Class Talk Fall 2016

Assessment: Findings related to RA are rheumatoid nodules and joint inflammation detected on palpation revealing spongy tissue. Assessment focuses on bilateral and symmetrical stiffness, swelling, tenderness, and temperature changes in the joints. The patient should also be assessed for sensory changes, weight loss, fatigue, and lymph node enlargement. Labs show the presence of rheumatoid factor, an elevated ESR and C-reactive protein, and decrease in RBCs.

Mobility limitations: Physical mobility will be impaired related to decreased range of motion, pain, and weakness. Joint motion will be affected due to the loss of articular surfaces, muscle fibers undergo degenerative changes, and the tendons will lose its elasticity and contractile power. As RA progresses, it can affect mobility in the knees, shoulders, hips, elbows, ankles, cervical spine, and temporomandibular joints. Long periods of immobility can lead to contractures.

D/C Teaching: This will include educating the patient about the pathophysiology of the disease and how to manage it. Educate the patient about self-care needs, joint protection, and energy conservation. Provide and educate on the use of assistive devices. Emphasize the need for activity and safe exercises. Also educate the patient about pain management techniques, relaxation techniques, medication adherence, and medication side effect

Assessment: Findings related to RA are rheumatoid nodules and joint inflammation detected on palpation revealing spongy tissue. Assessment focuses on bilateral and symmetrical stiffness, swelling, tenderness, and temperature changes in the joints. The patient should also be assessed for sensory changes, weight loss, fatigue, and lymph node enlargement. Labs show the presence of rheumatoid factor, an elevated ESR and C-reactive protein, and decrease in RBCs.

Mobility limitations: Physical mobility will be impaired related to decreased range of motion, pain, and weakness. Joint motion will be affected due to the loss of articular surfaces, muscle fibers undergo degenerative changes, and the tendons will lose its elasticity and contractile power. As RA progresses, it can affect mobility in the knees, shoulders, hips, elbows, ankles, cervical spine, and temporomandibular joints. Long periods of immobility can lead to contractures.

D/C Teaching: This will include educating the patient about the pathophysiology of the disease and how to manage it. Educate the patient about self-care needs, joint protection, and energy conservation. Provide and educate on the use of assistive devices. Emphasize the need for activity and safe exercises. Also educate the patient about pain management techniques, relaxation techniques, medication adherence, and medication side effect

Assessment: Findings related to RA are rheumatoid nodules and joint inflammation detected on palpation revealing spongy tissue. Assessment focuses on bilateral and symmetrical stiffness, swelling, tenderness, and temperature changes in the joints. The patient should also be assessed for sensory changes, weight loss, fatigue, and lymph node enlargement. Labs show the presence of rheumatoid factor, an elevated ESR and C-reactive protein, and decrease in RBCs.

Mobility limitations: Physical mobility will be impaired related to decreased range of motion, pain, and weakness. Joint motion will be affected due to the loss of articular surfaces, muscle fibers undergo degenerative changes, and the tendons will lose its elasticity and contractile power. As RA progresses, it can affect mobility in the knees, shoulders, hips, elbows, ankles, cervical spine, and temporomandibular joints. Long periods of immobility can lead to contractures.

D/C Teaching: This will include educating the patient about the pathophysiology of the disease and how to manage it. Educate the patient about self-care needs, joint protection, and energy conservation. Provide and educate on the use of assistive devices. Emphasize the need for activity and safe exercises. Also educate the patient about pain management techniques, relaxation techniques, medication adherence, and medication side effect

Assessment: Findings related to RA are rheumatoid nodules and joint inflammation detected on palpation revealing spongy tissue. Assessment focuses on bilateral and symmetrical stiffness, swelling, tenderness, and temperature changes in the joints. The patient should also be assessed for sensory changes, weight loss, fatigue, and lymph node enlargement. Labs show the presence of rheumatoid factor, an elevated ESR and C-reactive protein, and decrease in RBCs.

Mobility limitations: Physical mobility will be impaired related to decreased range of motion, pain, and weakness. Joint motion will be affected due to the loss of articular surfaces, muscle fibers undergo degenerative changes, and the tendons will lose its elasticity and contractile power. As RA progresses, it can affect mobility in the knees, shoulders, hips, elbows, ankles, cervical spine, and temporomandibular joints. Long periods of immobility can lead to contractures.

D/C Teaching: This will include educating the patient about the pathophysiology of the disease and how to manage it. Educate the patient about self-care needs, joint protection, and energy conservation. Provide and educate on the use of assistive devices. Emphasize the need for activity and safe exercises. Also educate the patient about pain management techniques, relaxation techniques, medication adherence, and medication side effect

Assessment: Findings related to RA are rheumatoid nodules and joint inflammation detected on palpation revealing spongy tissue. Assessment focuses on bilateral and symmetrical stiffness, swelling, tenderness, and temperature changes in the joints. The patient should also be assessed for sensory changes, weight loss, fatigue, and lymph node enlargement. Labs show the presence of rheumatoid factor, an elevated ESR and C-reactive protein, and decrease in RBCs.

Mobility limitations: Physical mobility will be impaired related to decreased range of motion, pain, and weakness. Joint motion will be affected due to the loss of articular surfaces, muscle fibers undergo degenerative changes, and the tendons will lose its elasticity and contractile power. As RA progresses, it can affect mobility in the knees, shoulders, hips, elbows, ankles, cervical spine, and temporomandibular joints. Long periods of immobility can lead to contractures.

D/C Teaching: This will include educating the patient about the pathophysiology of the disease and how to manage it. Educate the patient about self-care needs, joint protection, and energy conservation. Provide and educate on the use of assistive devices. Emphasize the need for activity and safe exercises. Also educate the patient about pain management techniques, relaxation techniques, medication adherence, and medication side effect

The point of traction is to use a pulling force to maintain alignment to an injured body part. Traction can either be applied to the skin or directly to the bony skeleton. Bucks traction, specifically, is skin traction to the lower leg (it can be bilateral or unilateral). This causes either partial or temporary immobilization, and is used for immobilization of fractures of the proximal femur and hip before corrective surgery.

Priority assessments include ensuring effective skin traction; the leg should be in a neutral position, and the bandage should be assessed to ensure there is no wrinkling or slipping of the bandage. Another important assessment is monitoring for skin breakdown, nerve damage, and circulatory impairment.

The patient’s mobility is limited. The only movement appropriate is for the patient to slightly shift position with assistance, but the patient should not move from side to side.

Usually a patient will have Buck’s traction before surgery, so discharge teaching would not be related to Buck’s traction, but rather about post-operative teaching. If the patient is to have Buck’s traction at home, it is important to encourage foot exercises every hour when awake to promote circulation. Also, the patient (if able–if not, ask a caregiver) should assess sensation in their legs and feet. A caregiver will be needed to assess for skin breakdown.

 

 

The point of traction is to use a pulling force to maintain alignment to an injured body part. Traction can either be applied to the skin or directly to the bony skeleton. Bucks traction, specifically, is skin traction to the lower leg (it can be bilateral or unilateral). This causes either partial or temporary immobilization, and is used for immobilization of fractures of the proximal femur and hip before corrective surgery.

Priority assessments include ensuring effective skin traction; the leg should be in a neutral position, and the bandage should be assessed to ensure there is no wrinkling or slipping of the bandage. Another important assessment is monitoring for skin breakdown, nerve damage, and circulatory impairment.

The patient’s mobility is limited. The only movement appropriate is for the patient to slightly shift position with assistance, but the patient should not move from side to side.

Usually a patient will have Buck’s traction before surgery, so discharge teaching would not be related to Buck’s traction, but rather about post-operative teaching. If the patient is to have Buck’s traction at home, it is important to encourage foot exercises every hour when awake to promote circulation. Also, the patient (if able–if not, ask a caregiver) should assess sensation in their legs and feet. A caregiver will be needed to assess for skin breakdown.

 

 

The point of traction is to use a pulling force to maintain alignment to an injured body part. Traction can either be applied to the skin or directly to the bony skeleton. Bucks traction, specifically, is skin traction to the lower leg (it can be bilateral or unilateral). This causes either partial or temporary immobilization, and is used for immobilization of fractures of the proximal femur and hip before corrective surgery.

Priority assessments include ensuring effective skin traction; the leg should be in a neutral position, and the bandage should be assessed to ensure there is no wrinkling or slipping of the bandage. Another important assessment is monitoring for skin breakdown, nerve damage, and circulatory impairment.

The patient’s mobility is limited. The only movement appropriate is for the patient to slightly shift position with assistance, but the patient should not move from side to side.

Usually a patient will have Buck’s traction before surgery, so discharge teaching would not be related to Buck’s traction, but rather about post-operative teaching. If the patient is to have Buck’s traction at home, it is important to encourage foot exercises every hour when awake to promote circulation. Also, the patient (if able–if not, ask a caregiver) should assess sensation in their legs and feet. A caregiver will be needed to assess for skin breakdown.

 

 

The point of traction is to use a pulling force to maintain alignment to an injured body part. Traction can either be applied to the skin or directly to the bony skeleton. Bucks traction, specifically, is skin traction to the lower leg (it can be bilateral or unilateral). This causes either partial or temporary immobilization, and is used for immobilization of fractures of the proximal femur and hip before corrective surgery.

Priority assessments include ensuring effective skin traction; the leg should be in a neutral position, and the bandage should be assessed to ensure there is no wrinkling or slipping of the bandage. Another important assessment is monitoring for skin breakdown, nerve damage, and circulatory impairment.

The patient’s mobility is limited. The only movement appropriate is for the patient to slightly shift position with assistance, but the patient should not move from side to side.

Usually a patient will have Buck’s traction before surgery, so discharge teaching would not be related to Buck’s traction, but rather about post-operative teaching. If the patient is to have Buck’s traction at home, it is important to encourage foot exercises every hour when awake to promote circulation. Also, the patient (if able–if not, ask a caregiver) should assess sensation in their legs and feet. A caregiver will be needed to assess for skin breakdown.

 

 

The point of traction is to use a pulling force to maintain alignment to an injured body part. Traction can either be applied to the skin or directly to the bony skeleton. Bucks traction, specifically, is skin traction to the lower leg (it can be bilateral or unilateral). This causes either partial or temporary immobilization, and is used for immobilization of fractures of the proximal femur and hip before corrective surgery.

Priority assessments include ensuring effective skin traction; the leg should be in a neutral position, and the bandage should be assessed to ensure there is no wrinkling or slipping of the bandage. Another important assessment is monitoring for skin breakdown, nerve damage, and circulatory impairment.

The patient’s mobility is limited. The only movement appropriate is for the patient to slightly shift position with assistance, but the patient should not move from side to side.

Usually a patient will have Buck’s traction before surgery, so discharge teaching would not be related to Buck’s traction, but rather about post-operative teaching. If the patient is to have Buck’s traction at home, it is important to encourage foot exercises every hour when awake to promote circulation. Also, the patient (if able–if not, ask a caregiver) should assess sensation in their legs and feet. A caregiver will be needed to assess for skin breakdown.