Question

21. What are some questions you can ask as a nurse when assessing the bone integrity? 22. How is joint function evaluated? 23. What is the difference between contracture an effusion? 24. How is the muscular system assessed? 25. What are some ways to assess the peripheral nerve function? 26. What is the difference between X-rays, CT scan, and MRI?

Answer 1

Ans) 21)

Suppose, the nurse is assessing the passive range of motion of a patient's shoulder. The patient complains of pain during circumduction when the nurse moves the arm behind the patient. The nurse should ask "Do you have difficulty in putting on a jacket?" As:

The patient's pain will make it more difficult to accomplish tasks like putting on a shirt or jacket. This pain should not impact the patient's ability to feed himself or herself or use the toilet because these tasks do not involve moving the arm behind the patient. The arm will not usually be positioned behind the patient during sleeping.

22) Joint function evaluation:

- Perform a musculoskeletal examination that includes assessing joint function. Joint function can be affected by injury or inflammation, so to look for redness, bruising, and how it compares with the opposite joint that may be uninjured. Are they the same size and shape?

The doctor will have the patient move the joint through its usual range of motion - flexing, extending, rotating. She will also manipulate the joint to move it. In both cases, she looks for restrictions on the range of motion and whether there is any pain during the movement. She places a hand on the joint to feel for crepitus(crackling) showing a degradation of the joint. She will perform some specific function tests for suspected injuries. She sees how well the patient can resist movement of the joint.

23) Difference between contracture and effusion:

Contracture: A condition of shortening and hardening of muscles, tendons, or other tissue, often leading to deformity and rigidity of joints.

A contracture deformity is the result of stiffness or constriction in the connective tissues of body. This can occur in your muscles, tendons, ligaments, and skin.

Effusion: An effusion is the accumulation of fluid within the joint space.

Effusions resulting from inflammatory arthritis (e.g. infection, gout, rheumatoid arthritis) are associated with other signs of inflammation, including: warmth, redness, pain with any movement.

24) Muscular system assessment:

- To assess the musculoskeletal system, inspect the patient, examining the symmetry of the joints, muscles, and bones and checking for swelling, redness, and ease of movement. Then palpate over the joints, noting any areas of warmth or tenderness.