Musculoskeletal Management

Musculoskeletal Mangement,long name, simple AOC. As mobility is already an overriding AOC, and you are assessing their balance,posture,equality of movement,assistive devices used and where the patient was moved to and their toleration of the activity.After all of that is done, not much is left to musculoskeletal management.
Think ahead to the type of patient will likely have this AOC assigned. A person in traction, a recent ortho patient,a post CVA or MVA .This will pull togather nicely with an impaired mobility diagnosis.
I will be using JSFASTH :Jump Shots Force Another Score To Happen. I picture a basketball player who has had an injury and needs me to assess and treat him/her.

For the purpose of the PCS, the student will be assigned upper OR lower extremeties to manage.ALL joints of the specified extremity needs to be assessed.For the arms this means shoulders,elbows,wrists,and fingers.The legs include hips,knees,ankles and toes. ALL assessments need to be done and recorded as bilateral as a critical element.

J: joints(bilateral)
S: strength(bilateral)
F: flexability(bilateral)
A: AROM/PROM .The student needs to either direct the pt through range of motion excercises,physically demonstrating on your own body if need be or performing them for FOR the patient supporting the joints. Adduction /Abduction OR Flexion/Extension need to be completed.If there is an affected limb,one side will be done though AROM and one through PROM.
S: supportive/theraputic devices. These can include any splints,CPM machines, immobilizers, positioning tools,and assistive mobility devices.
T: Traction.If the patient has traction, the nurse needs to verify the proper weight of the traction,that lines are hanging freely and unobstructed.Look and adjust the patient so they are in proper alignment and that the position they are in creates counter balance.
H: Heat/Cold if assigned. The type ,location and duration of heat or cold therapy will be indicated on the Kardex.Place a barrier over the skin.Standard is 20 minutes,so as not to injure tissues of the immobilized .Mark the time the treatment is applied as well as when it needs to be removed. Follow through! If you leave the implementaion phase, be sure to report the primary nurse what treatments are still in effect.
As with all management AOC the response of the patient will be assessed and recorded.Before implementation begins, verify the last analgesic dose. ROM will go much smoother if they are comfortable.
Again, this is where that pain assessment comes in with vital signs.Use it to your advantage when planning your care.