Nursing Care of Patients with Musculoskeletal Disorders
Osteoporosis
Osteoporosis is a disorder of bone metabolism in which there is a reduction of total bone
mass, making bones abnormally prone to fracture.
It affects one fourth of all older adults, and the greatest incidence occurs among white
females between the ages of 50 and 70 years.
Predisposing Factors:
1. Postmenopausal status.
2. Long-term corticosteroid use.
3. Prolonged immobilization.
4. Nutritional deficiency.
Clinical Manifestations:
1. Fractures.
2. Pain.
3. Visible deformity (e.g., kyphosis)
4. Loss of height.
5. Constipation.
Diagnostic Evaluation:
1. radiographic and bone density studies.
2. Serum calcium, phosphorus, and alkaline phosphates
levels are within normal ranges.
Nursing Interventions:
1. Administer analgesics as prescribed to relieve pain.
2. Assist patient with putting on back brace.
3. Encourage walking daily for strong bone remodelling.
4. Encourage young women at risk to maximize bone
mass through good nutrition (contain calcium) and exercises.
5. Suggest that perimenopausal women confer with the physician concerning need for
calcium supplements and oestrogen therapy.
6. Instruct patient to avoid ant trauma or falls.
Osteomyelitis
Osteomyelitis is a sever bone infection.
Etiology:
1. Trauma.
2. Secondary infection.
Clinical Manifestations:
1. Localized bone pain.
2. tenderness, heat, and oedema in the affected area.
3. Restricted movement in affected area.
4. Fever, and generalized weakness.
Osteomyelitis (cont’d)
Diagnostic Evaluation:
1. Increase in WBCs.
2. Increase in ESR.
3. Positive blood culture.
4. Radiograph and bone scan.
Nursing Intervention:
1. Administer analgesics and analgesics.
2. Provide ROM, and no weight bearing on affected limb.
3. Provide sterile dressing.
Osteoarthritis
Osteoarthritis is a slowly progressive, degenerative joint disease characterized by variable
changes in weight- bearing joints.
Affects both sexes, with onset usually after age 4o.
Predisposing Factors:
1. Obesity.
2. Aging.
3. Trauma.
4. Congenital abnormalities.
5. Genetics.
Clinical Manifestations:
1. Pain and muscle spasms (after exercises, at night, in the
early morning)
2. Limited motion in affected joints.
3. Flexion contractures, primarily in the hip and knee.
4 Joint tenderness.
Nursing Interventions:
1. Relieving pain.
2. Increasing physical mobility.
3. Promoting independence in ADLs
Fractures
Fracture is any break in a bone.
Classifications of Fractures:
1. Closed (simple fracture): a bone is broken but there is
no penetration extending from the fracture through
the skin.
2. Open (compound fracture): there is a wound over the
fracture site. And is more serious because the risk of
contamination and infection.
Causes:
1. Direct force, e.g., bullet injury.
2. Indirect force, e.g., after falling.
3. Aging.
4. Pathologic.
Clinical Manifestations:
1. Pain.
2. Swelling and discoloration.
3. Tenderness or discomfort.
4. Bone may Break through the skin.
5. Deformity.
Nursing Interventions:
1. Administer medications as prescribed (antibiotics, NSAIDs)
2. Prevent infection.
3. Provide care during transfer of the patient.
4. Teach the proper use of assistive devices.
5. Observe closely for signs and symptoms of other complications.