Nursing study guide
Musculoskeletal injuries + disorders
Assess function, protect tissue, preserve neurovascular status, and recognize limb-threatening change.
Nursing filter
Start with mechanism, pain, deformity, swelling, skin, movement, sensation, perfusion, mobility, and the patient’s baseline function.
Protect first
Support the injured area in the position found, limit unnecessary movement, and follow trauma and immobilization protocols.
Trend
Compare both sides and repeat neurovascular findings before and after splinting, casting, reduction, surgery, or a change in symptoms.
Assessment
Pain and neurovascular status tell the story
Document what the patient can feel and do—not only a numeric pain score.
| Check | Assess | Escalate for |
|---|---|---|
| Pain | Location, quality, timing, movement/passive-stretch effect, analgesic response | Rapid escalation, pain out of proportion, or new pain despite treatment |
| Perfusion | Color, temperature, capillary refill, swelling, pulses when appropriate | Coolness, pallor, delayed refill, worsening swelling, or diminished pulse |
| Nerve function | Sensation, tingling, numbness, and movement appropriate to the injury | New paresthesia, weakness, or paralysis |
| Skin + device | Wounds, drainage, pressure areas, cast/splint fit and edges | Open injury, pressure damage, drainage/odor, or a device that feels tighter |
Fractures
Immobilize, reassess, and prevent complications
An open fracture communicates with a wound and requires urgent contamination and tissue-injury management.
Immediate care
Control life threats first, cover an open wound with the ordered sterile approach, immobilize, and avoid pushing exposed bone back into tissue.
After stabilization
Trend pain and neurovascular status; monitor bleeding, skin, mobility, bowel function, thrombosis risk, and device complications.
Fat embolism concern
New respiratory distress, neurologic change, fever, tachycardia, or petechial rash after high-risk injury requires urgent escalation.
Teaching
Keep casts and dressings as directed, do not insert objects, report hot spots or tightness, and follow weight-bearing restrictions.
Limb emergency
Recognize acute compartment syndrome
A present pulse does not rule it out; absent pulses and paralysis are late findings.
Why it matters
Pressure within a closed muscle compartment can reduce blood flow and injure nerves and muscle.
Do not delay
Do not wait for every classic sign, and do not elevate a suspected limb well above the heart unless specifically directed.
Fasciotomy care
The emergency is treated, but surveillance continues
Open compartments require meticulous postoperative assessment.
Reassess
Trend pain, motor and sensory function, perfusion, swelling, and findings compared with the preoperative baseline.
Wound + bleeding
Monitor dressings or negative-pressure therapy, drainage, bleeding, exposed tissue protection, and infection indicators per orders.
Systemic risk
Monitor urine output, renal function, potassium, creatine kinase when ordered, fluid balance, and dysrhythmia risk after major muscle injury.
Recovery
Anticipate staged closure or grafting, mobility support, pain control, rehabilitation, and emotional support.
Soft-tissue injuries
Sprain, strain, and dislocation are not interchangeable
Preserve alignment and circulation while the injury is evaluated.
| Injury | Tissue | Nursing priorities |
|---|---|---|
| Sprain | Ligament | Protect, assess stability and neurovascular status, use prescribed compression/cold/elevation, and support gradual activity. |
| Strain | Muscle or tendon | Assess function and swelling, protect from reinjury, and follow the prescribed rehabilitation plan. |
| Dislocation | Joint surfaces displaced | Immobilize as found, perform neurovascular checks, and do not attempt reduction without an authorized clinician. |
Spine
Scoliosis affects posture, function, and sometimes breathing
Care depends on curve severity, growth, symptoms, and treatment plan.
Assess
Posture, shoulder or hip asymmetry, pain, activity, breathing, skin, body image, brace tolerance, and adherence barriers.
Brace care
Teach prescribed wear, skin inspection, clothing barriers, cleaning, and when pressure or neurologic symptoms need review.
After surgery
Use ordered spinal precautions, neurologic checks, pulmonary hygiene, pain control, bowel/bladder monitoring, mobility, and wound surveillance.
Bone + joint disorders
Match the disorder to the nursing priority
Pain is important, but safety, infection, fracture, and function may be more urgent.
| Disorder | Pattern | Nursing focus |
|---|---|---|
| Osteoporosis | Low bone strength and fragility fracture risk | Falls, calcium/vitamin D and medicines as ordered, weight-bearing activity when safe, and fracture teaching. |
| Osteomyelitis | Bone infection; may be acute or chronic | Cultures before antibiotics when ordered, antimicrobial completion, wound/device care, glucose/nutrition, and sepsis surveillance. |
| Osteoarthritis | Degenerative joint pain and stiffness | Function, activity pacing, weight support, heat/cold safety, analgesic risk, and assistive devices. |
| Rheumatoid arthritis | Systemic inflammatory autoimmune disease | Inflammation, fatigue, joint protection, infection risk from therapy, function, and specialist follow-up. |
Mobility + delegation
Safe movement is a clinical intervention
The RN assesses stability and response; delegated activity must match the patient and team member.
Before moving
Confirm orders, weight-bearing status, pain control, orthostasis, equipment, lines, footwear, and assistance needed.
Delegate safely
Routine ambulation or hygiene may be assigned to trained assistive personnel after RN assessment, with clear limits and findings to report.
RN retains
Initial and ongoing assessment, interpretation, unstable patients, teaching, care-plan changes, and evaluation of the response.
Sources
Reference notes
Use the current trauma, orthopedic, postoperative, and facility protocols.