Title: Apply the nursing process for a client with a disorder of the muscular and skeletal systems.
Course: Practical Nursing III (14052-III) > Section: Applying the Nursing Process to the Adult Client

Application should include

- recognizing the clinical judgment model components
- identification of the prevention of related disorders
- interdisciplinary collaboration
- identification of hazards of immobility
- description of steps in a nursing assessment
- nursing management in diagnostic tests
  - bone scan
  - wound culture
  - CT scan
  - urine studies
  - arthroscopy
  - myelogram
  - radiologic studies
  - arthrocentesis
  - MRI
  - blood studies (e.g., uric acid, calcium, phosphorus, rheumatoid factor, antinuclear antibody [ANA])
  - bone/muscle biopsies
  - gallium/thallium scans
- procedures to maintain physical comfort
- care related to orthopedic devices
- nursing management of selected disorders
- diagnoses, plan of care, pre- and post-operative care
- pharmacological management and dietary plan
- education of a client in terms of safe use of assistive devices.

Process/Skill Questions:

- How do exercise, weight control, and body mechanics relate to the prevention of muscular system and skeletal system disorders?
- What are the hazards of immobility and the psychosocial effect related to systems, such as
  - circulatory
  - respiratory
  - gastrointestinal
  - integumentary
  - urinary
  - muscular
  - skeletal?
- What are the steps in the nursing assessment of the muscular and skeletal systems, including the neurovascular assessment?
- What is the purpose and nursing management of each of the following diagnostic tests?
- How might one demonstrate procedures related to the operation of pressure-relieving beds/mattresses and air pillows?
- What is the importance of nursing care as it relates to cast care, decubiti prevention, active/passive range of motion, and use of orthopedic devices?
- What are the pathophysiology, clinical manifestations, nursing management, and treatment modalities of disorders, such as congenital deformities, traumatic injuries (e.g., fractures, dislocations, sprains, contusions, whiplash), low back pain, osteoporosis, carpal tunnel syndrome, inflammatory disorders (e.g., rheumatoid arthritis, osteoarthritis, gout, ankylosis, spondylitis, systemic lupus erythematosus [SLE]), and neoplasms of the muscles/bones?
- What are nursing diagnoses related to the client with muscular and skeletal systems disorders?
- What are the pre- and post-operative nursing care steps for the client experiencing surgical procedures (e.g., amputation, total joint replacement, arthroplasty, open reduction with internal/external fixation, and bunionectomy)?
- How important is the integration of
  - anti-inflammatory drugs (NSAIDS and corticosteroids)
  - gold salts
  - muscle relaxants
  - antihyperuricemic drugs
  - opioids and non-opioids
  - salicylates and non-salicylates
  - antibiotics
  - cytotoxic drugs

in the pharmacological management of the client?

- What is the importance of incorporating dietary principles into the care of the client?
- What steps are needed to educate the client to use assistive devices (e.g., walkers, crutches, and canes); to perform passive/active exercises; and to determine ways to prevent falls?