management:=
1)Explain joint fusion:=
This involves surgically fusing the joint to stabilize the joint.
2) Explain synovectomy:=
This mainly involves removing the joint lining.
This is mainly used to remove the inflamed tissues that create the pain.
Synovectomy is primarily used to reduce swelling and slow joint damage.
3) Explain tendon repairs:=
The tendon around the joint is inflamed and damaged due to which the tendon is lost, so the surgery is to repair the tendon around the joint.
and keeps it stable.
4) total joint replacement:=
In joint replacement, the surgeon removes the damaged joint part and inserts a prosthesis, which is made of metal or plastic, in its place.
explain nursing management
Assess the patient’s pain level.
To assess the amount of morning stiffness the patient has.
provide comfortable position to the patient.
Encourage patients for non-pharmacological management.
Such as yoga, relaxation techniques, guided imagery, and rhythmic breathing.
Advising patients on hot and cold applications.
Providing the prescribed medicine to the patient.
Asking the patient to rest between activities.
Ask the patient to take frequent rest.
Asking the patient to do physical activity like walking swimming etc.
Instruct the patient to use assistive devices.
Asking the patient to verbalize his feelings.
To provide complete education to the patient about the disease and its treatment.
Ask the patient to maintain a streak aseptic technique.
Provide education to the patient to participate in self care activities.
encourage the patient to jo
1) Define bone tumor. And explain the type of bone tumor (Define bone tumor and write its type.)
2) Explain Etiology, Clinical manifestation, And diagnostic evaluation of bone tumor. Write the causes of bone tumor, its symptoms and signs and diagnostic evolution.
3) Explain the management of bone tumor. (Write management of bone tumors.)
1) Define bone tumor. Define bone tumor.
Bone cancer starts from any bone in the body.
But it is mainly found in the long bones and mainly in the bones of the arms and legs.
Cancer that originates from bone is called primary bone cancer.
The most common bone cancer that originates from bone is sarcomas.
The cancer that metastasizes to the bone from another part of the body is called secondary bone cancer or metastatic bone cancer.
1) Benign bone tumor.
osteochondroma (in osteochondro).
Enchondroma (in Enchondroma).
Bone cyst (bone cyst).
Unicameral bone cyst
giant cell tumor of osteoclastoma
2) Malignant bone tumor.
osteosarcoma
Ewings sarcoma
Malignant fibrous histiocytoma (in malignant fibrous histiocytes)
fibrosarcoma
Chordoma ( Chordoma) .
3) metastatic bone tumor.
1) Benign bone tumor:=
A benign tumor is a non-cancerous tumor.
This type of tumor can be treated surgically.
This type of tumor grows slowly.
Benign tumors are common in bone and soft tissue.
Some types of benign tumors can also be malignant.
In osteochondroma (osteochondroma)
This type of tumor is the most common benign tumor.
Which is mainly found in the end of long bones such as knee bone and shoulder bone.
This mainly develops during growth.
Enchondroma
This tumor is primarily a tumor of hyaline cartilage.
And which is mainly found in the arm, ribs, femur, tibia, humerus, and pelvis bone and its symptoms are mild pain.
bone cyst
This is mainly seen in young adults.
Along with it pain full palpable mass is seen in long bone, vertebrae and flat bone.
Unichemral bone cyst. (unicameral bone cyst)
This is mainly seen in children which can cause mild discomfort and sometimes fracture.
giant cells tumor of osteoclastoma
It remains mainly a benign tumor for a long time but also in the surrounding tissue for a long time
Metastasis occurs and destroys tissues.
2) Malignant bone tumor
These are mainly rare but arise from sarcomas or myomas.
Malignant tumors are primarily cancerous and may also transport to other nearby body structures and disseminate there.
Most common bone tumor are
Osteosarcoma (in osteosarcoma) and
Chondrosarcoma (in chondrosarcoma).
1)osteosarcoma (in osteosarcoma)
In osteosarcoma, it is mainly found in the longbones which are the bones of the arms and legs.
And there is excessive growth in the bones of the knee and shoulder and it is mainly seen in children.
And this type of cancer is very aggressive and there are chances of spreading mainly in the lungs.
It is more common in males between 10 and 25 years of age and is mainly due to radiation exposure.
Its signs and symptoms include pain, swelling, weight loss, limited movement, etc.
2) chondrosarcoma
These are mainly large and slow growing tumors that occur mainly in adult males.
And these bone tumors mainly metastasize to the lungs.
And to survive, it is necessary to mutate the affected extremity from this bone tumor.
This tumor mainly arises and grows from cartilage cells.
Mainly this tumor affects pelvis and hip bone.
3) Ewings sarcoma
This tumor is mainly found in the middle of the long bone.
And in this, the three-year survival rate is 65%, but it gradually decreases if the tumor mainly spreads to the lungs or other parts of the body.
4) Malignant fibrous histiocytoma (in malignant fibrous histiocytos)
This tumor mainly affects the soft tissues.
Which includes muscles, ligaments, tendons and fat.
And this mainly affects the extremities and it mainly affects males more than females.
5) Fibrosarcoma
In fibrosarcoma, it mainly affects the soft tissues behind the knee in the legs and it mainly affects males more than females.
6) Chordoma
This is a very rare tumor and it mainly affects the upper and lower end of the spinal column.
3) Metastatic bone cancer.
Metastatic bone cancer mainly arises from breast, prostate, kidney, thyroid, and lung cancer.
Metastatic bone cancer arises from the bone and spreads to other parts of the body.
2) Explain Etiology Explain the cause
genetic factor,
hereditary,
Due to prior exposure to radiation therapy.
due to chemotherapy.
Due to Paget disease.
Due to any other disease of bone.
Due to having cancer in another part of the body.
due to multiple myeloma.
explain clinical manifestation / sign and symptoms
A lot of pain and it is worse mainly at night time.
Swelling.
Moment A Limited.
Palpation of the affected area should reveal tenderness.
Increase in body temperature.
Superficial vein dilatation.
Fever.
Feeling cold.
Night sweats.
Anemia.
Loss of appetite.
feeling tired
Filing of tender.
Weight loss.
Mass and lump like feeling.
explain the diagnostic evaluation (Write the diagnostic evaluation.)
history taking and physical examination
X Ray,
ct scan,
MRI,
BONE Biopsy,
bone scan,
Serum alkali phosphatase.
Complete blood count.
Blood chemistry.
Bence Jones protein in urine with multiple myeloma.
3) Explain the management of bone tumor (write the management of bone tumor)
Management of bine tumors depends on the type of tumor and how much it has spread.
If there is a primary tumor, its treatment is mainly provided with chemotherapy and radiation therapy along with surgery.
Monitoring the patient’s neurovascular status.
management surgery:=
This involves curettage or resection of the tumor.
Amputation.
Limb sparing surgery (Resection of the tumor and its surrounding tissues is done.)
lymph node dissection.
reconstructive surgery.
Radiation therapy.
Chemo therapy.
Cryosurgery.
Biological therapy or immunotherapy.
bisphosphonates.
explain nursing management
To monitor patient’s vital signs.
Taking different steps to alleviate the patient’s discomfort.
Assess how much blood the patient has lost.
To check whether the patient has any complications like deep vein thrombosis, pulmonary emboli, infection, contracture, etc.
Providing Analgesic medicine to relieve the patient’s pain.
Encouraging the patient to eat foods that are high in protein, vitamins, and folic acid.
Encouraging the patient to take adequate amount of fluid
Support the painful extremity of the patient with pillows.
Applying print for additional patient support.
Ask the patient to move slowly and quietly.
Providing education to the patient on how to use the assistive device.
Providing support while the patient is repositioning the joint.
Ask the patient and his family members to explain and verbalise his fears and feelings.
Guide the patient so that he does not fall.
Creating a supportive environment for the patient and providing psychological support to the patient.
Providing a protective environment to the patient.
Provide education to patients on how to deal with changes in body image due to surgery and imputation.
To provide answers to all the queries of the patient and his family members and remove their misconceptions about the disease and treatment.
Provide education to involve the patient in daily routine activities and become independent on his own.
Proper care of patients while undergoing chemotherapy and radiation therapy.
Maintain the patient’s hydration status while undergoing chemotherapy and radiation therapy and provide gargling mouthwash to clear the oral cavity.
To provide reassurance to the patient.
To provide education to the patient and his family members about the disease and diagnostic process and its treatment.
Maintain patient comfort.
Regularly checking the pain level of the patient and checking how effective the analgesia is and providing guided imagery of the patient.
Guide the patient about relaxation therapy.
To evaluate the patient’s coping ability and to assess if the patient has any anxiety, depression, and inability to cope with his condition.
Tell the patient to take plenty of rest and do physical exercise.
Tell the patient to keep a positive attitude towards his recovery.
1) Explain the spinal cord tumor.
2) Explain Etiology, Clinical manifestation, And diagnostic evaluation of spinal cord tumor.
3) Explain the management of spinal cord tumor. Write the management of spinal cord tumors.
1) Explain the spinal cord tumor.
Abnormal growth of tissues occurs in spinal cord tumor.
And it is mainly seen near the spinal cord because the spinal cord is rigid, bony structure and abnormal growth, sensation is caused by pressure and the function of the spinal cord is impaired.
Spinal cord tumors are mainly found adjacent to those occurring within the spinal cord.
A spinal cord tumor is a cancerous growth found within the spinal cord and can be primarily benign or malignant.
If the tumor is creating compression in the spinal cord or nerve root, then immediate medical attention is required as nerve compression can cause paralysis even if the tumor is benign.
Spinal cord tumors mainly originate from other parts of the body and metastasize and transfer to the spinal cord.
type of spinal cord tumor.
1) primary spinal cord tumor:=
Tumors that arise from the spinal cord are called primary spinal tumors.
Only about 10% of primary spinal cord tumors arise from the spinal cord.
2) secondary spinal cord tumor:=
A secondary spinal cord tumor is a tumor in another part of the body that is metastatic to the spinal cord.
Tumors in breast, lungs, prostate, thyroid gland spread to the vertebrae i.e.
Metastasis occurs.
Metastasis tumor mainly compresses the spinal cord and nerve root.
Lymphomas also spread to the spinal cord and compress the spinal cord
type:=
1) Intramedullary tumor.
2) intradural extramedullary tumor. (Intradural Extra Medullary Tumor)
3) Extradural spinal tumor
4) secondary bone cancer
1) Intramedullary tumor:=
This tumor mainly arises in the spinal cord itself.
And it is mainly located in the nave of the spinal cord.
There are many types of cancer in the spinal cord but there are two main common cancers.
1)Astrocytomas (astrocyte mass).
2)ependymomas
2) Intradural extramedullary tumor.
These tumors arise primarily from the dura itself but are located outside the spinal cord, so they are called intradural extramedullary tumors.
These are mainly inside the covering of the spinal cord but also outside the spinal cord itself.
Ex:=
1) meningiomas ( meningiomas) 2) schwannomas ( schwannomas)
3) extradural spinal tumor
:= Extradural spinal tumors are mainly metastases but arise from the vertebral body itself.
This mainly starts from the bone of the spine itself.
Ex:=
benign tumor includes:=
1) Chordomas
2) osteomas
malignant tumor includes:=
1) Chordosarcomas
2) fibrosarcomas (fibrosarcomas)
4) secondary bone cancer (secondary bone cancer).
This cancer mainly spreads from other parts of the body to the spinal cord.
This is called secondary bone cancer.
Mainly in lungs, breast, lymph, prostate cancer, and marrow, this cancer occurs towards the vertebrae.
Myeloma is a plasma cell cancer that mainly affects the liver.
2) Explain Etiology (Write reasons:=
Due to genetic defect,
Due to exposure to certain chemicals.
Due to a hereditary disorder.
Due to tumor metastases from other parts of the body.
Having a history of previous cancer.
explain clinical manifestation/sign and symptoms
Symptoms and signs depend on the location and type of tumor.
There is pain in back and neck.
Pain also occurs in other parts of the body.
Numbness, tingling sensation.
Muscle weakness and weakness mainly in the muscles of arms and legs.
Decreased sensation.
There is difficulty in walking.
Progressively weakness comes.
Pain, cold, heat sensitivity is reduced.
Loss of bowel and bladder function.
Difficulty in walking.
becoming paralyzed.
Muscle contraction and spasm.
Nerve damage.
to be in pain
Swelling to come.
Weakness.
explain diagnostic evaluation (Write diagnostic evaluation.)
history taking and physical examination.
X Ray.
ct scan.
MRI.
emissions tomography.
spinal tap.
Biopsy.
myelogram.
3) Explain the management of spinal tumor. (Write management of spinal tumors.)
medical management
strictly monitoring of patient.
radiation therapy,
chemo therapy,
steroid therapy,
surgery:=
D. Compassionate laminectomy.
explain the nursing management
Continuous neurological status of the patient.
Continuously checking patient’s vital signs.
Check the patient’s intracranial pressure.
Maintain strict aseptic technique while handling the patient.
Checking the conscious level of the patient.
Checking the patient’s visual acuity.
Sensory assessment of the patient.
To check whether the patient has a condition like headache, vomiting or not.
Continuously checking the patient’s intake output.
Checking the patient’s electrolyte level.
Maintain the patient’s hydration status.
Elevate the patient 15 to 30 degrees to reduce cerebral venous congestion.
If the patient has photophobia, keep him in a dark room and provide him with sunglasses.
To provide a quiet environment to the patient.
Ask the patient to take adequate rest.
Keep patient in upright position for proper expansion of lungs.
Provide chest physiotherapy to remove mucus.
Ask the patient to do pursed lip breathing.
Ask the agent to take meals in small and frequent amounts.
To provide work and comfortable environment to the patient.
1) Explain Amputation. Avoid amputation
introduction:=
A mutation a surgically
It is a reconstructive procedure in which the extremity is totally or partially removed.
Amutation is an acquired condition in which limb loss occurs and can be primarily due to any injury, disease or even surgery.
The word amputation is a Latin word
” amputare “
Which means
“to cut off”
is from
Mutation means partial or complete removal of a deformed body part.
Amputation is any acute condition
(traumatic event),
or chronic conditions such as
(peripheral vascular disease, diabetes mellitus, or surgery)
is done because of
explain Etiology:=
to be in tro.
Due to malignant tumors.
Due to congenital deformity.
inadequate tissue percussion.
crush injury.
due to burns.
frost bite.
Due to bone tumor.
electric burn.
Due to gangrene.
chronic osteomyelitis.
Due to ferral vascular disease.
diabetes.
Gas gangrene.
due to electrical injury.
To remove any tumor.
Explain the purpose of amputation.
To remove tissues that are not getting proper amount of blood supply.
If there is a malignant tumor to remove it.
To remove the body part if it is in severe trow.
explain the level of amputation (write the level of amputation)
1) circulation in the part.
2) It’s usefulness.
3) Level of maximum available tissues for wound healing.
4) Develops a functional, non tender, pressure tolerant residual limb.
1) Partial foot amputation
The lower part of the ankle joint is isolated.
2) Transversal Amputation (trans tarsal amputation):=
These are mainly amputated from the tarsal bone of the foot.
3) Syms’s Amputation or modified ankle disarticulation amputation.
In this, mainly if there is a very severe trauma in the foot, it is cut and it is mainly cut to the lower limb.
4) Ankle disarticulation
In this mainly the lower limb is cut from the ankle joint.
5) Below knee amputation
This lower limb has been cut between the knee joint and the ankle joint.
6)knee disarticulation (knee dish articulation) :=
In this mainly the lower limb is cut from the knee joint.
7) ubow knee Amputation (Abovanni Amutation) :=
In this, amputation is mainly done between hip joint and knee joint.
8) hip disarticulation hip dish articulation:=
In this the lower limb is amputated from the hip joint but the pelvis is intact.
9) trans pelvic amputated (trans pelvic mutation)
In this mainly the full lower limb is cut and a part of the hemi pelvis is also cut.
10) Partial Hand Amputation:=
In this, amputation of the upper limb is done and it is done distally from the wrist joint.
11) Wrist disarticulation
In this, the upper limb is mainly cut from the write joint.
12) Below Elbow Amputation:=
In this, the upper limb is mainly cut between the wrist joint and the elbow joint.
13) elbow disarticulation (elbodisarticulation):=
This is mainly done by disarticulation from the elbow joint.
14) Above elbow Amputation (above elbow amputation) :=
In this, cuts are mainly made between elbow joint and shoulder joint.
15) shoulder disarticulation (solder disarticulation) :=
These are mainly cut with solder joints.
16) Forequarter Amputation
In this mainly scapulo thoracic and sternoclavicular joints are cut.
17) Staged Amputation: =
Mainly in case of any gangrene or infection the body part is amputated.
type on the basis of amputated part
amputated finger
amputated thumb
amputated arm
amputated toe,
amputated leg
amputated lower leg
on the basis of type of surgery
1)open Amputation:=
Open amputation is also called guillotine amputation.
This type of amputation is mainly done when any infection is present or has chances of developing.
In this the bone is cut at the same level and the canal is not closed but left open to drain any secretions.
Many of these dressings are placed over the tip of the stump and when the infection is no longer present, the wound is closed and the drainage of fluid is stopped.
2) Closed Amputation: =
Closed or flap imputation is the preferred method because healing is faster and the patient has the opportunity to be fitted with a prosthetic device sooner.
In this, when any tissue or bone is cut, the part is covered by skin and sutured.
So this is called closed amputation.
explain the diagnostic evaluation
history taking and physical examination.
routine blood test.
biochemistry.
blood cross marching.
coagulation study.
blood pressure.
arteriography.
venogrsphy.
complete blood count.
White blood cell count.
vascular doppler ultrasonography.
explain complication Explain the complication
hemorrhage,
infection,
In the hematoma,
skin break down,
Delay in healing.
Contracture.
Skin flap necrosis.
Deformity in the joint.
Chronic pain.
Phantom Pen.
Explain rehabilitation of patients. Describe the rehabilitation of the patient
Rehabilitation is a process in which measures are taken to return the patient to the highest level of mobility and function.
A person who is young and healthy and has an mutation requires immediate rehabilitation.
Elevate the foot for 24 to 48 hours to reduce oedema.
Ask the patient to exercise.
Exercising can prevent contractures and strengthen muscles.
And the amputated part can be prepared for prosthesis.
A proper band should be done on the stump.
Training the patient for proper gait.
Psychological counseling of the patient.
Nursing management
To check patient’s vital sign.
1) Monitoring fluid balance:=
To check the patient’s blood pressure and any abnormality in any vital sign.
To check the amount of drainage of the patient.
Check the patient’s intake output.
2) Reliving pain
Assess the patient’s pain level.
To check the location and intensity of the patient’s pain level.
Providing the prescribed medicine to the patient.
Elevate the affected part or provide support through a pillow.
Providing comfort measures to the patient.
Ask the patient to adopt stress management techniques (deep breathing exercise, visualization and guided imaginary).
Ask the patient to take Analgesic medicine.
Ask the patient to administer the medication.
3) maintaining adequate peripheral tissue perfusion.
To check the patient’s vital signs.
Palpate peripheral pulse, noting strength and equality.
Periodically assess the neurovascular status of the patient.
Assess the patient’s pulse, skin color, and temperature.
Elevating the affected limb.
Asking the patient to adapt to his changes.
Ask the patient to use a proper dressing.
Soft, soft with pressure wrap, semi rigid or rigid.
Inspecting the patient dressing site.
Provide adequate fluid to the patient.
If bleeding occurs, apply direct pressure to the bleeding site.
Applying direct pressure on the bleeding side through a bandage.
Provide intravenous fluid to the patient.
4) preventing wound infections:=
Using a sterile dressing.
Maintain aseptic technique.
Ask the patient to take a protein rich diet.
Affected lemons should be handled gently.
Maintain aseptic technique when changing dressings.
Inspecting the wound.
Note that drainage is characteristic.
Patency and emptying of drainage devices.
To check Ticent’s vital signs.
Providing antibiotic medicine to the patient.
5) Promoting physical mobility
Providing stump care to the patient on a routine basis.
Changing the patient’s position frequently on the bed.
Ask the patient to do range of motion exercises.
Ask the patient to do daily routine activities in small amounts.
5)enhance body image:=
6) Promote independent self care.
Mutation changes the body image so it is necessary to maintain proper coordination with the patient Proper counseling of the patient is necessary.
Provide proper counseling of the patient.
Ask the patient to be active.
Asking the patient to become independent means trying to do dressing, bathing by himself.
Ask the patient to do wheel chair and self care activities.
Tell the patient to be careful not to injure the remaining extremity.
explain health education := Describe health education.
Inspect the stump daily for any redness, blisters or abrasions.
Use a mirror to examine the stump.
Asked to maintain the patient’s daily hygiene.
Clean the stump properly using mild soap.
Do not apply any alcohol, cream, lotion, powder on the stump after bathing.
To wear wollen stump shocks over the stump for cleanliness and comfort of the patient.
Ask the patient to exercise continuously.
It is necessary to keep the prosthesis socket properly clean and dry.
Provide education to the patient to wrap the stump properly.
Ask the patient to do exercise and physical activity.
Asking the patient to use an assistive device.
Ask the patient to make some modifications to the home environment.
1) Explain prosthesis.
This is a rehabilitation device in which an artificial device is placed in the whole or partially device.
This device is manufactured.
Prosthesis is a device that replaces missing body parts and improves body work.
Prosthesis is made of metal, titanium, stainless steel, cremium, plastic.
The prosthesis is placed in place using acrylic cement and helps the bone to grow.
Once the joint is repositioned, physical activity can be restored.
Bone substitutes are called biologics.
parts of prosthesis :=
1)interface,
2) components,
3) cover (cover).
1)interface:=
The prosthesis is attached to the body through an interface.
The interface consists of a socket (shocket) and a rigid frame (rigid frame).
The shocket :=
It is mainly made of plastic or laminated material attached to the working parts of the prosthesis.
2) the frame:=
The frame is mainly made of graphite or similar material that provides structural support to the socket.
The weir has to be done between the remaining part of the linear limb.
Shocket acts like a cushion.
Made of linear polyurethane and silicone.
Linear clings to the skin and does not cause friction.
An interface is a device that keeps the prosthesis securely in place.
A) suction valve:=
When the post is put inside the socket.
Air is forcibly entered through an opening below the stump.
A one way Saxon valve keeps the socket closed and open and holds the process in place.
B) Linear with a locking pain:=
Most of the liner is locked at the bottom of the socket and is primarily locked by a notched pin.
Because the pin is packed with the title in the stump.
This body part is stumped in such a way.
2) components:=
The component is the working part of the prosthesis.
A compound consists of a terminal device, a joint, and a metal shaft.
3) cover :=
Some people who wear prostheses have a cover.
Classification :=
1) Endo prosthesis :=
These are mainly implants that are also meant to replace the joint.
Ex:= Austin Moore prosthesis.
2) exo prosthesis :=
This part of the limb which is lost is done for external placement.
type of prospective
1) Trans tibial prosthesis.
2) trans femoral prosthesis.
3) trans humeral prosthesis.
4) Transdial prosthesis.
5) finger prosthesis.
6) Partial hand prosthesis.
7) Partial feet prosthesis.
8) hip prosthesis.
New innovation
1) Myoectric Prosthesis
Myoelectric prostheses use electromyography signals to contract muscles and control movement of the prosthesis.
Ex:=elbow flexion,
Wrist supination,
Opening or closing of finger.
advantage:=
Provides a natural response and requires less effort than traditional mechanical systems.
The myoelectric system enhances mobility and helps maximize function.
Ex:= transhumeral,
forequarter amputees and shoulder disarticulation.
2) Cable operated prosthesis:=
The prosthesis is held in solder by a slung
And this type of prosthesis is opened and closed by cables.
Cable prosthesis is primarily an upper extremity prosthesis.
3) ossiointegration: =
The prosthesis is mainly implanted in the bone.
4)Robotic limbs:=
This mainly uses the robot arm by pressing a button.
Mainly in this, the robot arm is designed to work more effectively and it is run by the mind of the person.
5)Neuroprosthesis:=
Neural prosthesis is a series of devices.
These are mainly motor, sensory or cognitive modality.
And this is mainly due to any diseases or injuries that can be damaged.
Ex:= cochlear implants.
Explain the care of prosthesis. (Describe the care of the prosthesis.)
Prosthesis is a very extensive and precise device.
If the prosthesis is cared for a little, its life can be increased.
Prosthesis has to be checked by a prosthetist every six months.
Wash things that come in contact with the skin properly.
Wash everything properly with soapy water and then dry it properly.
Do not use anything that contains alcohol.
Keep checking the prosthesis properly.
On the day the prosthesis is removed, properly clean the socket with warm water and a cloth and dry it properly.
Making sure that the size of the shoes should match the prosthesis.
Keep things handy in case of emergency (ex:= stumps, socks, pull socks, bandages, antibiotics, antihistamine, ointment).
If there is a prosthesis and there is any trouble, do not try to make changes on your own and go to a prosthetist immediately.
Checking the prosthesis once in the wick and seeing its attachment properly.
Check for any abnormality in the prosthesis by removing the shoes and shocks.
Explain skin care during prosthesis
When having a prosthesis, wash the lemon properly with soap and water once a day.
Proper drying of the washed lemons.
If the washed lemons are not dried properly, there are chances of fungal infection
Keep checking for any redness or soreness at the site of the prosthesis.
Keep checking for any screen breakdown at the site where the prosthesis is attached, especially in patients with diabetes.
If the skin is completely dry, apply a cream to make the skin soft.
Abrasion may occur due to not using telcompounder on the prosthesis area.
Do not use alcohol or any other chemicals on the affected limb.
Keep the limb covered all the time after the prosthesis and apply sunscreen if exposed to the sun.
Inform the prosthetist immediately if there is any problem with the prosthesis.
If there is a red spot on the place of the prosthesis, there are chances of soreness on that place, so avoid the prosthesis and inform the prosthetist immediately.
If there is no sensation on the limb of the prosthesis, it should be assessed frequently and should not be exposed to hot water and sun exposure as it may cause burns and blisters.
Prosthetic skin should be properly cared for.