Lecture Notes on Musculoskeletal Medications and Conditions

Introduction

• Focus on medications for the musculoskeletal system, diseases, and disorders.
• Key learning approach: Actively engage, think as a nurse caring for a patient.
• Importance of curiosity and building on prior knowledge.

Learning Objectives

• Understand various musculoskeletal conditions and their associated medications.
• Topics include soft tissue injuries, fractures, osteoarthritis, osteopenia, osteoporosis, osteomyelitis, and post-operative care.

Pain Management

Definitions

• Physiological Definition: Unpleasant sensory/emotional experience from tissue damage.
• Clinical Definition: Subjective experience; patient’s self-report is the most reliable indicator.

Types of Pain

• Acute Pain: Short duration, resolves with healing.
• Chronic Pain: Persists for months, can be intermittent or continuous.

Effects of Pain

• Endocrine: Increases/stress hormones (ACTH, cortisol, etc.), decreases insulin/testosterone.
• Metabolic: Gluconeogenesis, hyperglycemia, muscle protein catabolism.
• Cardiovascular: Increases heart rate, blood pressure, myocardial oxygen consumption.
• Respiratory: Reduces flow/volume; causes atelectasis, pneumonia.
• Gastrointestinal: Decreases motility.
• Musculoskeletal: Increases muscle spasms, causes fatigue/immobility.
• Cognitive & Immune: Reduces function, depresses immune response.
• Developmental: Affects behavior, increases stress disorders.
• Quality of Life: Causes anxiety, hopelessness.

Pain Assessment

• Use reliable tools: PQRST, ColdSpa, FACES for non-verbal patients.
• Empathy is crucial for effective nurse-patient relationships.

Pain Medications

• Over-the-counter: Acetaminophen, ibuprofen, aspirin for mild/moderate pain.
• Prescription: Tramadol, hydrocodone, morphine for severe pain.
• Comprehensive assessment is necessary before administration.

Immobility and Its Effects

Consequences

• DVT: Prevent with heparin, warfarin; use compression methods.
• Constipation: Treat with stool softeners, laxatives.
• Muscle Issues: Address with movement and exercises.
• Moisture: Use absorbent materials, keep skin dry.
• Psychosocial: Address anxiety with empathetic listening, resources.

Prevention and Treatment

• Utilize pharmacological and non-pharmacological methods to manage symptoms.
• Use positioning methods to prevent complications.

Inflammation

Signs and Treatment

• Local signs: Redness, heat, swelling.
• Systemic signs: Fever, muscle pain.
• Use PRICE for soft tissue injuries.
• Treatments vary by condition (e.g., NSAIDs for osteoarthritis).

Osteopenia and Osteoporosis

• Diagnosis: Bone mineral density deviations.
• Prevention: Calcium, Vitamin D intake, weight-bearing exercises.
• Medications: Bisphosphonates, denosumab.

Infections and Treatment

• Wound care: Monitor for infection; antibiotics specific to pathogens.
• Osteomyelitis: Long-term antibiotics, supportive care.

Post-Operative Care

• Concerns include atelectasis, pain management, and ensuring cardiac output.
• Use monitoring and interventions for effective recovery.

Conclusion

• Review and test understanding of content.
• Evaluate if learning objectives are met and address gaps in knowledge.