LATEST ISSUES, TRENDS IN THE CARE AND MANAGEMENT OF

MUSCULOSKELETAL SYSTEM

Instructions:

I – Research and choose one best topic on musculoskeletal system, this may include: (1) issues

on relevant ethical, moral standards in the care of a patient with musculoskeletal disorders, (2)

issues on complications and management, & (3) new trends in management and treatment of

musculoskeletal cases

II – Write a reflection on the trends or issues, and your responsibilities as a nurse

Musculoskeletal System: Issues on complications and management

I chose to use the article written by Santy-Tomlinson et al. titled “The Complications of

Musculoskeletal Conditions and Trauma”. It focuses on the patients on the possible reasons why

patients who underwent orthopaedic surgery experiences complications. In this article, it is said

that a patient having one or more complications following musculoskeletal care and procedures

commonly result to death, if not, it also lead to significant delays in recovery, patient distress and

discomfort. Some of the most common reasons for complications experienced by the patients

following orthopaedic and trauma surgery were mentioned in this article.

Infection is the first on the line. Orthopaedic and trauma patients are particularly

vulnerable infections such as soft tissue infection which is most often wound infection with

surgical site, bone infection (osteomyelitis) and joint infection (infective arthritis) is also

coomon, as well as urinary tract infection, and respiratory tract infection. Healthcare-associated

infection is the main cause of infection in orthopaedic and trauma patients. This is usually

acquired by the transfer of health care providered from one person or surface to another. The
prevention of orthopaedic infections is particularly important because of the potentially

devastating consequences of transfer of infection to bone and may result to osteomyelitis which

is difficult to eradicate and results in long term pain and distress. Shock is one of the

complications that can occur after surgery. It is a life-threatening condition that occurs when the

body is not getting enough blood flow. Lack of blood flow result to organs not getting enough

oxygen and nutrients to function properly. Orthopaedic patients are also often predisposed to be

at significant risk of developing a venous thromboembolism due to the nature of their disease

and condition. The inherent impaired physical mobility and activity intolerance that affects

orthopaedic patients gives rise to circulatory stasis. If they also have existing conditions of, or

have experienced trauma, to the circulatory system then they can be in real danger of developing

a venous thromboembolism.

Nurses have many tools available to create a safe environment for patients that among

others. To avoid the mentioned above, nurses have some responsibility toward the client to avoid

acquiring those. Some of the nurse’s responsibility to avoid infections includes the promotion of

hand hygiene, making use of aseptic techniques, having universal precautionary practices, and of

course educating the patient about the importance of cleaning and disinfection practices. Shock

such as hypovolemic shock can be prevented in some instances by closely monitoring patients

who is at risk for fluid deficit and assisting with fluid replacement before intravascular volume is

depleted. Nursing reponsibility includes administration of blood replacement with packed red

cells if there is blood loss to prevent hypoxia, safe administration of prescribed fluids and

medication and proper documentation, monitoring sign of complication & side effects, and

documentation of intake and output. For venous thromboembolism, the nurse should assist the

patient in positioning and exercise especially when the patient is on bed rest. The feet and lower
legs should be elevated periodically above the level of the heart and active and passive leg

exercises should be performed to increase blood flow.

Nurses are crucial in the recovery of the patient as well as the level of comfort they will

experience during recovery. Nurse’s and healthcare provider’s neglect on their responsibilities

toward the patient may lead to further complications or delay in the recovery of the patient. A

disorder in a one of the system in a person’s body can affect the other systems as well when it is

not well taken care of. When these complications worsen it could lead to death.