Musculoskeletal NCLEX Review: Musculoskeletal and Connective Tissue Module
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This week, we will be covering the Musculoskeletal and Connective Tissue Module from our Online NCLEX Review. The topics covered in this review are Corticosteroids, Muscle Spasms, Herniated Disk, and Traction Principles.
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Side Effects from Corticosteroids
Corticosteroids decrease the amount of swelling in the joints and are used in rheumatoid arthritis, bursitis, and tendonitis.
The side effects are shown in the flashcard below and include:
- Muscle weakness
- Osteoporosis
- Immunosuppression
- Polyuria
- Polydipsia
- Abnormal fat distribution
- Growth retardation in children
- Weight gain
- Mood swings such as depression
- Edema
Select medications for corticosteroids include:
- Betamethasone (Celestone)
- Cortisone (Cortone)
- Hydrocortisone (Solu-Cortef)
- Methylprednisolone (Medrol)
- Nabumetone
- Prednisone (Deltasone)
Muscle Spams and Muscle Spasticity
Muscle spasms are sudden, involuntary, painful muscle contractions which may occur after injury
Muscle spasticity is an increase in muscle tone which produces stiff muscle movements, which may occur with many disorders
Assessment of these disorders is as follows:
- Bruising
- Edema
- Joint swelling
- Inflammation
Use this flashcard to help you remember the management of muscle spasms and muscle spasticity. When in doubt, think of the P-R-I-C-E for musculoskeletal injuries.
- Protect
- Rest
- Ice
- Compression
- Elevation
Herniated Disk
Herniated disk is a condition when all or part of the soft center of a spinal disk is forced through a weakened part.
Assessment
- Numbness or tingling
- Muscle weakness
- Problems with bowel or bladder control
Pain characteristics
- Unilateral. Sudden or gradual. Constant or intermittent
- Worsened by sitting, prolonged standing, bending or twisting motions, sneezing, coughing or straining with defecation
A Myelogram may be used for diagnosis
Traction
Traction may be used after a fracture. May be a temporary measure until surgical repair can take place. Therapeutic benefits of traction:
- Reduces the fracture
- Lessens muscle spasms
- Relieves pain
- Corrects deformities
- Promotes rest
- Allows for exercise
Skin traction uses tape, boots and splints.
Skeletal traction uses pins and wire inserted into bones or joints. Uses balanced suspension to immobilize the body part.
Traction principles
T = Temperature of the extremity and oral to monitor for infection.
R = Ropes hang freely.
A = Alignment of the extremity, checks the set up, and assess for swelling.
C = Circulation checks for the 6 Ps.
T = Trapeze is frequently part of the traction.
I = Increase fluid intake. Address nutritional concerns such as increased roughage. Fluids and dietary prevent complications such as constipation, UTI and renal calculi.
O = Overhead trapeze to increase independence and muscle strength. Do exercises to maintain muscle tone, endurance and prevent bone demineralization.
N = No weights on the bed or the floor. Do not release once established.
For more information on Buck’s Traction, Russell’s Traction, Bryant’s Traction, and other types or Traction, you need to see purchase the textbook, which comes with the online NCLEX Review.
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